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advance directive disabled people

Michela Barichella, Giovanna Pinelli, Laura Iorio, Erica Cassani, Angela Valentino, Chiara Pusani, Valentina Ferri, Carlotta Bolliri, Marianna Pasqua, Gianni Pezzoli, Giuseppe Frazzitta, Emanuele Cereda
OBJECTIVES: To estimate prevalence of sarcopenia and dynapenia in outpatients with Parkinson disease (PD) and to investigate their association with the features of the disease. DESIGN: Cross-sectional study. SETTING: A specialized tertiary care center. PARTICIPANTS: Consecutive patients (n = 364) aged 65 years or older, affected by parkinsonian syndromes. MEASUREMENTS: Skeletal muscle mass (SMM), as well as strength and gait speed (GS) were assessed by bioimpedence analysis, handgrip dynamometry, and the 4-meter walking test, respectively...
July 1, 2016: Journal of the American Medical Directors Association
Valerie A J Block, Erica Pitsch, Peggy Tahir, Bruce A C Cree, Diane D Allen, Jeffrey M Gelfand
OBJECTIVE: To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. METHODS: Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded...
2016: PloS One
Hayley Barnes, Julie McDonald, Natasha Smallwood, Renée Manser
BACKGROUND: Breathlessness is a common and disabling symptom which affects many people with advanced cardiorespiratory disease and cancer. The most effective treatments are aimed at treating the underlying disease. However, this may not always be possible, and symptomatic treatment is often required in addition to maximal disease-directed therapy. Opioids are increasingly being used to treat breathlessness, although their mechanism of action is still not completely known. A few good sized, high quality trials have been conducted in this area...
March 31, 2016: Cochrane Database of Systematic Reviews
Luis Salvador-Carulla, Steve Symonds
PURPOSE OF REVIEW: We summarize the research published between 2011 and 2015 in healthcare utilization and costs for persons with intellectual disabilities/intellectual developmental disorders with a particular focus on context studies for evidence-informed policy. RECENT FINDINGS: Persons with intellectual disability show higher unmet needs and lower use of promotion and prevention services and generic health services. Use of generic psychiatric services varies across countries...
March 2016: Current Opinion in Psychiatry
Aline De Vleminck, Koen Pardon, Dirk Houttekier, Lieve Van den Block, Robert Vander Stichele, Luc Deliens
BACKGROUND: To determine the extent to which members of the general population have talked to their physician about their wishes regarding medical treatment at the end of life, to describe the prevalence of advance directives on euthanasia, and to identify associated factors. METHOD: This study used data from the cross-sectional Health Interview Study (HIS) 2008 that collected data from a representative sample (N = 9651) of the Belgian population. RESULTS: Of all respondents, 4...
2015: BMC Palliative Care
Beata Jarosiewicz, Anish A Sarma, Daniel Bacher, Nicolas Y Masse, John D Simeral, Brittany Sorice, Erin M Oakley, Christine Blabe, Chethan Pandarinath, Vikash Gilja, Sydney S Cash, Emad N Eskandar, Gerhard Friehs, Jaimie M Henderson, Krishna V Shenoy, John P Donoghue, Leigh R Hochberg
Brain-computer interfaces (BCIs) promise to restore independence for people with severe motor disabilities by translating decoded neural activity directly into the control of a computer. However, recorded neural signals are not stationary (that is, can change over time), degrading the quality of decoding. Requiring users to pause what they are doing whenever signals change to perform decoder recalibration routines is time-consuming and impractical for everyday use of BCIs. We demonstrate that signal nonstationarity in an intracortical BCI can be mitigated automatically in software, enabling long periods (hours to days) of self-paced point-and-click typing by people with tetraplegia, without degradation in neural control...
November 11, 2015: Science Translational Medicine
N Ng, M Sandberg, G Ahlström
BACKGROUND: The expected increase in longevity of individuals with intellectual disabilities (ID) in many countries of the world is a direct result of medical and social advances, which have also extended the longevity of the general population. It is important to assess the need for social services for people with ID across different administrative levels to ensure sufficient resources are allocated to where they are most needed. This study estimates the annual prevalence of older people with ID from 2004 to 2012 and in different counties and municipalities in Sweden, by sex and age group; identifies proxy indicators related to the care of older people with ID in different counties in 2012 in Sweden and analyses the spatial distribution and clustering of municipalities with a high prevalence of older people with ID...
December 2015: Journal of Intellectual Disability Research: JIDR
Richard P Menger, Christopher M Storey, Bharat Guthikonda, Symeon Missios, Anil Nanda, John M Cooper
World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson...
July 2015: Neurosurgical Focus
David R Beukelman, Karen Hux, Aimee Dietz, Miechelle McKelvey, Kristy Weissling
Research about the effectiveness of communicative supports and advances in photographic technology has prompted changes in the way speech-language pathologists design and implement interventions for people with aphasia. The purpose of this paper is to describe the use of photographic images as a basis for developing communication supports for people with chronic aphasia secondary to sudden-onset events due to cerebrovascular accidents (strokes). Topics include the evolution of AAC-based supports as they relate to people with aphasia, the development and key features of visual scene displays (VSDs), and future directions concerning the incorporation of photographs into communication supports for people with chronic and severe aphasia...
2015: Augmentative and Alternative Communication: AAC
Parisa Taheri Tanjani, Mohammad Esmaeil Motlagh, Mehdi Moradi Nazar, Farid Najafi
BACKGROUND: With advancing age comes dramatic increase in the incidence of chronic diseases, disabilities, and mental problems. This study was conducted to epidemiologically describe the health status of the elderly population of Iran. MATERIAL AND METHODS: People aged ≥60 were selected. Mini-nutritional assessment, activity of daily living, geriatric depression scale questionnaires were administered. Physical diseases and risk factors were also investigated. For the purpose of this study, 1350 elderly individuals were randomly selected...
March 2015: Archives of Gerontology and Geriatrics
Rubén Nieto
Chronic pain is common and strongly impacts the individual and society as a whole. Although there are effective multidisciplinary treatments available, they are often not easily accessible and designed for people with severe long-lasting problems. The main aim of this paper is to propose and stimulate debate about how the internet can help to increase accessibility and promote a shift toward secondary prevention. Specifically, internet can help by providing access to educational websites containing information for professionals and the general population...
July 2014: Pain Management
Andrew Solomon
The progress of lesbian, gay, bisexual, transsexual, and queer rights entails the erosion of prejudice, and erosion is a slow process. Much press accrues to the dramatic advancement of gay marriage, but that progress reflects decades of committed activism that antedate the sea change. Social science, physical science, politics, philosophy, religion, and innumerable other fields have bearing on the emergence of healthy LGBTQ identities. The field of bioethics is implicated both in revolutionizing attitudes and in determining how best to utilize such ameliorated positions...
September 2014: Hastings Center Report
Richard Schulz, Hans-Werner Wahl, Judith T Matthews, Annette De Vito Dabbs, Scott R Beach, Sara J Czaja
Interest in technology for older adults is driven by multiple converging trends: the rapid pace of technological development; the unprecedented growth of the aging population in the United States and worldwide; the increase in the number and survival of persons with disability; the growing and unsustainable costs of caring for the elderly people; and the increasing interest on the part of business, industry, and government agencies in addressing health care needs with technology. These trends have contributed to the strong conviction that technology can play an important role in enhancing quality of life and independence of older individuals with high levels of efficiency, potentially reducing individual and societal costs of caring for the elderly people...
October 2015: Gerontologist
Kent Buse, Patrick Eba, Jason Sigurdson, Kate Thomson, Susan Timberlake
Although AIDS remains a leading cause of death, especially in low- and middle-income countries, the movement to address it has greatly contributed to changing the world's response to health challenges. By fusing activism, political leadership, domestic and international investment, and accountability for results, the course of the epidemic has been radically shifted. People living with HIV and others directly affected by the epidemic have exerted immense leadership since the first days of the response: they have fought to end discrimination on the basis of sero-status, gender, sexual orientation, disability, migration status, drug use, or participation in sex work...
2013: Health and Human Rights
Antonella Mandas, Sandra Dessì
According to the World Health Organization statistics, dementias are the largest contributors to disease burden in advanced market economies, and the leading cause of disability and dependence among older people worldwide. So far, several techniques have been developed to identify dementias with reasonable accuracy while the patient is still alive, however, no single of them has proven to be ideal, especially if you need to have a satisfactory early diagnosis. Studies of early onset dementia are largely limited by the inaccessibility to direct examination of the living human brain: it appears therefore that for a correct biochemical and molecular characterization of dementias, potential surrogate tissues must be identified...
April 20, 2014: Clinica Chimica Acta; International Journal of Clinical Chemistry
María Luisa Arcos
The U.N. Convention on the Rights of Persons with Disabilities recognizes as the first of its general principles the "Respect for inherent dignity, individual autonomy including the freedom to make one's own choice, and independence of persons" (Art.3.a). With regard to health, States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without being discriminated on the basis of disability (Article 25), which includes requiring health professionals to provide care of the same quality to persons with disabilities as to others, including on the basis of free and informed consent (subsection d)...
December 2013: Medicine and Law
Derek Nord, Richard Luecking, David Mank, William Kiernan, Christina Wray
Employment, career advancement, and financial independence are highly valued in the United States. As expectations, they are often instilled at a young age and incentivized throughout adulthood. Despite their importance, employment and economic sufficiency continue to be out of reach for most people with intellectual and developmental disabilities (IDD). Over the last quarter century, extensive research and effort has been committed to understanding and improving these phenomena. This paper summarizes this employment research base by reviewing the literature on the effectiveness of the current employment support system, employment-specific interventions, and the economics and cost benefits of employment for people with IDD...
October 2013: Intellectual and Developmental Disabilities
Allison Hall, Jennifer Bose, Jean Winsor, Alberto Migliore
BACKGROUND: Although United States employment policies have increased support for people with disabilities working in community settings, the unemployment rate for this population remains very high, particularly for people with intellectual or developmental disabilities. Research shows that job developers (direct support professionals who assist people with disabilities to secure, maintain, and advance in employment) are critical to achieving quality employment outcomes. However, the extent to which job developers use practices that are considered promising in their field (such as engaging families) is not well known...
September 2014: Journal of Applied Research in Intellectual Disabilities: JARID
Nicolien M van der Kolk, Laurie A King
Parkinson's disease is a prevalent neurodegenerative disorder for which only symptomatic treatment exists. Gait and balance disturbance is common in Parkinson's disease and is a major contributor to increased disability and decreased health-related quality of life and survival. Balance and gait deficits in Parkinson's disease are notoriously difficult to treat and are not significantly helped by pharmacological or surgical treatment. The last two decades have seen a dramatic increase in the research and clinical interest in using exercise as a treatment for mobility problems in people with Parkinson's disease...
September 15, 2013: Movement Disorders: Official Journal of the Movement Disorder Society
M Daher
Cancer incidence will increase as the population ages; there will be a 50% increase in new cancer cases over the next 20 years, and the biggest rates of increase will occur in the developing world. Owing to technical advances in the care of critical illness, as it is the case in elderly people with advanced cancer, physicians, patients and families are often confronted with ambiguous circumstances in which medical advances may inadvertently prolong suffering and the dying process rather than bring healing and recovery...
October 2013: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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