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The present study thus aimed at: (i) providing updated, region-specific normative data for the Italian MoCA and its sub-tests (ii) comparing existing norms for the MoCA in the Italian population to those drawn from a region-specific Italian sample (iii) providing IRT-based information regarding sensitivity and discriminative capability of MoCA items in an Italian population sample.įive hundred and seventy nine healthy Italian native speakers were recruited in Lombardy, Northern Italy. It is furthermore worth highlighting that rapid socio-demographic changes may pose additional challenges to practitioners when drawing up-to-date clinical inferences since norms need to be frequently renewed. Therefore, providing region-/culture-specific psychometric fine-grained outcomes and normative data can ameliorate I-level cognitive testing in both clinical and research contexts. Cultural differences within a same country have been indeed highlighted as a relevant confounding predictor when interpreting test scores. įurther improvements to adaptive testing may come from deriving norms that account for inter-regional socio-demographic heterogeneity. IRT-based analyses indeed proved to yield relevant insights to performance interpretations for instance, executive- and memory-related items were often shown to be highly informative. To this last end, Item Response Theory (IRT) analyses have been conducted on MoCA items to assess both their sensitivity and discriminative capability. Moreover, information regarding single items can further help practitioners interpret test scores by qualitatively assigning different weights to different items. A widespread approach that allows a flexible use of cognitive screening tests is to provide norms for their domain-specific sub-tests. Psychometric investigations on the MoCA have been carried out both at the sub-test and the single-item levels. In Italy, the MoCA has been adapted and standardized-and both its statistical properties and clinical usability thoroughly examined. The MoCA is a rapid (5–10’) screening test which evaluates both non-instrumental (executive functioning, attention) and instrumental (language, memory, visuo-spatial abilities, orientation) domains. The Montreal Cognitive Assessment (MoCA) is one of the most widespread and psychometrically robust screening tools for cognitive impairments of graded severity. Fine-grained, adaptive psychometric approaches can thus help solve interpretation issues to facilitate diagnostic processes by magnifying informativity. Compared to screening tests for dementia, those aimed at detecting mild-to-moderate cognitive impairment may be harder for practitioners to interpret because of (a) the magnitude of the target construct (i.e., the deficit) being less obvious and (b) the amount of information provided by the test being limited. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA.Ĭognitive screening/first-level tests allow an estimate of global efficiency/functioning by adequately balancing between informativity and practicality of usage. Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Substantial disagreements with previous ESs classifications were detected. No sex differences were detected when tested along with age and education. ResultsĪge and education significantly predicted all MoCA measures except for Orientation, which was related to age only. Agreement with previous ESs classification was assessed via Cohen’s k. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination. Methodsįive hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females age: 63.4 ± 15, 21–96 education: 11.3 ± 4.6, 1–25) were administered the MoCA. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage (iii) information on sensitivity and discriminative capability at the item level. The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains. 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Click Review Appointment, then confirm your appointment.After you choose your appointment location and time, provide your contact information, and agree to the Terms and Conditions.The total time to get your passport includes both processing and mailing times. Processing times only include the time your application is at one of our passport agencies or centers. If you search by location first, you'll then be asked to choose a date and time if you search by date first, you'll then need to choose a location and time. Alert: Please use our online scheduler, a Post Office lobby self-service kiosk, or visit a Post Office retail counter to make an appointment for first-time. Mailing times are not included in processing times. passport photo when submitting an application by mail or. This image includes tips for taking a good U.S. Use a white or off-white background without shadows, texture, or lines.
If you've got an older computer that has a hard time with 64x, I highly recommend Dokucraft - it comes in lots of flavors and it's gorgeous even at 16x and 32x. Great for medieval related builds and survival world. (for the finished photos) Both are 64x and AWESOME. Minecraft: How to Build a Church Medieval Church (Tutorial)This video shows you how to build a church. The texture packs shown in this tutorial are Chroma Hills RPG (during the building) and Triton Core V2.
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Mary of Bethany! But that’s just it: we haven’t yet reached the story where Mary shines ( John 12:1-7). Read carefully John 11:2- Mary was the one who had anointed the Lord with perfumed oil and dried his feet with her hair it was her brother Lazarus who was ill. It is interesting that the author we call “John” expected his audience to be familiar with this story. Apparently with no surviving parents, these Judaean sisters, with brother dead, just lost any voice they could have and their social security besides! Raising Up a Well Known Johannine Story Lazarus rotting in his tomb is shamed, dishonored-this Beloved Disciple (don’t think John son of Zebedee) is abandoned by Jesus and his fellow followers in his darkest hour? And he is not the only one needing salvation from the shame of death! His sisters Mary and Martha equally need salvation from the sanction of shame. Another example would be when your beloved friends don’t show up at your time of need, or afterward, at your burial-that’s awfully shameful. For instance, a Middle Eastern family is shamed when, throwing a wedding, their neighbors and friends fail to help provide more wine when it runs out (sound familiar, John 2:1-12). Shame in this negative sense happens when others refuse to acknowledge or deny someone’s honor claim. Life at all levels of civilized society disintegrates when people are shamed. To be dishonored (or shamed) is a deadly circumstance. It indicates your emotions are under control, you won’t blow your top and derail social relations into a blood feud (“game over” in the Middle East).īut in the cultural world of the Scriptures, being shamed is terrible. To have shame means to not be shameless-therefore, shame in this sense is positive. Therefore, cultural insights from John Pilch and other Context Group scholars are of great assistance here.ĭespite sounding strange to American ears, in the Mediterranean world of the Bible, having shame is good! Having a sense of shame (i.e., concern for group honor) signifies that you are civilized and that you are committed to your community and its needs. And they most definitely are at work in this Gospel story. Here again is a shorthand overview of the story and its significance:Īlthough unseen by many 21 st century Western Bible readers, concerns for honor and shame very much on display everywhere in Scripture. Consequently, the story granted to them an awareness about reversals, life springing from the grave, joy of reunification emerging from the separation death brings. This final sign spoke volumes to the Johannine Jesus group. So then, according to Johannine thought, the very last public thing Jesus did was restore life to a beloved friend. 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