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Trials ; 21(1): 133, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32014029


BACKGROUND: Doll therapy is a non-pharmacological intervention for people with dementia aimed to reduce distressing behaviours. Reliable results on the efficacy of Doll therapy for people with dementia are needed. The concept of attachment theorised by Bowlby has been proposed to explain the Doll therapy process, but it has not been proven to influence the response to doll presentation. METHODS/DESIGN: This single-blind, randomised controlled trial will involve people with dementia living in nursing homes of the Canton Ticino (Switzerland). Participants will be randomised to one of two interventions: Doll Therapy Intervention or Sham Intervention with a non-anthropomorphic object, using a 1:1 allocation ratio. The two interventions will consist of 30 daily sessions lasting an hour at most, led by a trained nurse for an hour at most. We will enrol 64 participants per group, according to power analysis using an estimated medium effect size (f = 0.25), an alpha level of 0.05, and a power of 0.8. The primary goal is to test the efficacy of the Doll Therapy Intervention versus the Sham Intervention as the net change in the following measures from baseline to 30 days (blinded outcomes): the Neuropsychiatric Inventory-Nursing Home administered by a trained psychologist blinded to group assignment, the professional caregivers' perceived stress scale of the Neuropsychiatric Inventory-Nursing Home, patients' physiological indices of stress (salivary cortisol, blood pressure and heart rate) and interactive behaviours. The secondary goal is to assess the relationship between attachment styles of people with dementia (detected by means of the Adult Attachment Interview to the patients' offspring) and their caregiving behaviours shown during the Doll Therapy Intervention. DISCUSSION: This is the first single-blind, randomised controlled trial on the efficacy of Doll therapy for dementia and an explanatory model of the response of people with dementia to doll presentation. TRIAL REGISTRATION:, ID: NCT03224143. Retrospectively registered on 21 July 2017.

Sci Total Environ ; 700: 134415, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31629265


Bioclimatic indices combine atmospheric parameters to provide analytical indication of climatic features and their evolution in space and time that can directly relate with natural resource availability, distribution, and related bio-physical processes. The availability of bioclimatic information can provide natural resource managers with analytical means to assess the magnitude and temporal evolution of drought and climate change parameters that could affect the availability, demand and use of natural resources for various sectors. This paper presents a methodology to process bioclimatic data in the space and time domains for assessing the moisture/dryness level and water requirements of a region, and inform water resource planning and management decisions related to drought, climate variability and change. The methodology relies on a modular assembly of statistical tests and methods, and utilizes point scale measurements of meteorological data to perform the analysis of the spatial behavior of derived bioclimatic indicators at the continuous regional scale, and evaluate the significance of the temporal trends. Also, the article presents an application of the proposed methodology to a coastal area of southern Italy (the Apulia Region) that is characterized by recurring water supply limitations, involving the use of the popular De Martonne bioclimatic aridity index. The methodology allowed to obtain qualitative and quantitative information about the aridity level of the Apulia region, the identification of main bioclimatic zones, and the evaluation of spatial pattern and time evolution of aridity. The determination of bioclimatic zones showed that nearly 40% of the regional territory is characterized by dry sub-humid (Mediterranean) climate, about 30% by sub-humid climate, while nearly 10% and 20% are characterized by semi-arid and humid climates, respectively. The temporal analysis revealed that the Salento and the Ionian coastal zone are areas at risk of increasing aridity, with resulting impacts on the water supply and demand for irrigated agriculture.

Monitoramento Ambiental , Mudança Climática , Secas , Ecossistema , Itália , Conceitos Meteorológicos , Estações do Ano , Abastecimento de Água
Maturitas ; 121: 35-40, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30704563


OBJECTIVE: Hearing loss is a common chronic condition in elderly people. The prevalence of disabling hearing loss among the elderly worldwide is 33% and in Italy ranges from 0.6% (profound hearing loss) to 39% (mild hearing loss). We investigated the relationship between self-reported hearing disability and clinician-evaluated hearing status, and its longitudinal consequences in relation to cognitive impairment and functional decline. We hypothesised that subjects who report that they have a hearing disability have a worse functional and cognitive profile than people who do not report having a hearing disability. METHODS: We analysed 1171 participants in the InveCe.Ab study, a longitudinal population-based study. We evaluated whether self-reported hearing disability was consistent with clinician-evaluated hearing status (using the Whispered Voice Test; WVT), categorizing this variable as: unaware of hearing loss (UHL), aware of hearing loss (AHL), only subjective hearing loss (OSHL), without hearing loss (noHL). We also examined its relationship with various population characteristics, and its long-term effects on functional and cognitive performance and depressive symptoms. RESULTS: At baseline, hearing loss was found in 13.6% (95% CI: 11.7-15.7) of the participants [17.6% (95% CI: 12.0-24.4) AHL; 82.4% (95% CI: 75.6-88) UHL], while 2.3% (95% CI: 1.4-3.4) of the subjects with normal WVT hearing status had OSHL. Male gender, age, functional and cognitive performance, and depressive symptoms were associated with consistency between self-reported hearing disability and WVT hearing status. Longitudinal analysis revealed worsening functional performance and selective attention, global cognitive deterioration, and depressive symptoms in the AHL group. CONCLUSIONS: Our results showed that awareness of hearing disability in the elderly has adverse cognitive and functional consequences over time. When clinicians inform those who are unaware of their hearing problems, they should arrange for prompt referral not only for audiometric evaluation but also for counselling in order to prevent a negative impact of awareness of hearing loss.

Cognição , Depressão , Perda Auditiva/diagnóstico , Perda Auditiva/psicologia , Autorrelato , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Itália , Masculino
Medchemcomm ; 9(5): 862-869, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30108975


P-glycoprotein (P-gp, MDR1) is a membrane transporter expressed in several regions of our body. It plays a crucial defense role as it mediates the efflux of hundreds of potentially toxic substances. However, P-gp is one of the main causes of failure in cancer chemotherapy, as a number of chemotherapeutic agents are P-gp substrates. Another interesting implication concerns the correlation between P-gp expression impairment and the onset of several central nervous system pathologies such as Alzheimer's and Parkinson's diseases. In view of these considerations, in the present study, a new series of P-gp modulators have been designed, synthesized and evaluated for their activity towards P-gp and two other sister proteins (BCRP and MRP1). The compounds, structurally correlated to the potent but non-selective P-gp inhibitor MC70 [4'-(6,7-dimethoxy-3,4-dihydro-1H-isoquinolin-2-ylmethyl)biphenyl-4-ol], proved fairly selective towards P-gp, with a potency in the micromolar range. Compounds 5a, 5d and 12d proved capable of restoring doxorubicin toxicity in resistant cancer cells.

Europace ; 9(1): 55-60, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17224424


AIMS: The aim of the present study was to assess the effects of exercise training on heart rate, QT interval, and on the relation between ventricular repolarization and heart rate in men and women. METHODS AND RESULTS: A 24 h Holter recording was obtained in 80 healthy subjects (40 males) who differed for the degree of physical activity. Trained individuals showed a lower heart rate and a higher heart rate variability than sedentary subjects, independent of the gender difference in basal heart rate. Mean 24 h QTc was similar in trained and non-trained men, while a significant difference was observed between trained and non-trained women. Exercise training reduced the QT/RR slope in both genders. This effect on the QT/RR relation was more marked in women; in fact, the gender difference in the ventricular repolarization duration at low heart rate observed in sedentary subjects was no longer present among trained individuals. CONCLUSION: The results of this study suggest that the cardiovascular response to exercise training may be different in men and women. Women may benefit more from interventions aimed to increase physical activity as a tool for prevention of cardiovascular morbidity and mortality.

Eletrocardiografia , Exercício/fisiologia , Frequência Cardíaca/fisiologia , Caracteres Sexuais , Feminino , Humanos , Masculino , Descanso/fisiologia , Função Ventricular