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Publisher: Elsevier   (Total: 3123 journals)

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Showing 1 - 200 of 3120 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 8)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 26, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 378, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 26, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 237, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 5)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 138, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 4)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 9, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 12, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 23, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 6, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 13)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 7)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 6)
Advances in Drug Research     Full-text available via subscription   (Followers: 23)
Advances in Ecological Research     Full-text available via subscription   (Followers: 47, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 45, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 52, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 17, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 27)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 10)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 9, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 370, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 31, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 45, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 337, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 432, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 42, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 49, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 48, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 42, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 207, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 61, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 24, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 26, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 36, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 60, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 36, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 171, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 176, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)

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Journal Cover American Journal of Geriatric Psychiatry
  [SJR: 1.653]   [H-I: 93]   [14 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1064-7481 - ISSN (Online) 1545-7214
   Published by Elsevier Homepage  [3123 journals]
  • Pharmacogenetic Decision Support Tools: A New Paradigm for Late-Life
           Depression'
    • Authors: Ryan Abbott; Donald D. Chang; Harris A. Eyre; Chad A. Bousman; David A. Merrill; Helen Lavretsky
      Pages: 125 - 133
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Ryan Abbott, Donald D. Chang, Harris A. Eyre, Chad A. Bousman, David A. Merrill, Helen Lavretsky
      Clinicians still employ a “trial-and-error” approach to optimizing treatment regimens for late-life depression (LLD). With LLD affecting a significant and growing segment of the population, and with only about half of older adults responsive to antidepressant therapy, there is an urgent need for a better treatment paradigm. Pharmacogenetic decision support tools (DSTs), which are emerging technologies that aim to provide clinically actionable information based on a patient's genetic profile, offer a promising solution. Dozens of DSTs have entered the market in the past 15 years, but with varying level of empirical evidence to support their value. In this clinical review, we provide a critical analysis of the peer-reviewed literature on DSTs for major depression management. We then discuss clinical considerations for the use of these tools in treating LLD, including issues related to test interpretation, timing, and patient perspectives. In adult populations, newer generation DSTs show promise for the treatment of major depression. However, there are no primary clinical trials in LLD cohorts. Independent and comparative clinical trials are needed.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.05.012
       
  • A Systematic Review of Practice Guidelines and Recommendations for
           Discontinuation of Cholinesterase Inhibitors in Dementia
    • Authors: Brenna N. Renn; Ali Abbas Asghar-Ali; Stephen Thielke; Angela Catic; Sharyl R. Martini; Brian G. Mitchell; Mark E. Kunik
      Pages: 134 - 147
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Brenna N. Renn, Ali Abbas Asghar-Ali, Stephen Thielke, Angela Catic, Sharyl R. Martini, Brian G. Mitchell, Mark E. Kunik
      Cholinesterase inhibitors (ChEIs) are the primary pharmacological treatment for symptom management of Alzheimer disease (AD), but they carry known risks during long-term use, and do not guarantee clinical effects over time. The balance of risks and benefits may warrant discontinuation at different points during the disease course. Indeed, although there is limited scientific study of deprescribing ChEIs, clinicians routinely face practical decisions about whether to continue or stop medications. This review examined published practice recommendations for discontinuation of ChEIs in AD. To characterize the scientific basis for recommendations, we first summarized randomized controlled trials of ChEI discontinuation. We then identified practice guidelines by professional societies and in textbooks and classified them according to 1) whether they made a recommendation about discontinuation, 2) what the recommendation was, and 3) the proposed grounds for discontinuation. There was no consensus in guidelines and textbooks about discontinuation. Most recommended individualized discontinuation decisions, but there was essentially no agreement about what findings or situations would warrant discontinuation, or even about what domains to consider in this process. The only relevant domain identified by most guidelines and textbooks was a lack of response or a loss of effectiveness, both of which can be difficult to ascertain in the course of a progressive condition. Well-designed, long-term studies of discontinuation have not been conducted; such evidence is needed to provide a scientific basis for practice guidelines. It seems reasonable to apply an individualized approach to discontinuation while engaging patients and families in treatment decisions. 

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.09.027
       
  • Cholinesterase Inhibitor Discontinuation: The Buck Stops Here
    • Authors: Nathan Herrmann
      Pages: 148 - 149
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Nathan Herrmann


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.014
       
  • Safety and Effectiveness of Long-Term Treatment with Lurasidone in Older
           Adults with Bipolar Depression: Post-Hoc Analysis of a 6-Month, Open-Label
           Study
    • Authors: Brent P. Forester; Martha Sajatovic; Joyce Tsai; Andrei Pikalov; Josephine Cucchiaro; Antony Loebel
      Pages: 150 - 159
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Brent P. Forester, Martha Sajatovic, Joyce Tsai, Andrei Pikalov, Josephine Cucchiaro, Antony Loebel
      Objective To evaluate the safety and effectiveness of 6 months of treatment with lurasidone in older adults with a diagnosis of bipolar I depression. Design Post-hoc analysis of a multicenter, 6-month, open-label extension study. Setting Outpatient. Participants Patients aged 55 to 75 years with a DSM-IV-TR diagnosis of bipolar I depression who had completed 6 weeks of double-blind, placebo-controlled treatment with either lurasidone monotherapy (1 study) or adjunctive therapy with lithium or valproate (2 studies). Intervention Flexible doses of lurasidone, 20 to 120 mg/day, either as monotherapy, or adjunctive with lithium or valproate. Measurements Effectiveness was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS; change from open-label-baseline to month-6, observed case analysis). Results A total of 141 older adults entered the extension study (monotherapy, N = 55; 39%; adjunctive therapy, N = 86; 61%). At the end of 6 months of open-label treatment with lurasidone, as monotherapy or adjunctive therapy, minimal changes were observed in the older adult sample in mean weight (−1.0 kg and −0.4 kg, respectively); and median total cholesterol (−2.0 mg/dL and +6.0 md/dL, respectively), triglycerides (+2.5 mg/dL and +6.0 mg/dL, respectively), and HbA1c (0.0% and −0.1%, respectively). Patients treated with 6 months of lurasidone showed a mean improvement on the MADRS in both the monotherapy (−6.2) and adjunctive therapy (−6.7) groups. Conclusions Results of these post-hoc analyses found that up to 7.5 months of lurasidone treatment for bipolar depression in older adults was associated with minimal effects on weight and metabolic parameters, with low rates of switching to hypomania or mania, and was well tolerated. The antidepressant effectiveness of lurasidone in this age group was maintained over the 6-month treatment period.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.08.013
       
  • Lurasidone: A New Option for Older Adults with Bipolar Disorder'
    • Authors: Soham Rej
      Pages: 160 - 161
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Soham Rej


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.09.003
       
  • Two Interventions for Patients with Major Depression and Severe Chronic
           Obstructive Pulmonary Disease: Impact on Dyspnea-Related Disability
    • Authors: George S. Alexopoulos; Jo Anne Sirey; Samprit Banerjee; Danielle S. Jackson; Dimitris N. Kiosses; Cristina Pollari; Richard S. Novitch; Amanda Artis; Patrick J. Raue
      Pages: 162 - 171
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): George S. Alexopoulos, Jo Anne Sirey, Samprit Banerjee, Danielle S. Jackson, Dimitris N. Kiosses, Cristina Pollari, Richard S. Novitch, Amanda Artis, Patrick J. Raue
      Objective The Personalized Intervention for Depressed Patients with Chronic Obstructive Pulmonary Disease (PID-C) is an intervention aiming to help patients adhere to their rehabilitation and care. This study tested the hypothesis that the Problem-Solving Adherence (PSA) intervention, which integrates problem-solving into adherence enhancement procedures, reduces dyspnea-related disability more than PID-C. Exploratory analyses sought to identify patients with distinct dyspnea-related disability trajectories and to compare their clinical profiles. Methods In this randomized controlled trial in an acute inpatient rehabilitation and community, 101 participants diagnosed with chronic obstructive pulmonary disease (COPD) and major depression were included after screening 633 consecutive admissions for acute inpatient rehabilitation. Participants underwent 14 sessions of PID-C versus PSA over 26 weeks using the Pulmonary Functional Status and Dyspnea Questionnaire. Results The study hypothesis was not supported. Exploratory latent class growth modeling identified two distinct disability trajectories. Dyspnea-related disability improved in 39% of patients and remained unchanged in the rest. Patients whose dyspnea-related disability improved had more severe disability and less sense of control over their condition at baseline. Conclusion Improvement or no worsening of disability was noted in both treatment groups. This is a favorable course for depressed patients with a severe, deteriorating medical illness. PID-C is compatible with the expertise of clinicians working in community-based rehabilitation programs, and after further testing in the community, it can be integrated in the care of depressed COPD patients.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.002
       
  • Added Value of the Personalized Intervention for Depressed Patients with
           COPD
    • Authors: Gary J. Kennedy
      Pages: 172 - 173
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Gary J. Kennedy


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.015
       
  • Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life,
           and Prevalence According to Age, Gender, and Country
    • Authors: Alessandra Canuto; Kerstin Weber; Marc Baertschi; Sylke Andreas; Jana Volkert; Maria Christina Dehoust; Susanne Sehner; Anna Suling; Karl Wegscheider; Berta Ausín; Mike J. Crawford; Chiara Da Ronch; Luigi Grassi; Yael Hershkovitz; Manuel Muñoz; Alan Quirk; Ora Rotenstein; Ana Belén Santos-Olmo; Arieh Shalev; Jens Strehle; Hans-Ulrich Wittchen; Holger Schulz; Martin Härter
      Pages: 174 - 185
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Alessandra Canuto, Kerstin Weber, Marc Baertschi, Sylke Andreas, Jana Volkert, Maria Christina Dehoust, Susanne Sehner, Anna Suling, Karl Wegscheider, Berta Ausín, Mike J. Crawford, Chiara Da Ronch, Luigi Grassi, Yael Hershkovitz, Manuel Muñoz, Alan Quirk, Ora Rotenstein, Ana Belén Santos-Olmo, Arieh Shalev, Jens Strehle, Hans-Ulrich Wittchen, Holger Schulz, Martin Härter
      Objectives Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. Design The study used a cross-sectional multicenter survey. Participants The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Measurements Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). Results The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75–84 years compared with those aged 65–74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. Conclusions The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.08.015
       
  • Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life,
           and Prevalence According to Age, Gender, and Country
    • Authors: Aartjan T.F. Beekman
      Pages: 186 - 187
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Aartjan T.F. Beekman


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.004
       
  • Locked in and Growing Old: The Psychiatric, Forensic, and Cognitive
           Correlates of 30 Years of Psychiatric Hospitalization
    • Authors: Frederick Hives; Kenny A. Karyadi; Steve Nitch; Dominique Kinney
      Pages: 188 - 197
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Frederick Hives, Kenny A. Karyadi, Steve Nitch, Dominique Kinney
      Objective As the number of older adults in the United States continues to grow, the population of older adults with severe mental illness in institutional settings (OASIS) is expected to place a significant demand on healthcare resources. This study presents an update to research regarding the clinical characteristics of OASIS inpatients with histories of extensive hospitalization through the use of a newly developed psychiatric measure: the Clinician-Rated Dimension of Psychosis Symptom Severity. Methods We investigated an OASIS sample (N = 55) with an average of nearly 30 continuous years of hospitalization at a forensic state psychiatric hospital. Results The average OASIS patient exhibited the most prominent psychiatric symptoms via delusions and negative symptoms, received psychotropic medications at substantially higher doses than recommended therapeutic levels, rarely committed acts of institutional violence (IV), and performed more than two standard deviations below the normative mean on cognitive testing. More severe hallucination symptoms were associated with higher psychotropic medication dosage, and more severe depressive symptoms were associated with more IV incidents. OASIS inpatients performed moderately worse than general psychiatric inpatients in the areas of overall cognition, immediate memory, and delayed memory; older age was associated with poorer language and attention. No psychiatric or cognitive factors predicted IV incidents. Conclusion These results highlight the continued importance of understanding the psychiatric, forensic, and cognitive factors associated with aging in an institutional setting and how these factors among OASIS inpatients may vary from general psychiatric inpatients.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.003
       
  • What Is So Different About Psychotic Patients Who Have Extremely Long
           Institutional Stays'
    • Authors: Philip D. Harvey
      Pages: 198 - 199
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Philip D. Harvey


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.007
       
  • Occupational Determinants of Successful Aging in Older Physicians
    • Authors: Chanaka Wijeratne; Carmelle Peisah; Joanne Earl; Georgina Luscombe
      Pages: 200 - 208
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Chanaka Wijeratne, Carmelle Peisah, Joanne Earl, Georgina Luscombe
      Objectives Demographic, physical and psychological associations of successful aging (SA) have been evaluated, but occupational factors have not. Nor has SA been evaluated in a specific occupational group. The aims of this study were to examine the occupational associations of SA in older physicians, and to explore the concept of occupational SA. Methods Physicians aged 55+ years completed self-ratings of occupational and personal SA on a 10-point visual analogue scale (VAS; 1 being “least successful” and 10 “most successful”). Associations between occupational and personal SA (defined as 8–10 on the VAS), respectively, and demographic and practice characteristics; health; social and financial resources; cognitive, emotional and motivational resources; work centrality; and anxiety about aging were examined. Results Rates of occupational SA (69.2%; 95% CI: 66.3–72.0) were significantly higher than personal SA (63.1%; 95% CI: 60.1–66.0) in the sample of 1,048 physicians. Occupational and personal SA were strongly positively correlated (r = 0.73, N = 1,041, p < 0.001). Personal SA was predicted by demographic (older age, female, international medical graduate, urban practice), physical (better self-rated health), psychological (less depression, better cognitive, emotional and motivational resources, and greater anxiety about aging), and occupational (higher work centrality, fewer practice adaptations and not intending to retire) factors. Conclusions Occupational factors are central to physicians' self-conceptualization of SA. That greater work centrality, fewer work adaptations and less retirement planning were associated with personal SA suggests older physicians' sense of “success” is intertwined with continuing practice. There is a need for educating physicians to adapt to aging and retirement.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.07.008
       
  • Successful Aging of Physicians
    • Authors: Dilip V. Jeste; Tanya T. Nguyen
      Pages: 209 - 211
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Dilip V. Jeste, Tanya T. Nguyen


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.08.003
       
  • Aging and Post–Intensive Care Syndrome: A Critical Need for
           Geriatric Psychiatry
    • Authors: Sophia Wang; Duane Allen; You Na Kheir; Noll Campbell; Babar Khan
      Pages: 212 - 221
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Sophia Wang, Duane Allen, You Na Kheir, Noll Campbell, Babar Khan
      Because of the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments because of critical illness, known as post–intensive care syndrome (PICS). This article focuses on PICS-related cognitive, psychological, and physical impairments and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS and what roles geriatric psychiatrists could play in the future of this rapidly growing population.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.05.016
       
  • Post-Intensive Care Syndrome: The Role of Geriatric Psychiatry in
           Research, Practice, and Policy
    • Authors: Leslie P. Scheunemann; Elizabeth R. Skidmore; Charles F. Reynolds
      Pages: 222 - 223
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Leslie P. Scheunemann, Elizabeth R. Skidmore, Charles F. Reynolds


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.06.017
       
  • Complex Clinical Intersection: Palliative Care in Patients with Dementia
    • Authors: Ellen E. Lee; Beverly Chang; Steven Huege; Jeremy Hirst
      Pages: 224 - 234
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Ellen E. Lee, Beverly Chang, Steven Huege, Jeremy Hirst
      Because of the rapidly growing older population and increases in longevity, rates of dementia have been rising. Clinical challenges of treating dementia include limited resources and lack of curative therapies. Palliative care approaches improve quality of life and alleviate suffering for dementia patients at the end of life, although implementation may be limited by societal acceptance and feasibility. This review examines the published literature on pain assessments, pain and behavior interventions, tools for advanced care planning, and clinical concerns in dementia patients. Ultimately, modification of the traditional palliative care model may improve outcomes and functioning for dementia patients at all stages of their illness.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.06.015
       
  • The Importance of Palliative Care for Dementia
    • Authors: Scott A. Irwin; Joseph W. Shega; Greg A. Sachs
      Pages: 235 - 237
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Scott A. Irwin, Joseph W. Shega, Greg A. Sachs


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.08.010
       
  • Anxious Depression and Neurocognition among Middle-Aged and Older
           Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos
           (HCHS/SOL) Results
    • Authors: Alvaro Camacho; Wassim Tarraf; Daniel E. Jimenez; Linda C. Gallo; Patricia Gonzalez; Robert C. Kaplan; Melissa Lamar; Tasneem Khambaty; Bharat Thyagarajan; Krista M. Perreira; Rosalba Hernandez; Jianwen Cai; Martha L. Daviglus; Sylvia Wassertheil-Smoller; Hector M. González
      Pages: 238 - 249
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Alvaro Camacho, Wassim Tarraf, Daniel E. Jimenez, Linda C. Gallo, Patricia Gonzalez, Robert C. Kaplan, Melissa Lamar, Tasneem Khambaty, Bharat Thyagarajan, Krista M. Perreira, Rosalba Hernandez, Jianwen Cai, Martha L. Daviglus, Sylvia Wassertheil-Smoller, Hector M. González
      Objective The purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage. Design Data are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45–74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups. Results Among men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age. Conclusions Increased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.06.002
       
  • ¡HOLA, Amigos! Toward Preventing Anxiety and Depression in Older
           Latinos
    • Authors: Daniel E. Jimenez; Shariful Syed; Doris Perdomo-Johnson; Joseph F. Signorile
      Pages: 250 - 256
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Daniel E. Jimenez, Shariful Syed, Doris Perdomo-Johnson, Joseph F. Signorile
      Given the prevalence and morbidity of depression and anxiety in later life, the inadequacies of current treatment approaches for averting years living with disability, the disparities in access to the mental healthcare delivery system, and the workforce shortages to meet the mental health needs of older Latinos, development and testing of innovative strategies to prevent depression and anxiety are of great public health significance and have the potential to change practice. Although impediments to good depression and anxiety outcomes exist for all older adults, they are even more pronounced for older Latinos, who tend to have fewer socioeconomic resources. These factors underscore the need for prevention-based interventions that are effective, scalable, relevant, respectful, and specific to this population. The Happy Older Latinos are Active (HOLA) program is a community health worker–led, multicomponent, health promotion intervention. The diverse needs and circumstances of older Latinos (highly sedentary, culture-specific health beliefs, service disparities) were incorporated into the design of HOLA to reduce risk factors and improve health-related outcomes associated with common mental disorders in this group. The authors describe HOLA (highlighted in this case example) and why health promotion interventions like HOLA may hold promise as effective, practical, and nonstigmatizing interventions for preventing common mental disorders in older Latinos who are at risk for developing these disorders.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.06.020
       
  • My Odyssey Through the Changing World of Mental Health
    • Authors: Herbert C. Schulberg
      Pages: 257 - 263
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): Herbert C. Schulberg


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.10.006
       
  • Metropolitan Museum
    • Authors: J. Barrie Shepherd
      First page: 264
      Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2
      Author(s): J. Barrie Shepherd


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.09.012
       
  • Bipolar Disorder in Nursing Homes: Impact on Antipsychotic Use, Diagnosis
           Patterns, and New Diagnoses in People with Dementia
    • Authors: Ryan M. Carnahan; Elena M. Letuchy
      Pages: 2 - 10
      Abstract: Publication date: January 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 1
      Author(s): Ryan M. Carnahan, Elena M. Letuchy
      Objectives Nursing home quality measures include the proportion of residents who receive antipsychotics. Residents with bipolar disorder are included even though antipsychotics are FDA-approved for this indication. We evaluated how including residents with bipolar disorder impacted the antipsychotic use quality measure for long-stay residents. We evaluated the agreement of minimum data set (MDS) bipolar disorder diagnoses with Medicare data, whether dementia was diagnosed before bipolar disorder, and how less-specific bipolar disorder diagnoses impacted findings. Design Cross-sectional study. Setting Nursing homes in Iowa. Participants 21,955 long-stay nursing home residents in the first quarter of 2014. Measurements We identified antipsychotic use and bipolar disorder using MDS data. We compared MDS bipolar disorder diagnoses with Chronic Conditions Warehouse (CCW) “ever” bipolar disorder indicators, and prior year claims. We compared CCW condition onset dates to identify bipolar disorder diagnosed after dementia. Results The mean (SD) proportion receiving antipsychotics was 19.6% (11.1%) with bipolar disorder and 18.3% (10.8%) without. The positive predictive value (PPV) of MDS bipolar disorder diagnoses was 80.2% versus CCW lifetime indicators, and 74.6% versus claims. PPV decreased by 27.1% when “bipolar disorder, unspecified” and “other bipolar disorders” diagnoses were excluded. Nearly three-quarters of residents with bipolar disorder had dementia. Over half of those with dementia had dementia first per CCW records. This proportion was lower among those with more specific bipolar disorder diagnoses or MDS bipolar disorder indicators. Conclusions Bipolar disorder in nursing home residents is often first diagnosed after dementia using nonspecific diagnoses. This practice deserves further evaluation.

      PubDate: 2018-01-04T09:14:18Z
      DOI: 10.1016/j.jagp.2017.09.007
       
  • The Two-Year Course of Quality of Life in Nursing Home Residents with
           Dementia
    • Authors: Anne van der Zon; Roland B. Wetzels; Hans Bor; Sytse U. Zuidema; Raymond T.C.M. Koopmans; Debby L. Gerritsen
      Abstract: Publication date: Available online 2 February 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Anne van der Zon, Roland B. Wetzels, Hans Bor, Sytse U. Zuidema, Raymond T.C.M. Koopmans, Debby L. Gerritsen
      Objectives To assess the course of quality of life (QoL) in nursing home residents with dementia and to study its predictors. Design Longitudinal multi-center observational cohort study with two-year follow-up. Setting Fourteen dementia special care units in nine nursing homes in the Netherlands. Participants Two hundred ninety residents with dementia. Measurements QoL was assessed with the Qualidem, providing a total score and QoL profile with nine subscales. Residents were assessed at five assessments: every six months during two years. A linear mixed model was used for data analysis. Results No change was found in the Qualidem total score (range 0-111) over two years. However, a significant increase of QoL over time was seen in the subscales ‘Care relationship’, ‘Negative affect’, ‘Restless tense behavior’, ‘Positive self-image’, ‘Social isolation’ and ‘Feeling at home’. A significant decrease of QoL was seen in the subscales ‘Positive affect’, ‘Social relations’ and ‘Having something to do’. Most predictors of the course of Qol were found for the subscales ‘Positive self-image’ (sex, GDS, SIB, ADL and NPI) and ‘Having something to do’ (GDS, SIB and ADL). Sex and NPI at baseline are the predictors that were found most frequently. Conclusions The total QoL score was stable over a two-year period. However, QoL subscales showed multidirectional changes. The largest QoL decline in the subscale ‘Having something to do’ suggests that more attention should be given to useful activities in nursing home care.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.202
       
  • Raised Beds (at the Retirement Center)
    • Authors: J. Barrie Shepherd
      Abstract: Publication date: Available online 2 February 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): J. Barrie Shepherd


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.200
       
  • Information for Subscribers
    • Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2


      PubDate: 2018-02-17T15:47:46Z
       
  • In This Issue
    • Abstract: Publication date: February 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 2


      PubDate: 2018-02-17T15:47:46Z
       
  • Medical Care Tasks among Spousal Dementia Caregivers: Links to
           Care-Related Sleep Disturbances
    • Authors: Courtney A. Polenick; Amanda N. Leggett; Donovan T. Maust; Helen C. Kales
      Abstract: Publication date: Available online 1 February 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Courtney A. Polenick, Amanda N. Leggett, Donovan T. Maust, Helen C. Kales
      Objectives Medical care tasks are commonly provided by spouses caring for persons living with dementia (PLWDs). These tasks reflect complex care demands that may interfere with sleep, yet their implications for caregivers' sleep outcomes are unknown. We evaluated the association between caregivers' medical/nursing tasks (keeping track of medications; managing tasks such as ostomy care, IVs, or blood testing; giving shots/injections; and caring for skin wounds/sores) and care-related sleep disturbances. Design A retrospective analysis of cross-sectional data from the 2011 National Health and Aging Trends Study and National Study of Caregiving was conducted. Setting Spousal caregivers and PLWDs/proxies were interviewed by telephone at home. Participants The US sample included 104 community-dwelling spousal caregivers and PLWDs. Measurements Caregivers reported on their sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and sleep disturbances. PLWDs (or proxies) reported on their health conditions and sleep problems. Results Caregivers who performed a higher number of medical/nursing tasks reported significantly more frequent care-related sleep disturbances, controlling for sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and PLWDs' sleep problems and health conditions. Post hoc tests showed that wound care was independently associated with more frequent care-related sleep disturbances after accounting for the other medical/nursing tasks and covariates. Conclusions Spousal caregivers of PLWDs who perform medical/nursing tasks may be at heightened risk for sleep disturbances and associated adverse health consequences. Interventions to promote the well-being of both care partners may benefit from directly addressing caregivers' needs and concerns about their provision of medical/nursing care.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.206
       
  • Social Cognition Differentiates Behavioral Variant Frontotemporal Dementia
           From Other Neurodegenerative Diseases and Psychiatric Disorders
    • Authors: Flora Gossink; Sigfried Schouws; Welmoed Krudop; Philip Scheltens; Max Stek; Yolande Pijnenburg; Annemiek Dols
      Abstract: Publication date: Available online 1 February 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Flora Gossink, Sigfried Schouws, Welmoed Krudop, Philip Scheltens, Max Stek, Yolande Pijnenburg, Annemiek Dols
      Objective While deficits in social cognition are established as core features in bvFTD, it remains unresolved if impaired social cognition distinguishes bvFTD from the broad differential diagnosis in clinical practice. Our aim was to study whether social cognition discriminates bvFTD from other neurodegenerative diseases and psychiatric disorders in patients presenting with late onset frontal symptoms. Next we studied the association of social cognition with frontal symptoms and cognitive functioning. Methods In this longitudinal multicenter study, besides clinical rating scales for frontal symptoms, social cognition was determined by Ekman 60 Faces test and Faux Pas in addition to neuropsychological tests for other cognitive domains in patients with probable and definite bvFTD (n=22), other neurodegenerative diseases (n=24) and psychiatric disorders (n=33). Median symptom duration was 2.8 years and patients were prospectively followed over two-years. Results Total scores at Ekman 60 Faces test were significantly lower in bvFTD than in other neurodegenerative diseases and psychiatric disorders. Ekman 60 Faces test explained 91.2% of the variance of psychiatric disorders and other neurodegenerative diseases versus bvFTD (χ 11.02, df 1, p 0.001) and was associated with all other cognitive domains. Faux Pas and the other cognitive domains did not differ between these diagnostic groups. Conclusions In this clinical sample Ekman 60 Faces test distinguished bvFTD successfully from other neurodegenerative diseases and psychiatric disorders. Although associated to social cognition, other cognitive domains were not discriminative. This study provides arguments to add the Ekman 60 Faces test to the neuropsychological examination in the diagnostic procedure of bvFTD.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.12.008
       
  • Invited Perspective on “Assessing the Decision Making Capacity of
           Terminally Ill Patients with Cancer”
    • Authors: Jen Seaman
      Abstract: Publication date: Available online 1 February 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Jen Seaman


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.12.010
       
  • Perceived Treatment Status of Fluctuations in Parkinson's Disease Impacts
           Suicidality
    • Authors: Jared Hinkle; Kate Perepezko; Zoltan Mari; Laura Marsh; Gregory M. Pontone
      Abstract: Publication date: Available online 31 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Jared Hinkle, Kate Perepezko, Zoltan Mari, Laura Marsh, Gregory M. Pontone
      Objective On/off motor fluctuations in Parkinson's disease (PD) can be associated with extreme mood fluctuations and severe dysphoria. The impact of these affective symptoms may be overlooked in the treatment of motor fluctuations. Our goal was to examine the relationship between motor fluctuations, their treatment status, and suicidality in PD participants. Methods We analyzed data from the Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study of 223 individuals with PD. Suicidality was measured using items from four depression scales: Hamilton Depression Rating Scale (HAM-D-17); Montgomery-Åsberg Depression Rating Scale (MADRS); Inventory for Depressive Symptomatology (IDS-C); and the self-rated Beck Depression Inventory (BDI). Multivariable Poisson regression analyses tested whether self-reported motor fluctuations and their treatment status were associated with suicidality while controlling for recognized risk factors. Results Thirty-seven participants (16.6%) self-reported suicidality and 89 (39.5%) self-reported motor fluctuations, of whom 21 (23.6%) perceived their fluctuations as untreated. Participants reporting untreated motor fluctuations more frequently had a current depressive disorder (p < 0.001) and endorsed suicidality (p = 0.006) than participants with treated or no fluctuations. They also had significantly higher total scores on the HAM-D-17, MADRS, IDS-C, and BDI depression scales (p < 0.001 for each). Regression analyses showed significant associations between untreated motor fluctuations and higher scores on suicide questions extracted from the HAM-D-17, MADRS, and IDS-C (p < 0.01 for each). Conclusions PD patients with untreated motor fluctuations are at increased risk for suicidal thoughts and should be monitored for mood changes as treatment is adapted.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.005
       
  • Closing Up the Cottage
    • Authors: J. Barrie Shepherd
      Abstract: Publication date: Available online 31 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): J. Barrie Shepherd


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.201
       
  • Self-Perceived Health and Sleep Quality of Community Older Adults after
           Acupunch Exercises
    • Authors: Chih-Yin Hsiao; Kuei-Min Chen; Han-Ya Tsai; Hsin-Ting Huang; Yin-Yin Cheng; Athena Yijung Tsai
      Abstract: Publication date: Available online 31 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Chih-Yin Hsiao, Kuei-Min Chen, Han-Ya Tsai, Hsin-Ting Huang, Yin-Yin Cheng, Athena Yijung Tsai
      Objectives To test the long-term effects of the 12-month Healthy Beat Acupunch (HBA) exercise program on the self-perceived health and sleep quality of older adults in community care centers, and to compare the effects of two delivery methods: instructor-led HBA for the first 6 months and DVD-guided HBA for another 6 months. Design Cluster-randomized controlled trial. Setting Eight community care centers. Participants In total, 232 participants were recruited from eight community care centers, and cluster-randomized to the experimental (4 centers, N = 113) and control (4 centers, N = 119) groups. Intervention The experimental group received the instructor-led HBA program 3 times weekly for the first 6 months, followed by the DVD-guided HBA program for another 6 months. Measurements Self-perceived health and sleep quality were assessed using the Short Form Health Survey and the Pittsburgh Sleep Quality Index, respectively, at baseline and every 3 months for 1 year. Results The experimental group reported more favorable self-perceived physical and mental health, higher subjective sleep quality, and less daytime dysfunction than did the control group. Effect sizes of physical health and sleep quality increased from the instructor-led stage to the DVD-guided stage; the effect size of physical health showed the most significant change, increasing from 0.38 in the instructor-led stage to 0.55 in the DVD-guided stage. Conclusions The exercise program consisting of the instructor-led class, followed by the DVD-guided class, was an effective and feasible longitudinal program for older adults in community care centers.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.199
       
  • From Bereavement to Grief to Cognitive Decline: A Call for Novel Treatment
           and Prevention Approaches
    • Authors: Eric Bui; Olivia Okereke
      Abstract: Publication date: Available online 31 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Eric Bui, Olivia Okereke


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.006
       
  • John Henry in the Snow
    • Authors: David L. Coulter
      Abstract: Publication date: Available online 17 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): David L. Coulter


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2017.12.012
       
  • Palliating Severe Refractory Neuropsychiatric Symptoms of Dementia: Is
           There a Role for Electroconvulsive Therapy'
    • Authors: Tyler S. Kaster; Daniel M. Blumberger
      Abstract: Publication date: Available online 17 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Tyler S. Kaster, Daniel M. Blumberger


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.002
       
  • A Machine Learning Approach to Identifying Placebo Responders in Late-Life
           Depression Trials
    • Authors: Sigal Zilcha-Mano; Steven P. Roose; Patrick J. Brown; Bret R. Rutherford
      Abstract: Publication date: Available online 11 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Sigal Zilcha-Mano, Steven P. Roose, Patrick J. Brown, Bret R. Rutherford
      Objective Despite efforts to identify characteristics associated with medication–placebo differences in antidepressant trials, few consistent findings have emerged to guide participant selection in drug development settings and differential therapeutics in clinical practice. Limitations in the methodologies used, particularly searching for a single moderator while treating all other variables as noise, may partially explain the failure to generate consistent results. The present study tested whether interactions between pretreatment patient characteristics, rather than a single-variable solution, may better predict who is most likely to benefit from placebo versus medication. Methods Data were analyzed from 174 patients aged 75 years and older with unipolar depression who were randomly assigned to citalopram or placebo. Model-based recursive partitioning analysis was conducted to identify the most robust significant moderators of placebo versus citalopram response. Results The greatest signal detection between medication and placebo in favor of medication was among patients with fewer years of education (≤12) who suffered from a longer duration of depression since their first episode (>3.47 years) (B = 2.53, t(32) = 3.01, p = 0.004). Compared with medication, placebo had the greatest response for those who were more educated (>12 years), to the point where placebo almost outperformed medication (B = −0.57, t(96) = −1.90, p = 0.06). Conclusion Machine learning approaches capable of evaluating the contributions of multiple predictor variables may be a promising methodology for identifying placebo versus medication responders. Duration of depression and education should be considered in the efforts to modulate placebo magnitude in drug development settings and in clinical practice.

      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.001
       
  • 2017 Year in Review: Editor's Letter to the Readers of the American
           Journal of Geriatric Psychiatry
    • Authors: Charles F. Reynolds
      Abstract: Publication date: Available online 11 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Charles F. Reynolds


      PubDate: 2018-02-17T15:47:46Z
      DOI: 10.1016/j.jagp.2018.01.003
       
  • Symptomatic and Functional Recovery From Major Depressive Disorder in the
           Ibadan Study of Ageing
    • Authors: Akin Ojagbemi; Taiwo Abiona; Zhehui Luo; Oye Gureje
      Abstract: Publication date: Available online 4 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Akin Ojagbemi, Taiwo Abiona, Zhehui Luo, Oye Gureje
      Objectives: Very little is known about the association between symptomatic and functional recovery from late-life major depressive disorder (MDD) in sub-Saharan Africa. We investigated factors associated with sustained-symptomatic-remission (SR) from MDD and the 5-year trajectory of post-MDD physical functioning. Design: 5 years prospective study with three follow-up waves in 2007, 2008, and 2009. Setting/Participants: Household multistage probability sample of 2149 Nigerians who were 65 years or older. Measurements: Activities of Daily Living (ADL) and MDD were assessed using the Kadz index and Composite International Diagnostic Interview respectively. We studied those with current MDD (prevalent in 2003/04 or incident in 2007), and who achieved SR in subsequent waves compared with a chronic/recurrent course (CR). Results: Baseline demographic characteristics, health and lifestyle factors were not associated with SR in logistic regression analyses. In mixed-effect linear regression models adjusting for age, gender and socio-economic status, ADL worsened in SR (β= 1.0, 95% C.I= 0.2, 1.8), but more so in CR (β= 2.3, 95% C.I= 1.6, 3.0). Poorer ADL at follow-up was predicted by age (β=2.9, 95% C.I=1.8, 4.0) and economic status (β=1.4, 95% C.I= 0.3, 2.4). Conclusion: There was a deteriorating course of disability despite symptomatic recovery from late-life MDD in this sample. This finding has implications for policy and guidelines for the management of late-life depression and disability.

      PubDate: 2018-01-10T09:39:59Z
      DOI: 10.1016/j.jagp.2017.12.011
       
  • Walking While Talking and Risk of Incident Dementia
    • Authors: Mirnova E. Ceïde; Emmeline I. Ayers; Richard Lipton; Joe Verghese
      Abstract: Publication date: Available online 3 January 2018
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Mirnova E. Ceïde, Emmeline I. Ayers, Richard Lipton, Joe Verghese
      Introduction: Walking while talking (WWT) is a performance based test of divided attention, which examines cognitive-motor interactions. The purpose of this study is to examine the predictive validity of WWT for dementia and dementia subtypes. Methods: We prospectively studied the associations of WWT performance at baseline with risk of developing incident dementia in 1156 older adults (mean age 78.28±5.27, 60.7% female) enrolled in the Einstein Aging Study using Cox proportional hazard models. Associations were reported as hazard ratio (HR) with 95% confidence intervals (CI). Results: Over a median follow-up of 1.90 years (IQR= 4.70), 85 participants developed incident dementia (53 Alzheimer's dementia (AD) and 26 vascular dementia (VaD). 3 gait domains were derived using principal component analysis. Only Variability, which loaded heavily for swing time SD and step time SD, was associated with an increased risk of incident dementia per 1 point increase (HR 1.24, 95% CI: 1.02-1.54)) and VaD (HR 1.50, 95% CI: 1.06-2.12)) after adjusting for demographics, disease burden, mental status and normal walking velocity. Amongst 8 individual gait variables, only swing time variability (standard deviation (SD)) was associated with increased risk for both incident dementia (HR 1.35, 95% CI: 1.03-1.77) and VaD (1.78, 95% CI: 1.12-2.83). Variability and swing time SD were not significantly associated with risk of incident AD. Conclusion: Complex walking as assessed by the WWT task is a simple and pragmatic tool for assessing risk of developing dementia, especially VaD in older adults.

      PubDate: 2018-01-04T09:14:18Z
      DOI: 10.1016/j.jagp.2017.12.009
       
  • Images in Aging
    • Authors: Charles F. Reynolds
      First page: 1
      Abstract: Publication date: January 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 1
      Author(s): Charles F. Reynolds


      PubDate: 2017-12-27T09:02:13Z
      DOI: 10.1016/j.jagp.2017.10.005
       
  • Targeted Interdisciplinary Model for Evaluation and Treatment of
           Neuropsychiatric Symptoms: A Cluster Randomized Controlled Trial
    • Authors: Bjørn Lichtwarck; Geir Selbaek; Øyvind Kirkevold; Anne Marie Mork Rokstad; Jūratė Šaltytė Benth; Jonas Christoffer Lindstrøm; Sverre Bergh
      Pages: 25 - 38
      Abstract: Publication date: January 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 1
      Author(s): Bjørn Lichtwarck, Geir Selbaek, Øyvind Kirkevold, Anne Marie Mork Rokstad, Jūratė Šaltytė Benth, Jonas Christoffer Lindstrøm, Sverre Bergh
      Objective To determine the effectiveness of the Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) for treatment of moderate to severe agitation in people with dementia. Methods In a single-blinded, cluster randomized controlled trial in 33 nursing homes (clusters) from 20 municipalities in Norway, 229 patients (104 patients in 17 nursing homes and 125 patients in 16 nursing homes) were randomized to an intervention or control group, respectively. The intervention group received TIME, and the control group received a brief education-only intervention. TIME is an interdisciplinary multicomponent intervention and consists of a comprehensive assessment of the patient with the goal to create and put into action a tailored treatment plan. The primary outcome was the between-group difference in change at the agitation/aggression item of the Neuropsychiatric Inventory Nursing Home version between baseline and 8 weeks. Secondary outcomes were the between-group difference in change at the agitation/aggression between baseline and 12 weeks in other neuropsychiatric symptoms, quality of life, and use of psychotropic and analgesic medications between baseline and 8 and 12 weeks. Results A significant between-group difference in reduction of agitation at both 8 weeks (1.1; 95% confidence interval: 0.1–2.1; p = 0.03) and 12 weeks (1.6; 95% confidence interval: 0.6–2.7; p = 0.002) in favor of the TIME intervention was found. Conclusion The implementation of TIME resulted in a significant reduction of agitation among nursing homes patients with dementia. These results should inform training programs for care staff in Norway and internationally.

      PubDate: 2017-12-27T09:02:13Z
      DOI: 10.1016/j.jagp.2017.05.015
       
  • Information for Subscribers
    • Abstract: Publication date: January 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 1


      PubDate: 2017-12-27T09:02:13Z
       
  • In This Issue
    • Abstract: Publication date: January 2018
      Source:The American Journal of Geriatric Psychiatry, Volume 26, Issue 1


      PubDate: 2017-12-27T09:02:13Z
       
  • The Two Sides of Bipolar Disorder in Nursing Homes: Mental Health Care and
           Quality Indicators
    • Authors: Julia G. Kirkham; Dallas P. Seitz
      Abstract: Publication date: Available online 28 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Julia G. Kirkham, Dallas P. Seitz


      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.020
       
  • Blood Pressure's Role in Alzheimer's Disease Pathology
    • Authors: Timothy M. Hughes; Samuel N. Lockhart; Stephen F. Smagula
      Abstract: Publication date: Available online 25 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Timothy M. Hughes, Samuel N. Lockhart, Stephen F. Smagula


      PubDate: 2017-09-30T02:58:02Z
      DOI: 10.1016/j.jagp.2017.09.019
       
  • In vivo brain plaque and tangle burden mediates the association between
           
    • Authors: Florence F. Roussotte; Prabha Siddarth; David A. Merrill; Katherine L. Narr; Linda M. Ercoli; Jacqueline Martinez; Natacha D. Emerson; Jorge R. Barrio; Gary W. Small
      Abstract: Publication date: Available online 15 September 2017
      Source:The American Journal of Geriatric Psychiatry
      Author(s): Florence F. Roussotte, Prabha Siddarth, David A. Merrill, Katherine L. Narr, Linda M. Ercoli, Jacqueline Martinez, Natacha D. Emerson, Jorge R. Barrio, Gary W. Small
      Objective Growing evidence supports an association between increased blood pressure and: (a) poor cognitive performance in older adults, and (b) various biomarkers of increased Alzheimer's disease (AD) neuropathology. The objective of this study was to determine whether systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly associated with cognitive functioning in non-demented adults, and to examine in vivo AD pathology as a possible mediator of this association. Methods Positron emission tomography (PET) scans with 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile (FDDNP) provide in vivo measurements of plaque and tangle burden. A total of 101 non-demented older subjects with blood pressure data and FDDNP-PET scans were drawn from a larger study of predictors of cognitive decline. A neuropsychological test battery was used to compute “global cognitive scores” (averaged across five key domains), which served as an index of general cognitive functioning. Results Higher DBP (but not SBP) was significantly associated with lower cognitive scores, controlling for age, sex, antihypertensive medication use, and ApoE genotype (η2 = 0.06). However, this relationship was no longer significant after introducing FDDNP-PET binding as an additional covariate in the statistical models. In vivo plaque and tangle burden accounted for over 30% of the observed association between higher DBP and poorer cognitive performance. Conclusions By suggesting a mediation of the relationship between DBP and cognitive functioning by FDDNP-PET binding, this study advances our understanding of some potential predictors of cognitive decline in non-demented adults, and underscores the importance of devising early multimodal interventions to more effectively combat degenerative brain disorders.

      PubDate: 2017-09-18T02:03:23Z
      DOI: 10.1016/j.jagp.2017.09.001
       
 
 
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