The Burden of Dementia: A Medical and Research Perspective

Alzheimer's disease remains the most common form of dementia. Dementia symptoms vary depending on individual personality, life experience, and social and cultural influences. As dementia progresses, involvement of multi-disciplinary health care professionals is needed to manage the disease. Alzheimer research is progressing rapidly. While 5% of all Alzheimer's disease may be genetically determined, the majority is not. Susceptibility genes can reveal the risk of contracting Alzheimer's disease. Early life risk factors such as education, nutrition, and vascular disease may increase the likelihood of dementia in later life. In the United States, two acetylcholinesterase inhibitors have been approved as cognitive enhancers. Possible prevention and symptomatic treatment interventions have focused on estrogen replacement therapy, antioxidants, and anti-inflammatory medications. Research advances have improved the clinical management of dementia. Ethical implications to the patient, family, and society are multiple and remain challenging.     

Splitting a Difference of Opinion: The Shift to Negotiation

Negotiation is not only used to settle differences of interest but also to settle differences of opinion. Discussants who are unable to resolve their difference about the objective worth of a policy or action proposal may be willing to abandon their attempts to convince the other and search instead for a compromise that would, for each of them, though only a second choice yet be preferable to a lasting conflict. Our questions are: First, when is it sensible to enter into negotiations and when would this be unwarranted or even fallacious? Second, what is the nature of a compromise? What does it mean to settle instead of resolve a difference of opinion, and what might be the dialectical consequences of mistaking a compromise for a substantial resolution? Our main aim is to contribute to the theory of argumentation within the context of negotiation and compromise formation and to show how arguing disputants can shift to negotiation in a dialectically virtuous way.     

Treatment Outcome of 18-Month, Day Hospital Mentalization-Based Treatment (MBT) in Patients with Severe Borderline Personality Disorder in the Netherlands

Psychoanalytically oriented day hospital therapy, later manualized and named mentalization-based treatment (MBT), has proven to be a (cost-) effective treatment for patients with severe borderline personality disorder and a high degree of psychiatric comorbidity (BPD) in the United Kingdom (UK). As to yet it has not been shown whether manualized day hospital MBT would yield similar results when conducted by an independent institute outside the UK. We investigated the applicability and treatment outcome of 18-month, manualized day hospital MBT in the Netherlands by means of a prospective cohort study with 45 Dutch patients with severe BPD and a high degree of comorbid Axis I and Axis II disorders. Outcomes were assessed each six months. Symptom distress, social and interpersonal functioning, and personality pathology and functioning all improved significantly, with effect sizes between 0.7 and 1.7. Suicide attempts, acts of self-harm, and care consumption were also significantly reduced. The results indicate that MBT can effectively be implemented in an independent treatment institute outside the UK. This study also supports the clinical effectiveness of manualized day hospital MBT in patients with severe BPD and a high degree of psychiatric comorbidity.     

Validation of Catalan version of BRIEF-P

The BRIEF-P is one of the most used instruments to measure Executive Function (EF). This report is aimed at showing the psychometric properties of the Catalan version of it. To do this, a random cluster sampling was carried out in Osona (Catalonia), recruiting 417 teachers and 408 parents of children aged 3 to 6 years. As with the original instrument, results show that reliability is excellent and that girls have a better EF than boys in the following areas: Working Memory, Plan/Organize, and Inhibit. Since in some areas Catalonia's preschool children show EF values slightly better than those of the reference sample, a new scale for using it in this population is provided.