Abstract. Cognitive Stimulation Therapy (CST) is an internationally used, evidence-based psychosocial intervention for people with mild-to-moderate dementia. The present review thus aimed specifically to examine the reliability of the findings and the strength of the evidence obtained in studies on the CST protocol concerning any benefit in terms of cognitive functioning, perceived quality of life, psychological, behavioral, and everyday life functioning of people with dementia, and their family caregivers’ health status, quality of life, and burden of care. A systematic literature search on studies specifically adopting the CST protocol in patients with mild-to-moderate DSM-IV dementia – eventually involving their family members – was performed. A total of 238 papers were screened and 12 finally included in the qualitative analysis after inclusion/exclusion criteria were applied. The Jadad Scale and the Stroke Prevention and Educational Awareness Diffusion (SPREAD) method were used to appraise the studies’ methodological quality. Moderate levels of evidence emerged for general cognitive functioning, language comprehension and production, and quality of life. The levels of evidence were weaker for short-term memory, orientation, praxis, depression, social and emotional loneliness, behavior, and communication in people with dementia, and for their caregivers’ health status and anxiety symptoms. Albeit with the limited quality of reviewed evidence, and the need for more studies on CST, the present review highlights the value of this program as part of dementia care services to sustain the cognitive functioning and quality of life of people with dementia.
The findings confirm the efficacy, at least in the short term, of the CST in sustaining cognitive functions and perceived quality of life in older adults with dementia in the Italian care setting as well.
This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies.
ABSTRACT.Background:Cognitive stimulation therapy (CST) is an evidence-based psychosocial intervention for people with mild-to-moderate dementia due to various etiological factors.Objective:The aim of the present study was to assess the efficacy of the CST program, Italian adaptation -CST-IT-, in individuals who have vascular dementia (VaD).Methods:Older adults with mild-to-moderate VaD (N = 35) were assigned to one of two programs: one group (N = 21) attended the 14 sessions of the CST-IT program, while the other, active control group (N = 14) took part in alternative activities. The following domains were examined: cognitive functioning, quality of life, mood, behavior, functional activities of daily living.Results:Compared with the active controls, the CST-IT group showed a greater improvement in general cognitive functioning after the intervention (i.e. score increase on the Mini-Mental State Examination and decrease on the Alzheimer's Disease Assessment Scale – Cognitive subscale). A trend towards improvement was also identified in short-term/working memory – the backward digit span task- and perceived quality of life (Quality of Life – Alzheimer's Disease scale). No significant differences emerged between the two groups for the other domains considered.Conclusion:The present results support the efficacy of CST in people with vascular dementia.
Art heritage cities are popular tourist destinations but for many of them overcrowding is becoming an issue. In this paper, we address the problem of modeling and analytically studying the flow of tourists along the narrow alleys of the historic center of a heritage city. We initially present a mean field game model, where both continuous and switching decisional variables are introduced to respectively describe the position of a tourist and the point of interest that it may visit. We prove the existence of a mean field game equilibrium. A mean field game equilibrium is Nash-type equilibrium in the case of infinitely many players. Then, we study an optimization problem for an external controller who aims to induce a suitable mean field game equilibrium.Keywords Tourist flow optimal control · mean field games · switching variables · dynamics on networks Mathematics Subject Classification (2010) 91A13 · 49L20 · 90B20 · 91A80
A survey and some new results are presented concerning the dynamic programming for a class of optimal control problems of partial differential equations with age-structure and of delay systems that include some applied examples from economic theory and from population dynamics. A general optimal control problem in Hilbert spaces applying to all examples is investigated, with particular stress on one family of applications: optimal investment models with vintage capital. Some new results are given for the case of constrained investments, including a study of the properties of the optimal trajectories.age-structured systems, optimal control, economic growth, vintage models,
The Dynamic Programming approach for a family of optimal investment models with vintage capital is here developed. The problem falls into the class of infinite horizon optimal control problems of PDE's with age structure that have been studied in various papers (see e.g. [11,12], [30,32]) either in cases when explicit solutions can be found or using Maximum Principle techniques.The problem is rephrased into an infinite dimensional setting, it is proven that the value function is the unique regular solution of the associated stationary Hamilton-Jacobi-Bellman equation, and existence and uniqueness of optimal feedback controls is derived. It is then shown that the optimal path is the solution to the closed loop equation. Similar results were proven in the case of finite horizon in [26][27]. The case of infinite horizon is more challenging as a mathematical problem, and indeed more interesting from the point of view of optimal investment models with vintage capital, where what mainly matters is the behavior of optimal trajectories and controls in the long run.The study of infinite horizon is performed through a nontrivial limiting procedure from the corresponding finite horizon problems.
International audienceThe paper provides a continuous-time version of the discrete-time Mitra–Wan model of optimal forest management, where trees are harvested to maximize the utility of timber flow over an infinite time horizon. The available trees and the other parameters of the problem vary continuously with respect to both time and age of the trees, so that the system is ruled by a partial differential equation. The behavior of optimal or maximal couples is classified in the cases of linear, concave or strictly concave utility, and positive or null discount rate. All sets of data share the common feature that optimal controls need to be more general than functions, i.e. positive measures. Formulas are provided for golden-rule configurations (uniform density functions with cutting at the ages that solve a Faustmann problem) and for Faustmann policies, and their optimality/maximality is discussed. The results do not always confirm the corresponding ones in discrete time
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