Magister Curationis - MCur / Worldwide concerns have been raised about the presence and association of depressive symptoms, cognitive impairment, and dementia in older adults (60 years and older), which are often unrecognised and untreated in long-term care facilities (LTCF’s). The progression of cognitive impairment to dementia reduces quality of life with negative consequences of physical, mental, and psychosocial health. In many LTCF’s internationally, the standardised interRAI system is used to capture depressive symptoms and cognitive impairment. However, there is a fragmentation of systems for making evidence-based decisions to plan and manage care for residents with depressive symptoms, cognitive impairment, and dementia. This study, being the first of its kind in South Africa, addressed this gap, by describing a profile of depressive symptoms and cognitive impairment in residents, and analysing their coexistence, using the interRAI-LTCF in a LTCF in the Cape Metropole in South Africa. A quantitative, descriptive, and analytical cross-sectional secondary data analysis was conducted using the records of all 173 resident’s medical records of residents with a last interRAI-LTCF assessment from 2014 and 2016. The objectives were to determine the levels of depressive symptoms and cognitive impairment, and to assess variously associated demographics and clinical variables between depressive symptoms and cognitive impairment of the interRAI-LTCF in residents in a LTCF. Secondary data were analysed, using the IBM Statistical Package for Social Sciences (SPSS) software, version 25, to test any statistically significant relationship between the extracted variables (Significance was set as p˂0.05). The prevalence of possible depression, using the Depression Rating Scale (DRS) of the interRAI-LTCF in the residents in this study was 36.4%, of whom 54.3% had a documented clinical diagnosis of depression. The prevalence of cognitive impairment was 39.3%, using the Cognitive Performance Scale (CPS), of whom 34.1% had a documented clinical diagnosis of cognitive impairment/dementia. There were more females than males with the possibility for depression and cognitive impairment, especially in those who were older than 80 years of age, those without partners, and who had ≤12 years of education. The DRS and the CPS were able to predict the possibility for depression and CI. There is a 55.9% risk of possible depression with CI present as compared to a 23.8% risk of possible depression when CI is not present. That means that people meeting criteria for CI on the CPS are 2.3 times more likely to meet the criteria for possible depression on the DRS. Similarly, there is a 60.3% risk of CI with possible depression present as compared to a 27.3% risk of CI when possible depression is not present. That means that people meeting criteria for possible depression on the DRS are 2.2 times more likely to meet the criteria for CI on the CPS. The logistic regression confirmed the coexistence between depressive symptoms and cognitive impairment.

Thesis advisor: Elizabeth A. Kensinger / Although healthy young and older adults remember emotional information better than neutral, emotion does not confer the same benefit upon memory for those experiencing memory impairments due to Alzheimer's disease (AD). It is poorly understood at what stage of processing these deficits occur--are they due to declines in memory storage and retrieval processes, or to a decline in earlier stages of attention allocation, which then impact memory storage and retrieval? It remains an open question how attention and memory processes may interact in aging and age-related disease. The goal of this research was to examine the effects of aging on the neural mechanisms underlying selective memory for emotional information in visual scenes, and to compare memory between healthy older adults and patients with very early AD pathophysiological changes. Experiment 1 examined young and older adults' encoding-related neural activation associated with selective memory for emotional items within visual scenes and with successful memory for emotional items and the scene background. There were few regions showing significant interactions between age and memory for positive and negative scenes. In contrast, Experiment 2 showed that aging significantly affected the neural networks underlying selective emotional item memory and successful memory for emotional items and backgrounds. The results indicate that older adults require greater connectivity among prefrontal regions than young adults to encode all elements of a scene, rather than just encoding the emotional item. Experiment 3 showed that despite poorer memory overall, patients showing very early AD pathophysiological changes have relatively well preserved memory, especially for positive information. Dividing older adults' attention during encoding did not significantly alter their pattern of selective emotional item memory, suggesting that encoding of emotional items may be an easier or relatively automatic task compared to encoding of the background. In conclusion, there are significant age-related changes in the underlying neural networks, but not activation patterns, for selective memory for positive and negative scenes. Patients with early AD pathophysiological changes have impaired memory overall, however they may be able to recruit a similar neural network of prefrontal regions as healthy older adults for encoding of scenes with positive information. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Psychology.

Background: Goodwill activity has been very high in Sweden in recent years. Goodwill is regulated by IFRS 3, which came into effect in 2004. Instead of amortizing the asset over a specific number of years, goodwill should be tested for impairment every year. This change has received criticism due to its introduction of estimation of fair values and the possibility it gives managers to act discretionary, which has made it more difficult for investors to trust the financial information of the firm. Purpose: The purpose of the thesis is to examine the effects the switch from the amortization regime to the impairment regime has had on the relationship between goodwill costs and share price. The research question is if there is a difference in the association between share prices and goodwill costs between the amortization regime and the impairment regime. Method: The thesis conducts a quantitative study with a linear regression analysis to measure the association between goodwill costs and share prices. The sample consists of 19 of the firms listed on OMXS 30. In the model used for the linear regression share price is the dependent variable and there are nine different independent variables tested against share price, among which goodwill costs are included. To test if there is a difference between the two different regimes, the regression is divided into an amortization part and into an impairment part. Conclusion: The thesis concludes that it can find a difference between the amortization regime and impairment regime in the association between goodwill cost and share price. In the impairment regime goodwill cost affects share prices in contrast to the amortization regime where it does not.

Depression is associated with higher severity of memory disorders and has been shown to predict lower levels of cognitive functioning in those diagnosed with Mild Cognitive Impairment (MCI) or dementia. Yet, little is known about this association cross-culturally, particularly between Hispanics and European Americans. This study demonstrates that although levels of depression differed significantly across diagnostic group, Hispanics and European Americans were similar in levels of depression at each diagnosis. However, only for the European American group did depression levels predict lower scores in confrontational naming and semantic memory. Additionally, exploratory analyses of the entire sample demonstrated that lower depression predicted less likelihood of MCI or dementia diagnoses. This could indicate that there is a need for intervention and treatment of depression, in particular for later stages of MCI and dementia, that should be culturally catered to individual ethnicities. / Includes bibliography. / Thesis (M.A.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

Objective. To examine associations among attention-deficit/hyperactivity disorder (ADHD) symptom dimensions (hyperactivity, impulsivity, inattention, and sluggish cognitive tempo [SCT]) and functional impairment among adults. The potential influence of co-occurring internalizing and externalizing difficulties, as well as self-reported executive functioning deficits, on these associations was also evaluated. Methods. One thousand eight hundred and ninety-four adults (58.8% female; 75.9% Caucasian; age: M = 36.24 [SD = 11.65] years) recruited from Amazon’s Mechanical Turk (MTurk) completed extensive questionnaire batteries assessing ADHD symptoms, co-occurring internalizing and externalizing difficulties, executive functioning deficits, and functional impairment across a range of domains. First, factor analyses were completed to identify empirically-derived functional impairment factors for use in subsequent analyses. Second, associations between ADHD symptom dimensions and functional impairment factors were examined via a path model. Third, multiple mediation analyses were conducted to evaluate the impact of ADHD symptom dimensions on functional impairment domains via internalizing and externalizing difficulties. Finally, additional multiple mediation analyses were completed to examine to influence of ADHD symptom dimensions on functional impairment via self-reported executive functioning deficits. Results. Factor analyses identified four overlapping but distinct functional impairment factors indexing general impairment, quality of life, romantic relationship functioning, and social support. Path analyses revealed significant associations between increased ADHD symptoms and higher general impairment, lower quality of life, reduced romantic relationship functioning, and decrements in perceived social support. Multiple mediation analyses indicated that ADHD symptom dimensions influence functional impairment domains via specific internalizing, externalizing, and executive functioning difficulties. Conclusions. The pattern of findings provides further support for associations between ADHD symptom dimensions and a range of functional impairments, as well as highlighting potential exacerbation of these effects in the presence of co-occurring mental health and executive functioning difficulties. Current findings may help to clarify the complex phenomenology of ADHD in adults, and carry implications for improving extant treatment approaches.

Magister Chirurgiae Dentium (MChD) / Hearing impairment contributes significantly to the global burden of disabilities and has reported to be a prevalent disability in South Africa. The hearing impaired population has been associated with low levels of oral health due to numerous factors concomitant with reduced oral health care and knowledge. This predisposes these persons to oral disease including periodontal disease. Aim: To determine the prevalence of periodontal disease and the associated factors in adults with hearing impairment in designated facilities in the Western Cape, South Africa. Objectives: 1. To determine the oral health care practices in adults with hearing impairment. 2. To determine oral health knowledge of adults with hearing impairment. 3. To determine the frequency of dental visits of adults with hearing impairment and identify any associated barriers. 4. To determine the prevalence of periodontal disease in adults with hearing impairment in designated facilities in the Western Cape, South Africa. 5. To determine the relationship between the prevalence of periodontal disease and associated factors including; sociodemographic factors, oral health care practices, oral health knowledge and frequency of dental visits in adults with hearing impairment. Methodology: A quantitative, analytical cross-sectional study design was employed. A research questionnaire was used to evaluate oral health care practices, oral health knowledge, frequency of dental visits and related barriers to access oral health care. An intra-oral examination was conducted to determine the plaque index (PI), gingival index (GI) and clinical attachment loss (CAL) using the Ramjford six teeth. Data was analysed in Microsoft Excel and StataCorp using frequencies, means, standard deviations, confidence intervals, Chi-square and Fishers exact tests. Results: The prevalence of gingivitis was 100% and the prevalence of periodontitis was 26.09% amongst hearing impaired adults. The mean gingival index score (GI) was 1.24 (STD±0.49; 95% CI: 1.14-1.35) and the mean plaque index score (PI) was 1.3 (STD±0.5; 95% CI: 1.2-1.4). Periodontitis prevalence was established for those participants presenting with an average clinical attachment loss (CAL) of >3mm and the mean clinical attachment loss was 4.47mm (STD ±1.41; 95% CI: 4.18-4.76mm) for those presenting with evidence of periodontitis. Age was statistically significant (p<0.05). Prevalence of periodontitis was evident amongst participants over the age of 35 years with a mean age of 48years (STD±13). Oral health care showed a lack of the use of dental floss and regular dental visits. Access to dental care was compromised primarily due to communication barriers, dental fear and a low priority of oral health. Conclusion: The necessity of oral health care and oral health knowledge in hearing impaired adults such as education and motivation for the need of dental flossing, the use of fluoridated toothpastes and the benefits of regular dental visits, must be emphasized. Oral health care workers should strive to intensify efforts to facilitate a favourable periodontal health status amongst hearing impaired adults.

Against the background of a broad range of language features that are identified as characteristic of specific language impairment (SLI), some researchers have identified a narrower set of clinical markers considered the hallmark of SLI. However, comparisons with language impairments that fall outside the criteria for SLI are limited. This thesis is concerned with determining which language features, if any, are capable of differentiating children with SLI from children with non-specific language impairment (NLI). Conversation and oral narrative language samples were collected from seventy five children aged 2 ½ to 6 years comprising four research groups: 21 participants with SLI, 13 participants with NLI, 21 age-matched participants with normally developing language (AM) and 20 younger language-matched participants with normally developing language (LM). Matching for group comparisons required that the SLI and NLI groups had similar levels of language ability on a standardised assessment and mean length of utterance (MLU), which reduced the SLI group to 15 participants for these comparisons. The LM group was also matched to the SLI and NLI groups on MLU. A wide range of language variables from the conversation and narrative samples were analysed, covering the domains of general sample measures, morphosyntactic accuracy and complexity, narrative structure and cohesion. The SLI and NLI groups performed similarly in all domains and could not be differentiated diagnostically on the measures examined. The most consistent group effects were for comparisons between the AM and LM groups, which demonstrated the effects of maturation and development. The language impairment (LI) and LM groups could not be differentiated on the majority of general language sample or morphosyntactic measures but the SLI group produced narratives that were structurally more complex and cohesive than the LM group. Language tasks varied in their effectiveness in differentiating groups. More consistent group effects for the grammatical accuracy measures were obtained from the conversations than the narratives, and from composite measures compared to individual morpheme measures. Targeted elicitation tasks were more effective than the conversations or narratives in producing consistent group effects for accuracy of individual verb tense morphemes. More consistent group effects for the narrative features were obtained from a wordless picture book than a single scene picture. A set of discriminant function analyses showed that LI was most effectively identified using a combination of key morphosyntactic measures from the conversations and key narrative feature measures from the two narratives. The results have implications for diagnostic practices, intervention practices and theoretical constructs and explanations of SLI and NLI. In particular, a broad, holistic view of LI is supported, as an impairment that impacts on all domains of language which interact with each other and must be considered collectively, rather than as individual, splintered skills.

<p>Falls and fallinjuries are very common in peoples own homes in various institutions. Hospital inpatients often fall during daytime in connection with their visit to the toilet. Visual impairment such as cataract, glaucoma, macular degeneration and diabetic retinopathy can cause falls. The purpose of this study was to examine patient´s records where falls and fallinjuries were documented at an emergency clinic and to examine if they were registered to visual impairment. The records from 68 hospital inpatients from the age of 65 years and older who did fall during the year of 2004, were examined. In spite of different preventive actions that were taken, falls and fallinjuries often happened when the patients were on the move and left on their own. The number of patients who have any visual impairment and a record at an eye clinic, were 41. Thirtytwo of the patients who have any visual impairment did fall between 18:00 - 06:00. In the emergency clinics records, there were no records about how the patients experienced their visual ability. Objective and subjective visual impairment were only registered in the eye clinics records. When risk assessments are made, visual impairment should be considered as a riskfactor for falling. It should be considered as an independent riskfactor as well as in addition with other riskfactors. When the patient gets to the ward, the nurse should ask the patient and register if he or she has any visual impairment. The nurse can therefore use strategies to plan the caring and prevent falls and fallinjuries during the patients stay at the emergency clinic. Visual impairment as well as the natural ageing affects the visual ability and therefore the wards environment should contain sharp colours and bright lightening.</p>

<p>Objective: From the patient’s perspective describe communication difficulties, which can arise, and how they are handled in their contact with public health care and illustrate their needs of communication.</p><p>Method: A study of literature was carried out to receive a background and an insight in previous research concerning the subject area. Twelve women with hearing loss was asked to complete a questionnaire, with open questions, regarding communication difficulties in health care situations.</p><p>Sample: For the literature review, scientific papers were selected via the database, PubMed using relevant keywords. Seven were selected for closer review. For the survey study twelve women were asked to participate which ten of those responded.</p><p>Results: The study of literature shows that communication difficulties occur in public health care between patients with hearing loss and the nursing staff. These are mainly due to lack of information, lack of knowledge and comprehension regarding hearing disorders. Also, there is a lack of knowledge about methods in communication and factors regarding environment and surrounding. This affects the patients with a not sufficient quality of the care in comparison with the care for hearing patients. The causes of communication problems above are confirmed by the questionnaire study. Most of the participants experienced insecurity in their contact with public health care due to communication difficulties and they expressed that they often meet unsympathetic nursing staff. This can create dejectedness among the patients. The results from both literature review and the survey shows that education to all nursing staff, regarding communication and meeting of patient with hearing loss, can solve the problems.</p><p>Conclusions: Special education efforts to nursing staff regarding communication with patients with hearing loss are needed. That can give conditions to the health care service to achieve the goal about a good and high qualitative care.</p>

Objective: From the patient’s perspective describe communication difficulties, which can arise, and how they are handled in their contact with public health care and illustrate their needs of communication. Method: A study of literature was carried out to receive a background and an insight in previous research concerning the subject area. Twelve women with hearing loss was asked to complete a questionnaire, with open questions, regarding communication difficulties in health care situations. Sample: For the literature review, scientific papers were selected via the database, PubMed using relevant keywords. Seven were selected for closer review. For the survey study twelve women were asked to participate which ten of those responded. Results: The study of literature shows that communication difficulties occur in public health care between patients with hearing loss and the nursing staff. These are mainly due to lack of information, lack of knowledge and comprehension regarding hearing disorders. Also, there is a lack of knowledge about methods in communication and factors regarding environment and surrounding. This affects the patients with a not sufficient quality of the care in comparison with the care for hearing patients. The causes of communication problems above are confirmed by the questionnaire study. Most of the participants experienced insecurity in their contact with public health care due to communication difficulties and they expressed that they often meet unsympathetic nursing staff. This can create dejectedness among the patients. The results from both literature review and the survey shows that education to all nursing staff, regarding communication and meeting of patient with hearing loss, can solve the problems. Conclusions: Special education efforts to nursing staff regarding communication with patients with hearing loss are needed. That can give conditions to the health care service to achieve the goal about a good and high qualitative care.