Social Representation of Dementia : An Analysis of 5,792 Consecutive Cases Evaluated in a Memory Clinic

Background: Different interpretations of cognitive impairment and dementia due to differences in health structures, such as cultural differences could affect the diagnosis and treatment of the condition. it is reasonable to expect that the social and family impact of the disease and coping strategies will differ among societies. Objective: The general aim of this study is to understand the social representations of dementia, its associated practices, and the effects they imply. Methods: People diagnosed with clinical dementia and their families were assessed from 2005 to 2015 in the memory clinic of the Fundació ACE, Institut Català de Neurociències Aplicades in Barcelona, Spain. Results: 9,898 people were examined and 5,792 were diagnosed with dementia. For those with a caregiver (71%), the decision-making fell on the person with dementia in 16.2% of the cases; and for those without a caregiver, in 26.4% of the cases the family did not perceive the deficits as a disease, which led to multiple risk situations (74.6%). Conclusions: The recognition of dementia as part of aging is common among families. Consequently, risk situations may arise and diagnosis and access to treatment may be delayed. The incorporation of a social appraisal to the diagnostic process is a necessity to evaluate these situations

COVID Isolation Eating Scale (CIES): Analysis of the impact of confinement in eating disorders and obesity-A collaborative international study

Confinement during the COVID-19 pandemic is expected to have a serious and complex impact on the mental health of patients with an eating disorder (ED) and of patients with obesity. The present manuscript has the following aims: (1) to analyse the psychometric properties of the COVID Isolation Eating Scale (CIES), (2) to explore changes that occurred due to confinement in eating symptomatology; and (3) to explore the general acceptation of the use of telemedicine during confinement. The sample comprised 121 participants (87 ED patients and 34 patients with obesity) recruited from six different centres. Confirmatory Factor Analyses (CFA) tested the rational-theoretical structure of the CIES. Adequate goodness-of-fit was obtained for the confirmatory factor analysis, and Cronbach alpha values ranged from good to excellent. Regarding the effects of confinement, positive and negative impacts of the confinement depends of the eating disorder subtype. Patients with anorexia nervosa (AN) and with obesity endorsed a positive response to treatment during confinement, no significant changes were found in bulimia nervosa (BN) patients, whereas Other Specified Feeding or Eating Disorder (OSFED) patients endorsed an increase in eating symptomatology and in psychopathology. Furthermore, AN patients expressed the greatest dissatisfaction and accommodation difficulty with remote therapy when compared with the previously provided face-to-face therapy. The present study provides empirical evidence on the psychometric robustness of the CIES tool and shows that a negative confinement impact was associated with ED subtype, whereas OSFED patients showed the highest impairment in eating symptomatology and in psychopathology.This manuscript and research was supported by grants from the Ministeriode Economía y Competitividad (PSI2015-68701-R), Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290/ INT19/00046nd PI17/01167) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERobn, CIBERsam and CIBERDEM are all initiatives of ISCIII. GMB is supported by a postdoctoral grant from FUNCIVA. This initiative is supported by Generalitat de Catalunya. LM is supported by a postdoctoral grant of the mexican institution Consejo Nacional de Ciencia y Tecnología (CONACYT). PPM was supported, in part, by a Portuguese Foundation for Science and Technology grant (POCI-01-0145-FEDER-028145). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study

Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients

Funciones cognitivas y revascularización carotídea mediante stent por vía transcervical con flujo reverso

Como se ha comprobado, algunas de las investigaciones realizadas en los últimos años consideran la enfermedad ateriosclerótica carotídea como factor independiente asociado a la disfunción cognitiva, considerándose dicha alteración ya presente en estadios sub-clínicos. Varias líneas de investigación ponen de manifiesto la relación existente entre la enfermedad aterosclerótica carotídea, atrofia cerebral y el deterioro cognitivo de tipo vascular, lo que sugiere que puede existir sintomatología mucho más allá de los déficits clínicamente reconocidos (alteraciones visuales, sensoriales, motoras o en el habla). De esta manera se pone de manifiesto el carácter no tan silente de la enfermedad ateriosclerótica carotídea. Hay dos mecanismos que influyen de manera directa: microembolias y los cambios del flujo sanguíneo y que pueden explicar los cambios observados a nivel cognitivo. La intervención o tratamiento de la enfermedad arterioesclerótica carotídea está orientada en primera instancia como tratamiento preventivo de un posible ictus. Sabemos que la endarterectomía carotídea en pacientes con estenosis severa reduce la probabilidad de sufrir un ictus. Por otra parte se ha documentado cómo en este tipo de técnica existe también una afluencia de émbolos a lo largo de la intervención produciendo así lesiones isquémicas silentes. Dado que el stent carotídeo por vía transcervical con inversión de flujo no implica el arco aórtico y la lesión carotídea se atraviesa con la protección cerebral ya establecida, el número de embolias es muy inferior, por lo tanto, la afectación de las funciones cognitivas debería ser nula y puesto que se reestablece el flujo normal en la arteria carótida podría incluso observarse una mejoría en el rendimiento cognitivo. A pesar de ello, no disponemos de estudios suficientemente consistentes indicando cambios cognitivos después del tratamiento quirúrgico carotídeo de aquellos pacientes afectados de esta patología sin haber experimentado previamente un ictus; tampoco contamos con estudios en los que se ponga en evidencia el carácter profiláctico de los tratamientos de revascularización con el objetivo de prevenir un posible deterioro cognitivo en pacientes asintomáticos. Dado el carácter catastrófico y las implicaciones que conlleva el deterioro cognitivo no solo para los individuos que lo padecen sino en general para la sociedad, la identificación y tratamiento de este tipo de condición como es la ateriosclerosis carotídea tendría que ser tomada en cuenta. Es por ello que esta tesis propone analizar las repercusiones cognitivas del stent con flujo invertido transcervical en población con estenosis carotídea superior al 70 % sintomática y asintomática.Several studies have provided evidence of a close link between atherosclerotic carotid disease, cerebral atrophy and cognitive impairment. Some reports indicate that the symptoms of carotid atherosclerosis are broader than the clinically recognized manifestations of visual, sensory, motor, and language abnormalities associated with transient ischemic attacks and established stroke. Thus becomes clear the association between carotid stenosis and cognition. There are two mechanisms that influence directly: microbleeds and changes in blood flow and may explain the observed cognitive changes. The carotid artery disease treatment is oriented primarily as a possible stroke preventive treatment. We know that carotid endarterectomy in patients with severe carotid stenosis reduces the likelihood of having a stroke. Moreover it has been documented how in this type of technique there is also a high incidence of microbleeds despite the use of distal protection devices producing silent ischemic injury. Transcervical carotid artery stenting with flow reversal does not involve the aortic arch and provide protection against cerebral embolization therefore the effect on cognitive functions should be lower or even be observed an improvement in cognitive performance. However, we do not have sufficiently consistent studies indicating cognitive changes after surgical treatment in patients with these conditions without previous stroke events. Nor have studies bringing out the prophylactic character of carotid revascularization treatments in order to prevent a possible cognitive impairment in asymptomatic patients. Given the catastrophic nature and implications of cognitive impairment not only for individuals who suffer it but for society in general, identification and treatment of conditions such as carotid atherosclerosis should be taken into account. That is why this thesis aims to analyze the cognitive impact of stent with transcervical reversed flow in population with carotid artery stenosis over 70% symptomatic and asymptomatic

Funciones cognitivas y revascularización carotídea mediante stent por vía transcervical con flujo reverso

Como se ha comprobado, algunas de las investigaciones realizadas en los últimos años consideran la enfermedad ateriosclerótica carotídea como factor independiente asociado a la disfunción cognitiva, considerándose dicha alteración ya presente en estadios sub-clínicos. Varias líneas de investigación ponen de manifiesto la relación existente entre la enfermedad aterosclerótica carotídea, atrofia cerebral y el deterioro cognitivo de tipo vascular, lo que sugiere que puede existir sintomatología mucho más allá de los déficits clínicamente reconocidos (alteraciones visuales, sensoriales, motoras o en el habla). De esta manera se pone de manifiesto el carácter no tan silente de la enfermedad ateriosclerótica carotídea. Hay dos mecanismos que influyen de manera directa: microembolias y los cambios del flujo sanguíneo y que pueden explicar los cambios observados a nivel cognitivo. La intervención o tratamiento de la enfermedad arterioesclerótica carotídea está orientada en primera instancia como tratamiento preventivo de un posible ictus. Sabemos que la endarterectomía carotídea en pacientes con estenosis severa reduce la probabilidad de sufrir un ictus. Por otra parte se ha documentado cómo en este tipo de técnica existe también una afluencia de émbolos a lo largo de la intervención produciendo así lesiones isquémicas silentes. Dado que el stent carotídeo por vía transcervical con inversión de flujo no implica el arco aórtico y la lesión carotídea se atraviesa con la protección cerebral ya establecida, el número de embolias es muy inferior, por lo tanto, la afectación de las funciones cognitivas debería ser nula y puesto que se reestablece el flujo normal en la arteria carótida podría incluso observarse una mejoría en el rendimiento cognitivo. A pesar de ello, no disponemos de estudios suficientemente consistentes indicando cambios cognitivos después del tratamiento quirúrgico carotídeo de aquellos pacientes afectados de esta patología sin haber experimentado previamente un ictus; tampoco contamos con estudios en los que se ponga en evidencia el carácter profiláctico de los tratamientos de revascularización con el objetivo de prevenir un posible deterioro cognitivo en pacientes asintomáticos. Dado el carácter catastrófico y las implicaciones que conlleva el deterioro cognitivo no solo para los individuos que lo padecen sino en general para la sociedad, la identificación y tratamiento de este tipo de condición como es la ateriosclerosis carotídea tendría que ser tomada en cuenta. Es por ello que esta tesis propone analizar las repercusiones cognitivas del stent con flujo invertido transcervical en población con estenosis carotídea superior al 70 % sintomática y asintomática.Several studies have provided evidence of a close link between atherosclerotic carotid disease, cerebral atrophy and cognitive impairment. Some reports indicate that the symptoms of carotid atherosclerosis are broader than the clinically recognized manifestations of visual, sensory, motor, and language abnormalities associated with transient ischemic attacks and established stroke. Thus becomes clear the association between carotid stenosis and cognition. There are two mechanisms that influence directly: microbleeds and changes in blood flow and may explain the observed cognitive changes. The carotid artery disease treatment is oriented primarily as a possible stroke preventive treatment. We know that carotid endarterectomy in patients with severe carotid stenosis reduces the likelihood of having a stroke. Moreover it has been documented how in this type of technique there is also a high incidence of microbleeds despite the use of distal protection devices producing silent ischemic injury. Transcervical carotid artery stenting with flow reversal does not involve the aortic arch and provide protection against cerebral embolization therefore the effect on cognitive functions should be lower or even be observed an improvement in cognitive performance. However, we do not have sufficiently consistent studies indicating cognitive changes after surgical treatment in patients with these conditions without previous stroke events. Nor have studies bringing out the prophylactic character of carotid revascularization treatments in order to prevent a possible cognitive impairment in asymptomatic patients. Given the catastrophic nature and implications of cognitive impairment not only for individuals who suffer it but for society in general, identification and treatment of conditions such as carotid atherosclerosis should be taken into account. That is why this thesis aims to analyze the cognitive impact of stent with transcervical reversed flow in population with carotid artery stenosis over 70% symptomatic and asymptomatic

Social Representation of Dementia : An Analysis of 5,792 Consecutive Cases Evaluated in a Memory Clinic

Background: Different interpretations of cognitive impairment and dementia due to differences in health structures, such as cultural differences could affect the diagnosis and treatment of the condition. it is reasonable to expect that the social and family impact of the disease and coping strategies will differ among societies. Objective: The general aim of this study is to understand the social representations of dementia, its associated practices, and the effects they imply. Methods: People diagnosed with clinical dementia and their families were assessed from 2005 to 2015 in the memory clinic of the Fundació ACE, Institut Català de Neurociències Aplicades in Barcelona, Spain. Results: 9,898 people were examined and 5,792 were diagnosed with dementia. For those with a caregiver (71%), the decision-making fell on the person with dementia in 16.2% of the cases; and for those without a caregiver, in 26.4% of the cases the family did not perceive the deficits as a disease, which led to multiple risk situations (74.6%). Conclusions: The recognition of dementia as part of aging is common among families. Consequently, risk situations may arise and diagnosis and access to treatment may be delayed. The incorporation of a social appraisal to the diagnostic process is a necessity to evaluate these situations

Search for narrow resonances using the dijet mass spectrum in pp collisions at s√=8 TeV

Results are presented of a search for the production of new particles decaying to pairs of partons (quarks, antiquarks, or gluons), in the dijet mass spectrum in proton-proton collisions at s√=8  TeV. The data sample corresponds to an integrated luminosity of 4.0  fb−1, collected with the CMS detector at the LHC in 2012. No significant evidence for narrow resonance production is observed. Upper limits are set at the 95% confidence level on the production cross section of hypothetical new particles decaying to quark-quark, quark-gluon, or gluon-gluon final states. These limits are then translated into lower limits on the masses of new resonances in specific scenarios of physics beyond the standard model. The limits reach up to 4.8 TeV, depending on the model, and extend previous exclusions from similar searches performed at lower collision energies. For the first time mass limits are set for the Randall–Sundrum graviton model in the dijet channel

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study.

The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients