Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic ... more Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic modified Addenbrooke's CogniQve ExaminaQon--III (m--ACE--III) and to invesQgate the effects of age, gender and educaQon on test performance. Background: The ACE--III (2012) is a brief cogniQve ba]ery that assesses various aspects of cogniQon. Its 5 subdomains (A]enQon and OrientaQon, Memory, Verbal Fluency, Language, and VisuospaQal AbiliQes) are commonly impaired in Alzheimer disease and frontotemporal demenQa. Methods: We translated and adapted the ACE--III (2012) to the EgypQan populaQon. We evaluated this modified version on 77 cogniQvely healthy volunteers (50.6% men, 49.4% women) aged between 20 and 59 years. We straQfied the parQcipants both by age (20 to 34, 35 to 44, and 45 to 59 years) and by degree of educaQon (educaQon of university degree or above, or less than a university degree). None of the parQcipants had any complaints of cogniQve decline or history of neurological or psychiatric illness and none fulfilled the DiagnosQc and StaQsQcal Manual--IV criteria for depression.
BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery ... more BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery that assesses various aspects of cogni'on. Its 5 subdomains (ATen'on and Orienta'on, Memory, Verbal Fluency, Language, and Visuospa'al Abili'es) are commonly impaired in demen'as. OBJECTIVES: To describe the qualita've process of selec'on, transla'on and cultural adapta'on of ACE--III for use in the Egyp'an--Arabic speaking popula'on. METHOD: First, the ques'onnaire was translated into Arabic, and then back--translated into English. The process was then repeated un'l a consensus was reached about the op'mal transla'on. In addi'on, we modified the test to culturally adapt it to the Egyp'an popula'on. We modified the following parts of the ACE III: LeTer fluency, Name and address registra'on task, Knowledge memory task, Language repe''on tasks, Picture naming and recogni'on, Reading, Recogni'on of camouflaged pictures. The modified ACE III was then piloted on 20 subjects with no complaint of cogni've impairment. RESULTS: Pilot subjects included 13 males and 7 female. The mean age of the subjects was 42.85 (SD=18.32) years. Performance on the culturally--adopted items was as follows: on LeTer fluency subjects generated an average of 9.95 (SD=3.22) words per minute. Category fluency subjects generated an average of 31 (SD=15.7) words per minute. On comprehension, proverb repe''on and reading fragmented leTers, the subjects made no errors. 85% (n=17) of the subjects made no errors on knowledge task. On word repe''on, 95% (n=19) of the subjects made no errors. Of the 6 culturally--adapted pictures for the Egyp'an popula'on, 100% (n=20) of the subjects were able to correctly iden'fy the lion, Aud (Lute), and Lamp; 95% (n=19) of the subjects were able to correctly iden'fy a giraffe; 90% (n=18) of the subjects were able to correctly iden'fy a parrot; and only 55% were able to correctly iden'fy a violin. CONCLUSION: Egyp'an Arabic m--ACE III appears to be culturally equivalent aher all forms of biases or social norms specific to the culture of origin have been removed.
ABSTRACT There have been many socio-political and technological developments in the area of Elect... more ABSTRACT There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record; (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO); (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR; this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.
The British journal of psychiatry : the journal of mental science, Jan 9, 2016
The National Psychiatric Morbidity Surveys include English cross-sectional household samples surv... more The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007. To evaluate frequency of common mental disorders (CMDs), service contact and treatment. Common mental disorders were identified with the Clinical Interview Schedule - Revised (CIS-R). Service contact and treatment were established in structured interviews. There were 8615, 6126 and 5385 participants aged 16-64. Prevalence of CMDs was consistent (1993: 14.3%; 2000: 16.0%; 2007: 16.0%), as was past-year primary care physician contact for psychological problems (1993: 11.3%; 2000: 12.0%; 2007: 11.7%). Antidepressant receipt in people with CMDs more than doubled between 1993 (5.7%) and 2000 (14.5%), with little further increase by 2007 (15.9%). Psychological treatments increased in successive surveys. Many with CMDs received no treatment. Reduction in prevalence did not follow increased treatment uptake, and may require universal public health measures together w...
The objective of this study is to establish the effects of age, gender, and education and to prov... more The objective of this study is to establish the effects of age, gender, and education and to provide preliminary normative data for letter and category fluency tasks in the Egyptian Arabic-speaking population. We evaluated 139 cognitively healthy volunteers aged 20-93 by adapting the letter and category verbal fluency tasks for the Egyptian population. On the letter fluency task, mean number of words generated in one-minute beginning with the Arabic letter "Sheen" (pronounced "sh") was 8.14 words per minute (SD = 3.25). Letter fluency was significantly influenced by education. On category fluency tasks, mean number of animal names generated in one minute was 14.63 words (SD = 5.28). Category fluency was significantly influenced by age and education. We were able identify that age significantly affects category fluency while education significantly affected both letter and category fluency. We were also able to provide preliminary normative data for both tasks in the Egyptian population.
Results: In le&er fluency tasks, mean number of words generated in one minute beginning with the ... more Results: In le&er fluency tasks, mean number of words generated in one minute beginning with the Arabic le&er "Sheen" (pronounced "sh") was 8.17 (SD=3.28). Le&er fluency was significantly influenced by bi/mulLlingualism (p=0.017, regression co--efficient=1.683), and by degree of educaLon (p=0.001, regression co--efficient=0.811). In le&er fluency task, age had no significant effect (p>0.05). In category fluency tasks, mean number of names of animals in one minute was 14.85 (SD=5.376). Category fluency was significantly influenced by bi/mulLlingualism (p=0.045, regression co--efficient=2.184), age (p<0.001, regression co--efficient=--.116 ) and educaLon (p=0.037, regression co--efficient=0.711) . In either tasks gender and social class had no significant effect (p>0.05).
2014 Ninth International Conference on P2p Parallel Grid Cloud and Internet Computing, Nov 8, 2014
Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have... more Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have devastating impact on patients, carers and their loved ones. In this paper we argue that with the combined use of pervasive computing and big data, we could make significant progress in the diagnosis of the causes of BPSD, monitoring response to treatment and helping in the prevention of these symptoms. We review the available technologies, such as Cloud computing and context aware systems, and how they could help in managing and hopefully preventing the Behavioural and Psychological Symptoms of Dementia.
2015 9th International Conference on Innovative Mobile and Internet Services in Ubiquitous Computing, 2015
Mental disorders impose significant socio-economic and geo-political challenges which, if not add... more Mental disorders impose significant socio-economic and geo-political challenges which, if not addressed, have the potential to overwhelm the ability of healthcare systems globally to accommodate the growing demands both in human and resource management terms. From a treatment perspective there is a need to implement multi-modal systems where patients can be diagnosed, treated, and monitored. Such systems must incorporate triage and treatment capabilities in both hospital settings with monitoring in the community. This paper considers the practical challenges in realising the goal of achieving the effective monitoring of patients with mental disorders in Smart-Psychiatric Intensive Care Units and in the community. Illustrative scenarios are presented. We conclude that effective patient monitoring will provide benefits for all stakeholders in the management of mental disorders.
Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic ... more Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic modified Addenbrooke's CogniQve ExaminaQon--III (m--ACE--III) and to invesQgate the effects of age, gender and educaQon on test performance. Background: The ACE--III (2012) is a brief cogniQve ba]ery that assesses various aspects of cogniQon. Its 5 subdomains (A]enQon and OrientaQon, Memory, Verbal Fluency, Language, and VisuospaQal AbiliQes) are commonly impaired in Alzheimer disease and frontotemporal demenQa. Methods: We translated and adapted the ACE--III (2012) to the EgypQan populaQon. We evaluated this modified version on 77 cogniQvely healthy volunteers (50.6% men, 49.4% women) aged between 20 and 59 years. We straQfied the parQcipants both by age (20 to 34, 35 to 44, and 45 to 59 years) and by degree of educaQon (educaQon of university degree or above, or less than a university degree). None of the parQcipants had any complaints of cogniQve decline or history of neurological or psychiatric illness and none fulfilled the DiagnosQc and StaQsQcal Manual--IV criteria for depression.
BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery ... more BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery that assesses various aspects of cogni'on. Its 5 subdomains (ATen'on and Orienta'on, Memory, Verbal Fluency, Language, and Visuospa'al Abili'es) are commonly impaired in demen'as. OBJECTIVES: To describe the qualita've process of selec'on, transla'on and cultural adapta'on of ACE--III for use in the Egyp'an--Arabic speaking popula'on. METHOD: First, the ques'onnaire was translated into Arabic, and then back--translated into English. The process was then repeated un'l a consensus was reached about the op'mal transla'on. In addi'on, we modified the test to culturally adapt it to the Egyp'an popula'on. We modified the following parts of the ACE III: LeTer fluency, Name and address registra'on task, Knowledge memory task, Language repe''on tasks, Picture naming and recogni'on, Reading, Recogni'on of camouflaged pictures. The modified ACE III was then piloted on 20 subjects with no complaint of cogni've impairment. RESULTS: Pilot subjects included 13 males and 7 female. The mean age of the subjects was 42.85 (SD=18.32) years. Performance on the culturally--adopted items was as follows: on LeTer fluency subjects generated an average of 9.95 (SD=3.22) words per minute. Category fluency subjects generated an average of 31 (SD=15.7) words per minute. On comprehension, proverb repe''on and reading fragmented leTers, the subjects made no errors. 85% (n=17) of the subjects made no errors on knowledge task. On word repe''on, 95% (n=19) of the subjects made no errors. Of the 6 culturally--adapted pictures for the Egyp'an popula'on, 100% (n=20) of the subjects were able to correctly iden'fy the lion, Aud (Lute), and Lamp; 95% (n=19) of the subjects were able to correctly iden'fy a giraffe; 90% (n=18) of the subjects were able to correctly iden'fy a parrot; and only 55% were able to correctly iden'fy a violin. CONCLUSION: Egyp'an Arabic m--ACE III appears to be culturally equivalent aher all forms of biases or social norms specific to the culture of origin have been removed.
Background: Cognitive impairment in amnestic mild cognitive impairment (AMCI) appears associated ... more Background: Cognitive impairment in amnestic mild cognitive impairment (AMCI) appears associated with decreased brain activation in prefrontal cortex (PFC). Near infrared spectroscopy hemoencephalography applied to cortex can be used to provide biofeedback signals enabling voluntary control of brain activation, this is known as neurofeedback training (NT). Aims: We conducted a pilot study of NT of the PFC in AMCI in order to establish tolerability and treatment protocols. Method: Ten patients completed 12 weekly NT sessions. Results: All patients were able to obtain voluntary control of PFC activation. NT was well tolerated and only mild self-limiting headache was reported in two patients. In this small preliminary sample repeated behavioural measures revealed near significant trends for improved immediate and episodic memory and medium effect size for the same variables. Conclusions: These initial results indicate that NT of relevant cortical areas in AMCI warrants further investig...
2014 International Conference on Intelligent Networking and Collaborative Systems, 2014
ABSTRACT There have been many socio-political and technological developments in the area of Elect... more ABSTRACT There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record; (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO); (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR; this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.
ABSTRACT ntroduction: The Addenbrooke’s Cognitive Examination III (ACE-III) (2012) is a brief cog... more ABSTRACT ntroduction: The Addenbrooke’s Cognitive Examination III (ACE-III) (2012) is a brief cognitive battery that assesses various aspects of cognition. Its five subdomains (attention and orientation, memory, verbal fluency, language and visuospatial abilities) are commonly impaired in Alzheimer’s disease and frontotemporal dementia. Objective: The aim of the study was to provide normative data for healthy adult performance on Egyptian–Arabic ACE-III. Participants and methods: We adapted the ACE-III (2012) to the Egyptian population. We evaluated this version on 139 cognitively healthy volunteers aged 20 years or older (54.7% male and 45.3% female). We stratified the participants both by age (&lt;60 years and &gt;60 years) and by degree of education (basic, secondary or university education). None of the participants had any complaints of cognitive decline. Results: We established normative data for healthy Egyptian adults below 60 years and above 60 years on each of the subdomains of the ACE-III. The data generated from the performance was assigned according to percentiles. We found a significant difference (P&lt;0.001) between the performance of older and younger adults on the category task of the verbal fluency test. Conclusion: By adapting the ACE-III to the Egyptian–Arabic population, we were able to establish normative data for healthy Egyptian adults.
2014 Ninth International Conference on P2P, Parallel, Grid, Cloud and Internet Computing, 2014
Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have... more Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have devastating impact on patients, carers and their loved ones. In this paper we argue that with the combined use of pervasive computing and big data, we could make significant progress in the diagnosis of the causes of BPSD, monitoring response to treatment and helping in the prevention of these symptoms. We review the available technologies, such as Cloud computing and context aware systems, and how they could help in managing and hopefully preventing the Behavioural and Psychological Symptoms of Dementia.
Objectives: Dementia with Lewy bodies (DLB) accounts for 10%e15% of dementia cases at autopsy and... more Objectives: Dementia with Lewy bodies (DLB) accounts for 10%e15% of dementia cases at autopsy and has distinct clinical features associated with earlier institutionalisation and a higher level of carer distress than are seen in Alzheimer's disease (AD). At present, there is on-going debate as to whether DLB is associated with a more rapid cognitive decline than AD. An understanding of the rate of decline of cognitive and non-cognitive symptoms in DLB may help patients and carers to plan for the future.
Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical s... more Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score.
ABSTRACT Background: Bipolar disorder has been identified as the sixth cause of disability among ... more ABSTRACT Background: Bipolar disorder has been identified as the sixth cause of disability among all medical illnesses, as it had been widely accepted that patients recovered completely and remain free in-between episodes. However, recent studies have shown that euthymic bipolar patients continue to have psychosocial difficulties and have reduced ability to regain premorbid levels of social and vocational functioning even after episodes of remission, suggesting that a gap exists between syndromal recovery and functional recovery, and this gap may be because of cognitive impairments. Cognitive deficits, most notably in attention, verbal learning, and executive function, can be observed across multiple phases of bipolar disorder. Aim of the study: To show the range of neuropsychological deficits in the various cognitive domains in euthymic bipolar I patients depending on the previous clinical state and to correlate these cognitive deficits with illness characteristics and profile. Participants and methods: This was a case–control study that included 60 patients divided into two major groups: a stratified random sample of 30 patients in the euthymic phase of bipolar I disorders and a control group. The patient group was diagnosed using Structured Clinical Interview for DSM-IV (SCID-I) and the euthymic state was determined using the Young Mania Rating Scale (YMRS) and the Hamilton Rating Scale for Depression (HRSD); we used Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale-Revised (WMSR) for cognitive assessment. Results: Euthymic patients with bipolar I performed poorer than controls on tests of intelligence, attention, memory, and executive functions. Performance on most domains of Wechsler Adult Intelligence Scale (WAIS) was associated with age of onset of illness and the number of depressive episodes. These differences were statistically significant, with residual symptoms not reaching clinical significance. Conclusion: We conclude that cognitive deficits associated with euthymia in bipolar disorder can be considered both a consequence of the disorder and a determinant of outcome in recovery for bipolar I disorder.
Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic ... more Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic modified Addenbrooke's CogniQve ExaminaQon--III (m--ACE--III) and to invesQgate the effects of age, gender and educaQon on test performance. Background: The ACE--III (2012) is a brief cogniQve ba]ery that assesses various aspects of cogniQon. Its 5 subdomains (A]enQon and OrientaQon, Memory, Verbal Fluency, Language, and VisuospaQal AbiliQes) are commonly impaired in Alzheimer disease and frontotemporal demenQa. Methods: We translated and adapted the ACE--III (2012) to the EgypQan populaQon. We evaluated this modified version on 77 cogniQvely healthy volunteers (50.6% men, 49.4% women) aged between 20 and 59 years. We straQfied the parQcipants both by age (20 to 34, 35 to 44, and 45 to 59 years) and by degree of educaQon (educaQon of university degree or above, or less than a university degree). None of the parQcipants had any complaints of cogniQve decline or history of neurological or psychiatric illness and none fulfilled the DiagnosQc and StaQsQcal Manual--IV criteria for depression.
BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery ... more BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery that assesses various aspects of cogni'on. Its 5 subdomains (ATen'on and Orienta'on, Memory, Verbal Fluency, Language, and Visuospa'al Abili'es) are commonly impaired in demen'as. OBJECTIVES: To describe the qualita've process of selec'on, transla'on and cultural adapta'on of ACE--III for use in the Egyp'an--Arabic speaking popula'on. METHOD: First, the ques'onnaire was translated into Arabic, and then back--translated into English. The process was then repeated un'l a consensus was reached about the op'mal transla'on. In addi'on, we modified the test to culturally adapt it to the Egyp'an popula'on. We modified the following parts of the ACE III: LeTer fluency, Name and address registra'on task, Knowledge memory task, Language repe''on tasks, Picture naming and recogni'on, Reading, Recogni'on of camouflaged pictures. The modified ACE III was then piloted on 20 subjects with no complaint of cogni've impairment. RESULTS: Pilot subjects included 13 males and 7 female. The mean age of the subjects was 42.85 (SD=18.32) years. Performance on the culturally--adopted items was as follows: on LeTer fluency subjects generated an average of 9.95 (SD=3.22) words per minute. Category fluency subjects generated an average of 31 (SD=15.7) words per minute. On comprehension, proverb repe''on and reading fragmented leTers, the subjects made no errors. 85% (n=17) of the subjects made no errors on knowledge task. On word repe''on, 95% (n=19) of the subjects made no errors. Of the 6 culturally--adapted pictures for the Egyp'an popula'on, 100% (n=20) of the subjects were able to correctly iden'fy the lion, Aud (Lute), and Lamp; 95% (n=19) of the subjects were able to correctly iden'fy a giraffe; 90% (n=18) of the subjects were able to correctly iden'fy a parrot; and only 55% were able to correctly iden'fy a violin. CONCLUSION: Egyp'an Arabic m--ACE III appears to be culturally equivalent aher all forms of biases or social norms specific to the culture of origin have been removed.
ABSTRACT There have been many socio-political and technological developments in the area of Elect... more ABSTRACT There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record; (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO); (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR; this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.
The British journal of psychiatry : the journal of mental science, Jan 9, 2016
The National Psychiatric Morbidity Surveys include English cross-sectional household samples surv... more The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007. To evaluate frequency of common mental disorders (CMDs), service contact and treatment. Common mental disorders were identified with the Clinical Interview Schedule - Revised (CIS-R). Service contact and treatment were established in structured interviews. There were 8615, 6126 and 5385 participants aged 16-64. Prevalence of CMDs was consistent (1993: 14.3%; 2000: 16.0%; 2007: 16.0%), as was past-year primary care physician contact for psychological problems (1993: 11.3%; 2000: 12.0%; 2007: 11.7%). Antidepressant receipt in people with CMDs more than doubled between 1993 (5.7%) and 2000 (14.5%), with little further increase by 2007 (15.9%). Psychological treatments increased in successive surveys. Many with CMDs received no treatment. Reduction in prevalence did not follow increased treatment uptake, and may require universal public health measures together w...
The objective of this study is to establish the effects of age, gender, and education and to prov... more The objective of this study is to establish the effects of age, gender, and education and to provide preliminary normative data for letter and category fluency tasks in the Egyptian Arabic-speaking population. We evaluated 139 cognitively healthy volunteers aged 20-93 by adapting the letter and category verbal fluency tasks for the Egyptian population. On the letter fluency task, mean number of words generated in one-minute beginning with the Arabic letter &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Sheen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (pronounced &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sh&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;) was 8.14 words per minute (SD = 3.25). Letter fluency was significantly influenced by education. On category fluency tasks, mean number of animal names generated in one minute was 14.63 words (SD = 5.28). Category fluency was significantly influenced by age and education. We were able identify that age significantly affects category fluency while education significantly affected both letter and category fluency. We were also able to provide preliminary normative data for both tasks in the Egyptian population.
Results: In le&er fluency tasks, mean number of words generated in one minute beginning with the ... more Results: In le&er fluency tasks, mean number of words generated in one minute beginning with the Arabic le&er "Sheen" (pronounced "sh") was 8.17 (SD=3.28). Le&er fluency was significantly influenced by bi/mulLlingualism (p=0.017, regression co--efficient=1.683), and by degree of educaLon (p=0.001, regression co--efficient=0.811). In le&er fluency task, age had no significant effect (p>0.05). In category fluency tasks, mean number of names of animals in one minute was 14.85 (SD=5.376). Category fluency was significantly influenced by bi/mulLlingualism (p=0.045, regression co--efficient=2.184), age (p<0.001, regression co--efficient=--.116 ) and educaLon (p=0.037, regression co--efficient=0.711) . In either tasks gender and social class had no significant effect (p>0.05).
2014 Ninth International Conference on P2p Parallel Grid Cloud and Internet Computing, Nov 8, 2014
Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have... more Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have devastating impact on patients, carers and their loved ones. In this paper we argue that with the combined use of pervasive computing and big data, we could make significant progress in the diagnosis of the causes of BPSD, monitoring response to treatment and helping in the prevention of these symptoms. We review the available technologies, such as Cloud computing and context aware systems, and how they could help in managing and hopefully preventing the Behavioural and Psychological Symptoms of Dementia.
2015 9th International Conference on Innovative Mobile and Internet Services in Ubiquitous Computing, 2015
Mental disorders impose significant socio-economic and geo-political challenges which, if not add... more Mental disorders impose significant socio-economic and geo-political challenges which, if not addressed, have the potential to overwhelm the ability of healthcare systems globally to accommodate the growing demands both in human and resource management terms. From a treatment perspective there is a need to implement multi-modal systems where patients can be diagnosed, treated, and monitored. Such systems must incorporate triage and treatment capabilities in both hospital settings with monitoring in the community. This paper considers the practical challenges in realising the goal of achieving the effective monitoring of patients with mental disorders in Smart-Psychiatric Intensive Care Units and in the community. Illustrative scenarios are presented. We conclude that effective patient monitoring will provide benefits for all stakeholders in the management of mental disorders.
Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic ... more Objec&ve: To provide normaQve data for healthy younger adults performance on the EgypQan--Arabic modified Addenbrooke's CogniQve ExaminaQon--III (m--ACE--III) and to invesQgate the effects of age, gender and educaQon on test performance. Background: The ACE--III (2012) is a brief cogniQve ba]ery that assesses various aspects of cogniQon. Its 5 subdomains (A]enQon and OrientaQon, Memory, Verbal Fluency, Language, and VisuospaQal AbiliQes) are commonly impaired in Alzheimer disease and frontotemporal demenQa. Methods: We translated and adapted the ACE--III (2012) to the EgypQan populaQon. We evaluated this modified version on 77 cogniQvely healthy volunteers (50.6% men, 49.4% women) aged between 20 and 59 years. We straQfied the parQcipants both by age (20 to 34, 35 to 44, and 45 to 59 years) and by degree of educaQon (educaQon of university degree or above, or less than a university degree). None of the parQcipants had any complaints of cogniQve decline or history of neurological or psychiatric illness and none fulfilled the DiagnosQc and StaQsQcal Manual--IV criteria for depression.
BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery ... more BACKGROUND: The Addenbrooke's Cogni've Examina'on III ACE--III (2012) is a brief cogni've baTery that assesses various aspects of cogni'on. Its 5 subdomains (ATen'on and Orienta'on, Memory, Verbal Fluency, Language, and Visuospa'al Abili'es) are commonly impaired in demen'as. OBJECTIVES: To describe the qualita've process of selec'on, transla'on and cultural adapta'on of ACE--III for use in the Egyp'an--Arabic speaking popula'on. METHOD: First, the ques'onnaire was translated into Arabic, and then back--translated into English. The process was then repeated un'l a consensus was reached about the op'mal transla'on. In addi'on, we modified the test to culturally adapt it to the Egyp'an popula'on. We modified the following parts of the ACE III: LeTer fluency, Name and address registra'on task, Knowledge memory task, Language repe''on tasks, Picture naming and recogni'on, Reading, Recogni'on of camouflaged pictures. The modified ACE III was then piloted on 20 subjects with no complaint of cogni've impairment. RESULTS: Pilot subjects included 13 males and 7 female. The mean age of the subjects was 42.85 (SD=18.32) years. Performance on the culturally--adopted items was as follows: on LeTer fluency subjects generated an average of 9.95 (SD=3.22) words per minute. Category fluency subjects generated an average of 31 (SD=15.7) words per minute. On comprehension, proverb repe''on and reading fragmented leTers, the subjects made no errors. 85% (n=17) of the subjects made no errors on knowledge task. On word repe''on, 95% (n=19) of the subjects made no errors. Of the 6 culturally--adapted pictures for the Egyp'an popula'on, 100% (n=20) of the subjects were able to correctly iden'fy the lion, Aud (Lute), and Lamp; 95% (n=19) of the subjects were able to correctly iden'fy a giraffe; 90% (n=18) of the subjects were able to correctly iden'fy a parrot; and only 55% were able to correctly iden'fy a violin. CONCLUSION: Egyp'an Arabic m--ACE III appears to be culturally equivalent aher all forms of biases or social norms specific to the culture of origin have been removed.
Background: Cognitive impairment in amnestic mild cognitive impairment (AMCI) appears associated ... more Background: Cognitive impairment in amnestic mild cognitive impairment (AMCI) appears associated with decreased brain activation in prefrontal cortex (PFC). Near infrared spectroscopy hemoencephalography applied to cortex can be used to provide biofeedback signals enabling voluntary control of brain activation, this is known as neurofeedback training (NT). Aims: We conducted a pilot study of NT of the PFC in AMCI in order to establish tolerability and treatment protocols. Method: Ten patients completed 12 weekly NT sessions. Results: All patients were able to obtain voluntary control of PFC activation. NT was well tolerated and only mild self-limiting headache was reported in two patients. In this small preliminary sample repeated behavioural measures revealed near significant trends for improved immediate and episodic memory and medium effect size for the same variables. Conclusions: These initial results indicate that NT of relevant cortical areas in AMCI warrants further investig...
2014 International Conference on Intelligent Networking and Collaborative Systems, 2014
ABSTRACT There have been many socio-political and technological developments in the area of Elect... more ABSTRACT There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record; (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO); (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR; this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.
ABSTRACT ntroduction: The Addenbrooke’s Cognitive Examination III (ACE-III) (2012) is a brief cog... more ABSTRACT ntroduction: The Addenbrooke’s Cognitive Examination III (ACE-III) (2012) is a brief cognitive battery that assesses various aspects of cognition. Its five subdomains (attention and orientation, memory, verbal fluency, language and visuospatial abilities) are commonly impaired in Alzheimer’s disease and frontotemporal dementia. Objective: The aim of the study was to provide normative data for healthy adult performance on Egyptian–Arabic ACE-III. Participants and methods: We adapted the ACE-III (2012) to the Egyptian population. We evaluated this version on 139 cognitively healthy volunteers aged 20 years or older (54.7% male and 45.3% female). We stratified the participants both by age (&lt;60 years and &gt;60 years) and by degree of education (basic, secondary or university education). None of the participants had any complaints of cognitive decline. Results: We established normative data for healthy Egyptian adults below 60 years and above 60 years on each of the subdomains of the ACE-III. The data generated from the performance was assigned according to percentiles. We found a significant difference (P&lt;0.001) between the performance of older and younger adults on the category task of the verbal fluency test. Conclusion: By adapting the ACE-III to the Egyptian–Arabic population, we were able to establish normative data for healthy Egyptian adults.
2014 Ninth International Conference on P2P, Parallel, Grid, Cloud and Internet Computing, 2014
Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have... more Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have devastating impact on patients, carers and their loved ones. In this paper we argue that with the combined use of pervasive computing and big data, we could make significant progress in the diagnosis of the causes of BPSD, monitoring response to treatment and helping in the prevention of these symptoms. We review the available technologies, such as Cloud computing and context aware systems, and how they could help in managing and hopefully preventing the Behavioural and Psychological Symptoms of Dementia.
Objectives: Dementia with Lewy bodies (DLB) accounts for 10%e15% of dementia cases at autopsy and... more Objectives: Dementia with Lewy bodies (DLB) accounts for 10%e15% of dementia cases at autopsy and has distinct clinical features associated with earlier institutionalisation and a higher level of carer distress than are seen in Alzheimer's disease (AD). At present, there is on-going debate as to whether DLB is associated with a more rapid cognitive decline than AD. An understanding of the rate of decline of cognitive and non-cognitive symptoms in DLB may help patients and carers to plan for the future.
Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical s... more Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score.
ABSTRACT Background: Bipolar disorder has been identified as the sixth cause of disability among ... more ABSTRACT Background: Bipolar disorder has been identified as the sixth cause of disability among all medical illnesses, as it had been widely accepted that patients recovered completely and remain free in-between episodes. However, recent studies have shown that euthymic bipolar patients continue to have psychosocial difficulties and have reduced ability to regain premorbid levels of social and vocational functioning even after episodes of remission, suggesting that a gap exists between syndromal recovery and functional recovery, and this gap may be because of cognitive impairments. Cognitive deficits, most notably in attention, verbal learning, and executive function, can be observed across multiple phases of bipolar disorder. Aim of the study: To show the range of neuropsychological deficits in the various cognitive domains in euthymic bipolar I patients depending on the previous clinical state and to correlate these cognitive deficits with illness characteristics and profile. Participants and methods: This was a case–control study that included 60 patients divided into two major groups: a stratified random sample of 30 patients in the euthymic phase of bipolar I disorders and a control group. The patient group was diagnosed using Structured Clinical Interview for DSM-IV (SCID-I) and the euthymic state was determined using the Young Mania Rating Scale (YMRS) and the Hamilton Rating Scale for Depression (HRSD); we used Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale-Revised (WMSR) for cognitive assessment. Results: Euthymic patients with bipolar I performed poorer than controls on tests of intelligence, attention, memory, and executive functions. Performance on most domains of Wechsler Adult Intelligence Scale (WAIS) was associated with age of onset of illness and the number of depressive episodes. These differences were statistically significant, with residual symptoms not reaching clinical significance. Conclusion: We conclude that cognitive deficits associated with euthymia in bipolar disorder can be considered both a consequence of the disorder and a determinant of outcome in recovery for bipolar I disorder.
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Papers by Tarik Qassem