Talking bodies: nonverbal behavior in the assessment of depression severity

BACKGROUND: Evaluations of clinical depression are traditionally based on verbal information. Nonverbal expressive behavior, however, being associated with a person's reflexive responses, may reveal negative emotional or social processes that are not under complete control of the patients. However, investigations of nonverbal behavior in the evaluation of depressed patients are still scarce. This study examines the nonverbal behaviors of a group of Brazilian patients, associating their nonverbal behavior with severity of depression. METHODS: Forty depressed patients were evaluated at baseline (T0) and after a two-week transcranial direct current stimulation treatment (T1), according to rating scales and through a 21-category Ethogram for assessment of the frequency of nonverbal behaviors displayed during an interview. RESULTS: Behaviors that were related to negative feelings and social disinterest decreased with corresponding clinical improvement and were associated with increased severity of symptoms at T0 and greater negative affect and dissatisfaction at T1. Pro-social behaviors were associated with milder symptoms at T0 and increased after treatment. Facial, head and hand expressive movements stood out as important indicators because of their associations with severity of depression. LIMITATIONS: Duration of behaviors was not assessed and there was not a healthy control group with which to compare the findings. CONCLUSIONS: These results support the usefulness of nonverbal behavior as an evaluation technique in the assessment of clinical depression.

THE PERCEPTION AND UNDERSTANDING OF HEALTH PROFESSIONALS AND UNDERGRADUATE STUDENTS REGARDING AGING AND THE ELDERLY

This qualitative study was developed with 117 healthcare professionals and undergraduate students who were participants of a non-verbal communication training program in gerontology, with the objective to identify the perception and understanding of healthcare undergraduates and graduates regarding aging and the elderly. The results allowed the construction of the following categories: an evolution of life that brings a variety of experiences; natural, mysterious and with accumulated experiences; a decrease in overall happiness due to an increase in isolation; a time of valuing affection and respect; an inevitable stage including distress, prejudice, and limitations worthy of attention; a natural consequence of life; and the presence of disease and the global physiological process. Regarding perceptions of the elderly, the answers were classified as positive, negative, mixed and neutral. We considered that the understanding regarding the elderly and aging was limited and pessimist, indicating a need to become aware that one's views affect the way we relate to others.

Semantic Dementia Versus Nonfluent Progressive Aphasia Neuropsychological Characterization and Differentiation

Background: Early progressive nonfluent aphasia (PNFA) may be difficult to differentiate from semantic dementia (SD) in a nonspecialist setting. There are descriptions of the clinical and neuropsychological profiles of patients with PNFA and SD but few systematic comparisons. Method: We compared the performance of groups with SD (n = 27) and PNFA (n = 16) with comparable ages, education, disease duration, and severity of dementia as measured by the Clinical Dementia Rating Scale on a comprehensive neuropsychological battery. Principal components analysis and intergroup comparisons were used. Results: A 5-factor solution accounted for 78.4% of the total variance with good separation of neuropsychological variables. As expected, both groups were anomic with preserved visuospatial function and mental speed. Patients with SD had lower scores on comprehension-based semantic tests and better performance on verbal working memory and phonological processing tasks. The opposite pattern was found in the PNFA group. Conclusions: Neuropsychological tests that examine verbal and nonverbal semantic associations, verbal working memory, and phonological processing are the most helpful for distinguishing between PNFA and SD.

Potential Contribution of Translational Factors to Triiodo-L-Thyronine-Induced Insulin Synthesis by Pancreatic Beta Cells

Background: Thyroid hormones (THs) are known to regulate protein synthesis by acting at the transcriptional level and inducing the expression of many genes. However, little is known about their role in protein expression at the post-transcriptional level, even though studies have shown enhancement of protein synthesis associated with mTOR/p70S6K activation after triiodo-l-thyronine (T3) administration. On the other hand, the effects of TH on translation initiation and polypeptidic chain elongation factors, being essential for activating protein synthesis, have been poorly explored. Therefore, considering that preliminary studies from our laboratory have demonstrated an increase in insulin content in INS-1E cells in response to T3 treatment, the aim of the present study was to investigate if proteins of translational nature might be involved in this effect. Methods: INS-1E cells were maintained in the presence or absence of T3 (10(-6) or 10(-8) M) for 12 hours. Thereafter, insulin concentration in the culture medium was determined by radioimmunoassay, and the cells were processed for Western blot detection of insulin, eukaryotic initiation factor 2 (eIF2), p-eIF2, eIF5A, EF1A, eIF4E binding protein (4E-BP), p-4E-BP, p70S6K, and p-p70S6K. Results: It was found that, in parallel with increased insulin generation, T3 induced p70S6K phosphorylation and the expression of the translational factors eIF2, eIF5A, and eukaryotic elongation factor 1 alpha (eEF1A). In contrast, total and phosphorylated 4E-BP, as well as total p70S6K and p-eIF2 content, remained unchanged after T3 treatment. Conclusions: Considering that (i) p70S6K induces S6 phosphorylation of the 40S ribosomal subunit, an essential condition for protein synthesis; (ii) eIF2 is essential for the initiation of messenger RNA translation process; and (iii) eIF5A and eEF1A play a central role in the elongation of the polypeptidic chain during the transcripts decoding, the data presented here lead us to suppose that a part of T3-induced insulin expression in INS-1E cells depends on the protein synthesis activation at the post-transcriptional level, as these proteins of the translational machinery were shown to be regulated by T3.

Fatores ambientais como coadjuvantes na comunicação e no cuidar do idoso hospitalizado

Estudo exploratório com abordagem qualitativa desenvolvido com 117 graduandos e profissionais da área da saúde, no interior paulista, com o objetivo de identificar os fatores ambientais que interferem na comunicação do profissional da saúde com o idoso. As respostas puderam ser ordenadas e analisadas em sete agrupamentos: fatores sonoros e vibratórios, decorativos e espaciais, luminosos, cores e texturas, térmicos e ventilatórios, higiênicos e de segurança profissional e sinalizadores visuais. Considera-se que a utilização dos fatores ambientais durante o processo de cuidar seja uma possibilidade efetiva do cuidado, uma vez que interfere no bem estar do idoso, na sua recuperação e no relacionamento entre o binômio profissional-idoso.

Percepção e compreensão de profissionais e graduandos de saúde sobre o idoso e o envelhecimento humano

Estudo qualitativo desenvolvido com 117 profissionais e graduandos na área da saúde, que participaram da capacitação em comunicação não verbal em gerontologia, com objetivo de identificar a percepção e compreensão de graduandos e graduados da área da saúde, sobre o que é o idoso e o envelhecimento humano. Os resultados sobre o entendimento sobre envelhecimento humano permitiu a construção das categorias: evolução da vida que traz experiências; natural, misteriosa e com experiências acumuladas; perda da alegria e ganho do isolamento; época de valorização do carinho e respeito; etapa inevitável com desgaste, preconceito, limitações e exige atenção; consequência da vida e presença de doenças e processo fisiológico global. Quanto à percepção do idoso, as respostas foram classificadas em positivas, negativas, mistas e neutras. Consideramos que a compreensão do idoso e do envelhecimento foi limitada e pessimista, sendo necessário que tenhamos a consciência de que a visão que se possui interfere na maneira pela qual nos relacionamos.