Milan sadek motivational speakers
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Try out PMC Labs and tell us what you think. Learn More. Also considering each single cognitive domain, UPSA-B performance both total and at subtests confirmed the association with neurocognitive performance. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF.
HIV is a chronic illness, frequently resulting in everyday functioning EF impairment. EF impairment may affect basic daily activities as cooking and housekeeping Heaton et al. The functional damage in everyday life is a notable public health concern, since it is associated to reduce ability to care for oneself and properly manage HIV disease Scott et al. EF impairments among PLWH may be due to a combination of several factors, and it is still not well understood because of its factorial nature.
Some predictors of EF impairment are lower cognitive reserve, neuropsychiatric complications, mood, inadequate motivation, substance abuse, and advanced HIV disease Blackstone et al. Among others, neurocognitive impairment is a strong and substantial predictor of EF deficits in HIV disease, mainly when involving executive functions, learning, attention, working memory, and linguistic abilities Heaton et al.
Indeed, on the basis of Frascati criteria classification, EF has a central role for the diagnostic differentiation between HAND subcategories Antinori et al. Usually, EF is measured by IADL scale Instrumental Activities of Daily Living, Lawton and Brody , but this tool has shown low sensitivity in patients with no overt dementia, and, as a self-reported questionnaire, it is sensitive to errors due to retrospective recall, cognitive deficits, state-dependent biases e.
Furthermore, self-reported attributions may be closely related to poor metacognition, often affected by HAND Casaletto et al. Considering these limitations, MND is likely underrated, and a misdiagnosis of asymptomatic HAND could result in delayed interventions, more rapid disease progression, imprecise clinical recommendations, and an increased risk of public health concerns Obermeit et al.
Previous studies have highlighted the importance to use an ecologic and multi-domain EF assessment, by adding a performance-based evaluation to the common self-report scales, in order to better differentiate asymptomatic versus symptomatic HAND Blackstone et al.
UPSA-B is the short version of a performance-based assessment used to measure functional capacity that expends 10 min and assesses financial and communication skills through 4 tasks: counting money and making change, paying bills, telephone use, and a medical appointment rescheduling task.
It was originally developed and validated in samples of individuals with serious mental illness, showing sensitivity in detecting psychiatric disorders and resulting associated with employment status, residential independence, daily living skills, and work skills Mausbach et al. However, literature still reports inconsistent results in PLWH.
Twenty-three age- and education-matched healthy control HC were also enrolled. Data on the following demographic, clinical, and laboratory variables were collected for each participant at the time of neuropsychological testing: sex, age, education, ethnicity, risk factors for HIV infection, time from HIV diagnosis, current and past antiretroviral regimen, current and nadir CD4 cell count, HIV-1 viral load, co-infection with hepatitis C virus HCV , comorbidities, and concomitant medications.
HC had no history or risk factors for neurologic impairment and were not taking any medication deemed to affect cognitive abilities. All subjects were volunteers. They did not receive any financial remuneration for participating. The study was approved by the institutional ethic committee and all participants provided written informed consent prior to enrollment. IADL questionnaire Instrumental Activities of Daily Living Lawton and Brody : a self-report measure that asks participants to answer questions relating to the level of assistance needed in managing finances, transportation, using the telephone, cooking, housekeeping and laundry, buying groceries, and responsibility for own medication.
In the financial skills module, participants were asked to count change, generate change from an item purchased at a store, and pay a utility bill. In the communication skills module, participants were asked to dial a telephone to contact emergency services, call information in order to obtain a telephone number, and call a doctor in order to reschedule an appointment.
PLWH underwent a standardized neuropsychological test battery SNB , exploring memory, attention, language, executive functions, and fine motor abilities. Cognitive areas were investigated as follows:. Global performance was measured by transforming raw scores at each task into standardized Z-scores using means and standard deviations of Italian normative data Capitani and Laiacona ; Carlesimo et al.
According to Frascati criteria Antinori et al. Each area ranges from 0 to mean 50, SD 10 , and higher scores correspond to better health status. Elevated negative perception of both mental and physical health was considered if patient scored at least 1 SD below the normative mean.
Zung Self-Rating Depression Scale Zung ; Zung : a short self-report questionnaire which survey four common characteristics of depression: the pervasive effect, the physiological equivalents, other disturbances, and psychomotor activities. Adherence to therapy questionnaire: a self-report judgment about accuracy in taking antiretroviral drugs on a 0— Visual Analogue Scale VAS Murri et al.
Descriptive statistics were calculated for quantitative variables [median, interquartile range IQR , mean, standard deviation SD ] and qualitative variables percent frequencies. A 2-tailed p value of less than 0. All analyses were performed using the SPSS version The total mean Z-score on SNB was 0. About the health-related quality of life SF , Exploring the UPSA-B subtests, mean communication score significantly differed between the two groups [mean At multivariate analysis, higher total cognitive Z-score was associated with better performance at UPSA-B total score after adjusting for education, smoking, and adherence.
For simplicity, only significant associations at multivariate analyses where reported. IADL has shown low sensitivity in patients with no overt dementia, partly related to the limitations of a self-reported questionnaire Heaton et al.
Our results differed from other previous studies. In our study, the two groups where matched for education but not for sex; however, we found no association between sex and UPSA-B performance at univariate regression analysis.
Similarly a lower performance at communication score was observed in another study, despite this observation showed only a trend towards statistically significance Moore et al. A wider difference in our study could be explained by older age and lower education of our population when compared with the aforementioned study or by sociocultural difference in the Italian population. Indeed, we found an independent association between the performance at UPSA-B total score and the global cognitive performance.
Moreover, higher performances at UPSA-B communication and financial subtests were independently associated to better global cognitive performance. Furthermore, all cognitive domains assessed in the current study memory, linguistic skills, attention values, executive functions, and motor abilities were associated with UPSA-B total and communication scores, while UPSA-B financial score turned out associated with attention values, executive functions, and motor abilities.
As suggested by Sheppard Sheppard et al. We acknowledge that our study has some limitations. First of all, this is a cross-sectional study and uncontrolled biases could occur in routine clinical practice. Secondly, we investigated EF in a predominately male sample. There may be sex differences in the associations examined, and larger sample studies are needed to analyze them.
Lastly our findings are applicable only to PLWH with a very good viroimmunological condition and with no neuroaids. All other authors declare that they have no conflict of interest. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. National Center for Biotechnology Information , U. Journal of Neurovirology. J Neurovirol. Published online Aug Author information Article notes Copyright and License information Disclaimer.
Nicoletta Ciccarelli, Email: ti. Corresponding author. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
Neuropsychological examination PLWH underwent a standardized neuropsychological test battery SNB , exploring memory, attention, language, executive functions, and fine motor abilities. Statistical analysis Descriptive statistics were calculated for quantitative variables [median, interquartile range IQR , mean, standard deviation SD ] and qualitative variables percent frequencies.
Open in a separate window. Table 2 Neuropsychological performances in each cognitive domain. Compliance with ethical standards The study was approved by the institutional ethic committee and all participants provided written informed consent prior to enrollment. Updates research nosology for HIV-associated neurocognitive disorders. Defining neurocognitive impairment in HIV: deficit scores versus clinical ratings. Clin Neuropsychol. Human immunodeficiency virus infection heightens concurrent risk of functional dependence in persons with long-term methamphetamine use.
J Addict Med. Composite neuropsychological batteries and demographic correction: standardization based on equivalent scores, with a review of published data.
The Italian Group for the Neuropsychological Study of ageing. J Clin Exp Neuropsychol. The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The Group for the Standardization of the mental deterioration battery.
Eur Neurol. Arch Clin Neuropsychol. Population disparities in mental health: insights from cultural neuroscience. Am J Public Health. Considerations on nosology for HIV-associated neurocognitive disorders: it is time to update?
Revised central nervous system neuropenetration-effectiveness score is associated with cognitive disorders in HIV-infected patients with controlled plasma viraemia.
Antivir Ther. Liver fibrosis is associated with cognitive impairment in people living with HIV. Antiretroviral neuropenetration scores better correlate with cognitive performance of HIV-infected patients after accounting for drug susceptibility. J Acquir Immune Defic Syndr. J Neuro-Oncol. HIV-associated central nervous system diseases in the recent combination antiretroviral therapy era. Eur J Neurol. Performance-based measures of everyday function in mild cognitive impairment.
Am J Psychiatry. Functional consequences of HIV-associated neuropsychological impairment.
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January - District 73 Toastmasters. With a change of decade Southern Cross sees a change of Editor. Michelle Monaghan is moving on to. We have lots to look forward to in this coming year and I hope that this edition will reflect on some of. Just ask anyone at Cannington I.
The journalists and colleagues we’ve lost to the coronavirus
His commitment to establish fair relationships between the automotive industry and international bodies, with a multi-stakeholder approach is also reflected by his commitment to the advisory board of the International Forum of OECD Transport Ministers from the beginning and to the Global Council of Automotive Industry of the World Economic Forum since its creation He holds several degrees in geography, urban planning, humanities. After studying at the University of Tokyo, Dr. Sakao worked at Mitsubishi Research Inst. Moreover, Prof.
BODYBUILDING 2017 Mr. Olympia | The Shapes Of Some Bodybuilders
Are you building a startup and want to share your story? Do you have tips for entrepreneurs, or insights to MENA industries? Submit your article with a photo and we'll get in touch with you. Meet the 22 pioneers and keynote speakers at the MENA's most promising entrepreneurial event. The time is ticking and the seventh edition of the RiseUp Summit is just around the block, where hundreds of emerging startups and industry leaders in major local and global ecosystems are gearing up to innovate. Taking place in the American University in Cairo - New Cairo Branch, the region's most game-changing entrepreneurial summit will explore its three main tracks, Capital, Tech, and Creative, with an exciting expansion to each - totaling up to seven tracks.
Ragab is also a selected entrepreneur with Endeavor Egypt. When Founder and Managing Director of Ayton Global Research, Susan Ayton, looked to expand into the Middle East, Andrew offered his time and knowledge to help the company become established in this region. Andrew will be introducing Susan Ayton. Ayton System Software won a British Government Research and Development Grant because of its ability to provide an homogenous global research platform in real-time and in any language.
The transgenic rat model of Huntington disease expressing a fragment of mutant HTT tgHD rat has been thoroughly characterized and reproduces hallmark symptoms of human adult-onset HD. Pursuing the optimization of this model for evaluation of translational therapeutic approaches, the F inbred rat strain was considered as advantageous genetic background for the expression of the HD transgenic construct. To assess the behavioral phenotype, classical assays investigating motor function, emotion, and sensorimotor gating were applied, along with automated screening of metabolic and activity parameters as well as operant conditioning tasks. The neuropathological phenotype was analyzed by immunohistochemistry and ex vivo magnetic resonance imaging. FtgHD rats displayed markedly reduced anxiety-like behavior in the social interaction test and elevated impulsivity traits already at 3 months of age.
Try out PMC Labs and tell us what you think. Learn More. Also considering each single cognitive domain, UPSA-B performance both total and at subtests confirmed the association with neurocognitive performance. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF. HIV is a chronic illness, frequently resulting in everyday functioning EF impairment. EF impairment may affect basic daily activities as cooking and housekeeping Heaton et al.
The Geneva process has been increasingly overshadowed by a separate track organised by regime allies Russia and Iran, and rebel backer Turkey. And on Sunday, a ceasefire brokered by the US, Russia and Jordan began in southern Syria, the latest agreement reached outside the Geneva framework. In principle, the new round of negotiations will focus on four so-called "baskets": a new constitution, governance, elections and combating "terrorism".
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