World Alzheimer report 2015: the global impact of dementia

Today, over 46 million people live with dementia worldwide, more than the population of Spain. This number is estimated to increase to 131.5 million by 2050. Dementia also has a huge economic impact. Today, the total estimated worldwide cost of dementia is US $818 billion, and it will become a trillion dollar disease by 2018. This means that if dementia care were a country, it would be the world’s 18th largest economy, more than the market values of companies such as Apple (US$ 742 billion), Google (US$368 billion) and Exxon (US$ 357 billion). In many parts of the world, there is a growing awareness of dementia, but across the globe it remains the case that a diagnosis of dementia can bring with it stigma and social isolation. Today, we estimate that 94% of people living with dementia in low and middle income countries are cared for at home. These are regions where health and care systems often provide limited or no support to people living with dementia or to their families. The 2015 World Alzheimer Report updates data on the prevalence, incidence, cost and trends of dementia worldwide. It also estimates how these numbers will increase in the future, leaving us with no doubt that dementia, including Alzheimer’s disease and other causes, is one of the biggest global public health and social care challenges facing people today and in the future. Authors Prof Martin Prince The Global Observatory for Ageing and Dementia Care, King’s College London, UK Prof Anders Wimo Department of Neurobiology, Care sciences and Society, Karolinska Institute, Stockholm, Sweden Dr Maëlenn Guerchet The Global Observatory for Ageing and Dementia Care, King’s College London, UK Miss Gemma-Claire Ali The Global Observatory for Ageing and Dementia Care, King’s College London, UK Dr Yu-Tzu Wu Cambridge Institute of Public Health, University of Cambridge, UK Dr Matthew Prina The Global Observatory for Ageing and Dementia Care, King’s College London, UK Alzheimer\u27s Disease Internationa

Helping carers to care: the 10/66 dementia research group's randomized control trial of a caregiver intervention in Peru

OBJECTIVE There is a need, in the absence of formal services, to design interventions aimed at improving the lives of people with dementia and their families. This study tested the effectiveness of the 10/66 caregiver intervention among people with dementia and their caregivers in Lima, Peru. METHOD Design/participants: a randomized controlled trial was performed involving 58 caregivers of people with dementia that received the intervention in the beginning of the trial (n = 29) or six months later (n = 29). The intervention consisted of three modules: 1) assessment (one session); 2) basic education about dementia (two sessions); and 3) training regarding specific problem behaviors (two sessions). Main outcome measures: Caregivers and patients with dementia were assessed at baseline and after six months. For caregivers, the measures included strain (Zarit Burden Interview), psychological distress (SRQ-20), and quality of life (WHOQOL-BREF). Dementia patients completed scales assessing behavioral and psychological symptoms (NPI-Q) and quality of life (DEMQOL). RESULTS Caregivers in the intervention group reported significantly decreased strain measures six months after the intervention compared to controls. No group differences were found in respect to the caregivers' psychological distress and to quality of life in both caregivers and patients. CONCLUSION The 10/66 intervention seems to be as effective as similar interventions used in more developed countries

A BIOMECHANICAL AND KINESIOLOGICAL APPROACH IN THE TEACHING OF EFFICIENT SURGICAL SKILLS TO MEDICAL STUDENTS

A competency-based surgery residents teaching and training program including a biomechanical and kinesiological approach was developed in order to improve procedural learning and mastery of invasive skills. Principles of biomechanics and kinesiology have been taught and applied to many aspects of surgical tasks, including instrument holding and manipulation, body positioning and posture, segments alignment. Results demonstrate more precise movements and more efficient performance of surgical tasks in residents participating in the program

Institutional ageism in global health policy

The sustainable development goals agreed in March 2016 by the United Nations General Assembly set the global development agenda for the next 15 years. They include an ambitious target to reduce premature mortality from non-communicable diseases by a third by 2030. Premature mortality, defined by the World Health Organization as deaths occurring between the ages of 15 and 70, has gained broad acceptance in health research and policy over the past decade. We argue that it is explicitly ageist, reflecting institutional ageism in global health policy. Its inclusion in the sustainable development goals sends a strong signal in favour of discriminating against older people in the allocation of health resources and the collection of data. We consider the emergence of ageist approaches in global health policy and the potential effects of ageism in the sustainable development goals. We propose a less discriminatory approach

Imaging for Diagnosis and Monitoring of Cardiac Sarcoidosis

Sarcoidosis is a granulomatous condition, primarily affecting the lungs and thoracic lymph nodes. Clinical cardiac involvement might occur in 2 to 5% of patients with sarcoidosis, and can be associated with serious complications including heart block, cardiomyopathy, ventricular arrhythmias, and potentially death. Timely diagnosis helps initiate treatment before cardiac damage becomes irreversible. In this brief review, we discuss imaging updates for diagnosis and monitoring of cardiac sarcoidosis

World Alzheimer report 2016: improving healthcare for people living with dementia: coverage, quality and costs now and in the future

The World Alzheimer Report 2016, Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future, reviews research evidence on the elements of healthcare for people with dementia, and, using economic modelling, suggests how it should be improved and made more efficient. The report argues that current dementia healthcare services are over-specialised, and that a rebalancing is required with a more prominent role for primary and community care. This would increase capacity, limit the increased costs associated with scaling up coverage of care, and, coupled with the introduction of care pathways and case management, improve the coordination and integration of care. Modelling of the costs of care pathways was carried out in Canada, China, Indonesia, Mexico, South Africa, South Korea and Switzerland, to estimate the costs of dementia healthcare under different assumptions regarding delivery systems. The report was researched and authored by Prof Martin Prince, Ms Adelina Comas-Herrera, Prof Martin Knapp, Dr Maëlenn Guerchet and Ms Maria Karagiannidou from The Global Observatory for Ageing and Dementia Care, King’s College London and the Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science

BIOMECHANICAL OPTIMIZATION OF SURGICAL SKILLS: INFLUENCE OF HEIGHT ADJUSTMENT OF SURGICAL TABLE ON MOVEMENTS ACCURACY AND MUSCULAR FATIGUE

The purpose of this study was to investigate the influence of the height of the surgical table on movements accuracy and muscular fatigue, as well as on alignment of mechanical axes at the wrist and at the shoulder level. A "standard" table height was compared with an "ergonomic" height which was set 10% lower. Nine (9) first year residents in surgery performed a surgical procedure and were evaluated on movements accuracy and shoulder muscular fatigue. Results obtained with the table set at "ergonomic" height demonstrated higher accuracy (p < 0.01) and less shoulder fatigue (p < 0.01), as well as smaller deviations from neutral position both at the shoulder level (p < 0.01) and at the wrist level (