Menopause, rurlity, and obesity in rural African American women

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires — and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC^

The Effects of Classroom Environmental Quality on the Early Literacy Outcomes of a Regionally Heterogeneous Population of Latino Children

The purpose of this study was to examine the relation between classroom environmental quality and early literacy outcomes amongst a sample of Latino children from various Latin-American countries. Participants included 116 preschoolers that attended various childcare centers in Southeast Florida. Participant’s literacy knowledge was assessed using the Test of Preschool Early Literacy. Classrooms were assessed on environmental quality using the Early Childhood Environmental Rating Scale-Revised. A regression analysis revealed that classroom environmental quality did not account for Latino children’s early literacy outcomes. However, a multiple regression analysis was significant (R2= .15, F(5, 115) = 3.86, p< .05) indicating that quality has a varying impact on children’s early literacy skills based on children’s region of origin. Findings suggest that high classroom environmental quality does not necessarily mean better literacy development for Latino children. Additionally, Latino children should not be viewed as a homogeneous group, particularly in relation to their development of literacy skills in English.

Coping with life events through possible selves

This study examines the integration of life events into the possible selves repertoire and explores the potential relationship between event-related possible selves and coping. The sample consisted of 198 participants, with age ranging from 18 - 84. Participants were administered interviews consisting of demographic information, the Possible Selves Interview, the Social Readjustment Rating Scale, the Ways of Coping Checklist-Revised, the Satisfaction with Life Scale, and the General Well-Being Schedule. Results indicate that the Integration of stressful events into the possible selves repertoire positively impacted coping. This study paves the way for important prevention programs aimed at promoting an individual's well being.

Uso da cinza do bagaço da cana-de-açúcar como matéria-prima na substituição dos fundentes para aplicações em porcelanato

The present study aims to evaluate the potential use of bagasse ash from sugar cane (CBC) as a flux, replacing phyllite and/or feldspar in standard industrial mass production of enameled porcelain, verifying the possibility of the CBC contribute to the overall reduction of the coefficient of thermal expansion of the ceramic mass. To this end, as a result of the research, we characterized the raw material components of the standard mass (clay, phyllite, kaolin, feldspar, quartz and talc) and the residue of BCC, by testing by XRF, XRD, AG, DTA and ATG. Specimens (CDP) were manufactured in the dimensions of 100 mm x 50 mm x 8 mm in uniaxial matrix under compaction pressure of 33 MPa, assembled in batches of 3 units subsequently sintered at temperatures of 1150°C to 1210°C by varying the Rating Scale at 10°C, heating and cooling ramp of 50°C/min and 25°C/min, with levels of 1 min, 3 min, 5 min, 8 min, 10 min, 15 min, 30 min and 60 min. analyzing the results of the physical properties of water absorption (WA), linear firing shrinkage (LFS), dilatometric analysis (DTA), flexural strain (SFT) and SEM of the sintered bodies in order to verify the adequacy of CDP to ISO 13006, ISO 10545, NBR 13816 standards; NBR 13817 and NBR 13818. The study showed that the formulations that best suit the requirements of the standards are:. G4 - which was applied in 10% of replacing the CBC phyllite, sintering temperature 1210 ° C for 10 min and porch, and F3 - with application of 7.5% of CBC to replace the feldspar in the sintering temperatures of 1190°C, 1200°C and 1210°C for 10 min and porch. These formulations showed better performance regarding the formation of primary and secondary mullite, with considerable reduction of cracks and pores, meeting the prerequisites of standards for glazed porcelain. The results shows that the use of the CBC as a flux in the preparation of porcelain mass meets standard parameters for the manufacture of the product, and thereby can reduce environmental impact and the cost of production. Therefore, it is recommended to use this residue in the ceramics industry, due to its industrial, commercial and collaborative viability for sustainability.

Acolhimento na estratégia saúde da família: o que dizem os usuários?

The objective of the National Humanization Policy (NHP) is to humanize relations between professionals and users. It is guided by the proposal of expanded clinic and proposes the embracement as a strategy for its existence. The embracement requires qualified hearing, the provision of adequate technologies and the establishment of relations for better solving health problems of users. The objective of this study was to evaluate user satisfaction of the Family Health Strategy (FHS) regarding the embracement from the perspective of qualified hearing and improved relations in the city of Recife- PE. In this quantitative, qualitative, evaluative and cross-sectional study, 297 users of the services offered by the FHS were interviewed in six health districts of the city. For data collection, the Satisfaction Rating Scale of users with Mental Health Services - Satis-BR- abbreviated and adapted to the subject embracement was used. Quantitative data were analyzed by using the software Statistical Package for Social Science (SPSS) 17.0, calculating the absolute and relative frequencies. Qualitative data were analyzed by content analysis of Bardin with the elaboration of thematic categories. The results indicate that most users are satisfied with the embracement offered by the teams. About 66% reported being very or fairly heard by professionals; 80.2% reported to have obtained some or much help when searched for embracement; 64.6% indicated that the embracement is friendly or very friendly. Regarding ambience, 55.9% of users demonstrated indifference and dissatisfaction with comfort and appearance; regarding general facilities of the service, 69.4% reported as regular to awful. Three thematic categories were revealed by the speeches: satisfaction with embracement, dissatisfaction with the ambience, and suggestions for improvements in embracement and service. This study contributed to the understanding that both the hearing and relations are present in the embracement of the city and also to demonstrate that the ambience is a possible weakness in the opinion of the users.

Relação do polimorfismo BDNF val66met e níveis periféricos de BDNF com a doença de Parkinson e sua sintomatologia

Neurodegenerative diseases are frequently studied due to the increasing number of cases associated with the populational ageing and to the impact on the conditions on the quality of life. Parkinson’s disease (DP) is the second most frequent neurodegenerative disease. Despite the fact that its etiology is not completely understood, it is known that DP is caused by environmental and genetic factors. Thus, the investigation of etiologic factors and mechanisms responsible for the changes that lead to DP may help early diagnostic and prevention. A possible association between DP and the common polymorphism of Brain Derived Neurotrophic Factor (BDNF) G196A (Val66Met) has been suggested by different studies with contrasting results. For this reason, the aim of this study is to investigate if the BDNF Val66Met polymorphism is related to susceptibility to DP in a cohort of Brazilian patients. Additionaly, we verify if the presence of the polymorphism implies in alterations in the BDNF whole blood concentrations, as well as variations in symptomatology. The sample comprised Brazilian patients accompanied by the neurology service of the Onofre Lopes University Hospital (HUOL) and healthy controls (CTRL). The motor aspects of DP were evaluated by Hoehn e Yahr Scale (HY), Unified Parkinson’s Disease Rating Scale (UPDRS) and Schwab & England Scale (SE). For the evaluation of non-motor symptoms were used the following instruments: Frontal Assessment Battery (BAF), Mini-Mental State Examination (MEEM), Beck Depression Inventory (IDB) and the Beck Anxiety Inventory (IAB). Blood samples were collected for BDNF Val66Met polymorphism genotyping and BDNF whole blood measurement. As expected, DP patients performed worse in motor, cognitive and emotional battery of questionnaires. Alleles distribution between DP and CTRL was not significantly different, but the A/G genotype was significantly associated with a protector factor for DP. In contrast, the G/G genotype was significantly associated with depression and anxiety development in DP patients. However, BDNF concentrations were not different between genotypes or groups. This is the first study of genetic association of this polymorphism with DP in Brazilian subjects and the first one that associate A/G genotype with protection against DP.

Epidemiology of medication discrepancies upon hospital admission in children - a systematic review

Objectives: NICE/NPSA excluded children under 16 from their guidance concerning medicines reconciliation (MR) upon admission.1 Our aims and objectives of conducting the literature review was to identify the epidemiology of medication discrepancies upon admission, transfer and discharge in children, and if they require MR. Method: Six bibliographical databases (Medline, Embase, CINAHL, International Pharmaceutical Abstracts, Web of Science and Biosis Previews) and selected key words were used to find epidemiological studies on medication discrepancies in children upon hospital admission, transfer and discharge (key words included ‘medication discrepancy’; ‘medication reconciliation’; ‘hospital admission’; ‘hospital discharge’; ‘hospital transfer’); studies where the data for children could be extracted were included. Results: From the 1239 articles found (in May 2011), eight of the articles had extractable paediatric information, (five from Canada, two from USA, one from UK). Five of the studies involved discrepancies on admission, one involved discrepancies on admission and transfer, one involved discrepancies at transfer and one considered discharge. The reference point used to compare against the admission, transfer and the discharge order differed in each of the studies. Four studies used a rating scale to assess the clinical significance of the discrepancies to demonstrate the potential adverse clinical outcome of patients in the absence of clinical intervention. Two studies2 3 used a rating scale that was used in adults.4 A study of paediatric neurosurgical patients found that initial hospital prescriptions for children differed from the preadmission prescriptions in 39% of occasions and 50% of all prescribing variations had the potential to cause moderate or severe discomfort or clinical deterioration.2 A study by Coffey et al in general paediatric admissions in Canada showed 22% of patients experienced at least one discrepancy and 29% of the discrepancies had the potential to cause moderate or severe discomfort or clinical deterioration.3 By comparison an epidemiological study in discrepancies in adults on admission had 38.6% of the discrepancies identified with a potential to cause moderate or severe discomfort or clinical deterioration.4 All the studies involved small samples or specific patient groups such as medically complex patients. However all of the studies demonstrated that discrepancies occurred among paediatric populations during transitions in care settings and mentioned MR as an intervention. Conclusion: The results have shown that discrepancies of medication upon hospital admission, transfer and discharge occur regularly in children. With only one published study in the UK looking at hospital admission in children, and no published articles on the incidence and epidemiology of medication discrepancies upon hospital transfer or discharge further research is required in a wider paediatric population. Further work is also required to define the required interventions to improve practice.

Early detection of delirium in older medical inpatients: prodrome, predictors and motor subtyping

Background Delirium is highly prevalent, especially in older patients. It independently leads to adverse outcomes, but remains under-detected, particularly hypoactive forms. Although early identification and intervention is important, delirium prevention is key to improving outcomes. The delirium prodrome concept has been mooted for decades, but remains poorly characterised. Greater understanding of this prodrome would promote prompt identification of delirium-prone patients, and facilitate improved strategies for delirium prevention and management. Methods Medical inpatients of ≥70 years were screened for prevalent delirium using the Revised Delirium Rating Scale (DRS--‐R98). Those without prevalent delirium were assessed daily for delirium development, prodromal features and motor subtype. Survival analysis models identified which prodromal features predicted the emergence of incident delirium in the cohort in the first week of admission. The Delirium Motor Subtype Scale-4 was used to ascertain motor subtype. Results Of 555 patients approached, 191 patients were included in the prospective study. The median age was 80 (IQR 10) and 101 (52.9%) were male. Sixty-one patients developed incident delirium within a week of admission. Several prodromal features predicted delirium emergence in the cohort. Firstly, using a novel Prodromal Checklist based on the existing literature, and controlling for confounders, seven predictive behavioural features were identified in the prodromal period (for example, increasing confusion; and being easily distractible). Additionally, using serial cognitive tests and the DRS-R98 daily, multiple cognitive and other core delirium features were detected in the prodrome (for example inattention; and sleep-wake cycle disturbance). Examining longitudinal motor subtypes in delirium cases, subtypes were found to be predominantly stable over time, the most prevalent being hypoactive subtype (62.3%). Discussion This thesis explored multiple aspects of delirium in older medical inpatients, with particular focus on the characterisation of the delirium prodrome. These findings should help to inform future delirium educational programmes, and detection and prevention strategies.

Menopause, Rurality, And Obesity in Rural African American Women

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires – and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC

Comprometimento Organizacional, Autocriticismo e Autocompaixão em Profissionais/Cuidadores Formais que Trabalham com Pessoas com Deficiência/Doença Mental

Introdução: Alguns estudos internacionais e nacionais têm-se dedicado a estudar as caraterísticas psicológicas de profissionais/cuidadores que trabalham na área da prestação de cuidados a pessoas com doença e deficiência mental. Porém, segundo temos conhecimento são escassos ou mesmo inexistentes os estudos que abordem os níveis de autocriticismo, autocompaixão e comprometimento organizacional destes profissionais/cuidadores. Foram nossos objetivos: caraterizar uma amostra de cuidadores formais/profissionais que trabalham com pessoas com doença e deficiência mental em diferentes variáveis sociodemográficas e profissionais; analisar os níveis de autocriticismo, autocompaixão e comprometimento organizacional destes cuidadores formais/profissionais, bem como explorar as associações entre todas estas variáveis (entre si e com as variáveis sociodemográficas e profissionais). Metodologia: 55 cuidadores formais de pessoas com doença/deficiência mental (sexo feminino/n = 49, 84,5%; idade média de 45,21; DP = 10,92; variação = 22-65) preencheram um questionário sociodemográfico, o Questionário de Comprometimento Organizacional, a Escala das Formas do Autocriticismo e Autotranquilização e a Escala de Autocompaixão. Resultados: O Eu inadequado apresentou um valor médio bastante maior que o Eu detestado. O valor médio do Eu tranquilizador foi superior a qualquer dimensão de autocriticismo. O Calor-Compreensão (autocompaixão) apresentou o valor médio mais elevado e a Autocrítica o valor médio mais baixo. O Eu inadequado e detestado associaram-se positivamente às dimensões negativas de autocompaixão e o Eu tranquilizador às dimensões positivas de autocompaixão. O Comprometimento Afetivo associou-se positivamente ao Autocriticismo total. O Comprometimento Calculativo associou-se positivamente ao Eu detestado, que foi seu preditor. O Comprometimento Normativo associou-se de forma positiva ao Eu detestado, Autocriticismo total e idade negativamente ao Mindfulness. A idade foi o seu preditor. O Comprometimento Afetivo associou-se positivamente aos meses de trabalho na instituição, que foram seus preditores. Os cuidadores com um familiar com deficiência mental tiveram um valor mais baixo de Eu inadequado. Discussão: No geral, esta amostra de cuidadores formais apresentou caraterísticas psicológicas que nos tranquilizam quanto ao papel que desempenham junto de pessoas com doença/deficiência mental, mas as instituições devem sempre encontrar formas de estimular os níveis de comprometimento e autocompaixão dos seus profissionais. / Introduction: Some international and national studies have focused on studying the psychological characteristics of professionals/caregivers working with people with mental disease and intelectual disability. However, to our knowledge, the studies exploring levels of selfcriticism, self-compassion and organizational commitment in these professionals are scarce or even nonexistent. Our goals were to: characterize a sample of formal caregivers/professionals who work with people with mental illness and intellectual in different sociodemographic and professional variables; analyze the levels of selfcriticism, self-compassion and organizational commitment of these formal caregivers/professionals, as well as explore the associations between all these variables (with each other and with the sociodemographic and professional variables and professionals). Methodology: 55 caregivers of people with mental disease/intelectual disability (female/n = 49, 84.5%; mean age of 45,21; DP = 10,92; variation = 22-65) completed a sociodemographic questionnaire, the Organizational Commitment questionnaire, the Forms of Self Criticism Rating Scale and the Self- Compassion Scale. Results: Inadequate Self had na higher mean value than the Hated Self. The mean value of the Reassuring Self was higher than any dimension of selfcriticism. Self-Kindness was the one with a higher mean value (of self-compassion) and Self-Judjment the one with the lowest mean value. The Inadequate Self and the Hated Self were positively associated with the negative dimensions of selfcompassion and the Reassuring Self with the positive dimensions of selfcompassion. The Affective Commitment was positively associated to total selfcriticism. The Continuance Commitment was associated with the Hated Self (positively), being its predictor. The Normative Commitment was positively associated to the Hated Self, the total selfcriticism and age and negatively to Mindfulness. Age was its predictor. The Affective Commitment was positively associated to months of work at the institution. This variable was its predictor. Professionals with a family member with intellectual disability had a lower value of Inadequate Self. Discussion: In general, this sample of formal caregivers presented psychological characteristics that reassure us about the role that they have while working with people with mental disease/intellectual disability, but the institutions must always find ways of stimulating the commitment and selfcompassion levels of their professionals.

Objetivos de Vida e Satisfação na Vida Conjugal em Pais/Progenitores de Crianças com Autismo

Introdução: A presença do diagnóstico de autismo numa criança é algo marcante no seio familiar. Implica inúmeros desafios para os seus pais/progenitores, podendo influenciar os objetivos delineados para as suas vidas e a satisfação na relação conjugal. Os nossos objetivos foram: caraterizar progenitores de crianças com autismo quanto aos objetivos de vida e satisfação na vida conjugal e explorar as associações existentes entre estas duas variáveis (e com variáveis sociodemográficas e relativas ao apoio recebido). Não deixamos de explorar os níveis de depressão, ansiedade, e stress, vivenciados por estes pais. Metodologia: 66 progenitores (sexo feminino, n = 52, 78,8%; idade média, M = 40,2, DP = 6,45) de crianças com autismo preencheram um questionário sociodemográfico, o Teste dos objetivos de vida/PIL-R, a Escala de Avaliação da Satisfação em Áreas da Vida Conjugal/EASAVIC e a Depression, Anxiety and Stress Scale-21/DASS-21. Resultados: Os progenitores revelaram valores médios de objetivos de vida (PIL-R). Foi na dimensão vivencial (PIL-R) e nas dimensões Comunicação e Intimidade Emocional (satisfação em áreas da vida conjugal/EASAVIC) que os progenitores apresentaram valores médios mais elevados. No caso da DASS-21, foi na escala Stress que os progenitores apresentaram valores mais elevados. Porém, em todas as dimensões da DASS-21, os níveis encontrados foram normais. Não se verificaram diferenças estatisticamente significativas por sexo em todas as dimensões do PIL-R, da EASAVIC e DASS-21. Ambas as dimensões do PIL-R, dimensional e existencial, bem como a sua pontuação total mostraram estar associadas com todas as dimensões da EASAVIC (satisfação em áreas da vida conjugal). As três dimensões da DASS-21 (Depressão, Ansiedade e Stress) revelaram estar associada (negativamente) com praticamente todas as dimensões da EASAVIC e do PIL-R. Os progenitores que pertenciam a associações de apoio apenas se diferenciaram dos progenitores que pertenciam a um grupo (de apoio e partilha) numa rede social na dimensão Ansiedade, com estes últimos a apresentarem um nível mais elevado. Discussão: Neste estudo (ainda que numa amostra de tamanho reduzido), inovador pelo tema explorado, os níveis dos objetivos de vida e de satisfação em áreas da vida conjugal (bem como de sintomas de psicopatologia) pareceram “não sofrer” o impacto associado ao facto dos progenitores terem um filho com autismo. Os objetivos de vida mantidos por estes pais influenciam a sua satisfação com a vida conjugal e vice-versa, indicando a importância das equipas que trabalham com estes pais não esquecerem a promoção destas variáveis. / Introduction: The presence of the diagnosis of autism in a child is something remarkable in the family. Involves many challenges for parents/progenitors, which can influence the goals they define in their lives and their satisfaction with the marital relationship. Our objectives were to characterize parents of children with autism on the objectives of life and satisfaction with marital life and explore the associations between these two variables (and with sociodemographic and support variables). We will not forget to explore the levels of depression, anxiety, and stress, experienced by these parents. Methodology: 66 parents (females, n = 52, 78.8%, mean age, M = 40.2, SD = 6.45) of children with autism completed a sociodemographic questionnaire, the Test of Life Goals/PIL-R, the Areas of Marital Satisfaction Rating Scale/EASAVIC and the Depression, Anxiety and Stress Scale-21/DASS-21. Results: Parents showed a mean value of life goals (PIL-R). Was in the experiential dimension (PIL-R) and the Communication and Emotional Intimacy dimensions (satisfaction in areas of marital life/EASAVIC) that the parents presented higher mean values. Regarding DASS-21, Stress was the scale in which the parents had higher values. However, in all the DASS-21, levels were “normal”. There were no statistically significant differences by gender in all the PIL-R, EASAVIC and DASS-21 scales. Both dimensions of the PIL-R, dimensional and existential, as well as the total score were found to be associated with all the dimensions of EASAVIC (satisfaction in areas of marital life). The three dimensions of the DASS-21 (Depression, Anxiety and Stress) revealed to be associated (negatively) with virtually all dimensions of the EASAVIC and the PIL-R. Parents who belonged to associations only differed from the parents from a social network group (of support and sharing) in the anxiety dimension, with the later presenting an higher level. Discussion: In this study (even if in a small sample size), innovative by the theme explored, levels of life goals and satisfaction in areas of marital life (as well as symptoms of psychopathology) seemed not to suffer from the impact of the parents having a child with autism. The life goals held by these parents influence their satisfaction with marital life and vice versa, indicating the importance of teams working with these parents of not forgetting the promotion of these variables.

Functional Magnetic Resonance Imaging Neurofeedback and Motor training for Parkinson’s Disease: Randomised Trial

Objective: Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient’s own brain activity to self-regulate brain networks which in turn could lead to a change in behaviour and clinical symptoms. The objective was to determine the effect of neurofeedback and motor training and motor training (MOT) alone on motor and non-motor functions in Parkinson’s disease (PD) in a 10-week small Phase I randomised controlled trial. Methods: 30 patients with PD (Hoehn & Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with motor training. Group 2 (MOT: 15 patients) received motor training alone. The primary outcome measure was the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention ‘off-medication’. The secondary outcome measures were the ‘on-medication’ MDS-UPDRS, the Parkinson’s disease Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks. Results: Patients in the NF group were able to upregulate activity in the supplementary motor area by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the ‘off-medication’ state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group. Interpretation: This Phase I study suggests that NF combined with motor training is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions. Clinical Trial website : Unique Identifier: NCT01867827 URL: https://clinicaltrials.gov/ct2/show/NCT01867827?term=NCT01867827&rank=1

Développement d’un questionnaire cognitif bref, le FaCE (The Fast Cognitive Evaluation), selon la modélisation Rasch adapté aux patients avec cancer

Les déficits cognitifs sont présents chez les patients atteints de cancer. Les tests cognitifs tels que le Montreal Cognitive Assessment se sont révélés peu spécifiques, incapables de détecter des déficits légers et ne sont pas linéaires. Pour suppléer à ces limitations nous avons développé un questionnaire cognitif simple, bref et adapté aux dimensions cognitives atteintes chez les patients avec un cancer, le FaCE « The Fast Cognitif Evaluation », en utilisant la modélisation Rasch (MR). La MR est une méthode mathématique probabiliste qui détermine les conditions pour qu’un outil soit considéré une échelle de mesure et elle est indépendante de l’échantillon. Si les résultats s’ajustent au modèle, l’échelle de mesure est linéaire avec des intervalles égaux. Les réponses sont basées sur la capacité des sujets et la difficulté des items. La carte des items permet de sélectionner les items les plus adaptés pour l’évaluation de chaque aspect cognitif et d’en réduire le nombre au minimum. L’analyse de l’unidimensionnalité évalue si l’outil mesure une autre dimension que celle attendue. Les résultats d’analyses, conduites sur 165 patients, montrent que le FaCE distingue avec une excellente fiabilité et des niveaux suffisamment différents les compétences des patients (person-reliability-index=0.86; person-separation-index=2.51). La taille de la population et le nombre d’items sont suffisants pour que les items aient une hiérarchisation fiable et précise (item-reliability=0.99; item-séparation-index=8.75). La carte des items montre une bonne dispersion de ceux-ci et une linéarité du score sans effet plafond. Enfin, l’unidimensionnalité est respectée et le temps d’accomplissement moyen est d’environ 6 minutes. Par définition la MR permet d’assurer la linéarité et la continuité de l’échelle de mesure. Nous avons réussi à développer un questionnaire bref, simple, rapide et adapté aux déficits cognitifs des patients avec un cancer. Le FaCE pourrait, aussi, servir de mesure de référence pour les futures recherches dans le domaine.

Metacognition and executive functioning in Elementary School

This study analyzes differences in metacognitive skills and executive functioning between two groups of students (10-12 years) with different levels of metacognitive knowledge (high n = 50, low n = 64). Groups were established based on students' score on a test of knowledge of strategy use. Metacognitive skills were assessed by means of self-report. Students reported the frequency with which they applied these strategies during the phases of planning, execution, and evaluation of learning. Information about student executive functioning was provided by families and teachers, who completed two parallel forms of a behavior rating scale. The results indicated that: a) the group with high levels of metacognitive knowledge reported using their metacognitive skills more frequently than their peers in the other group. These differences were statistically significant in the phases of planning and execution; b) both family and teachers informed of better levels of executive functioning in the students with high metacognitive knowledge. Statistically significant differences were found in planning, functional memory, focus, and sustained attention. These results show the existence of an association between different levels of metacognitive knowledge, and differences in metacognitive skills and executive functions, and suggest the need to emphasize this set of variables in order to encourage students to acquire increasing levels of control over their learning process.

Investimento na vida pessoal da pessoa idosa institucionalizada

Enquadramento: Nas últimas décadas, tem-se assistido a um envelhecimento populacional crescente e a um progressivo aumento da institucionalização dos idosos. A institucionalização representa frequentemente para o idoso uma rutura com o seu passado, levando à perda da sua individualidade e consequentemente a um processo de isolamento que poderá contribuir para níveis elevados de insatisfação com a vida. O Investimento na vida pessoal remete-nos para a valorização e atribuição de objetivos de vida ao ser humano, naquela que é a última etapa da sua vida, em todos os seus atributos e caraterísticas, inclusive na sua complexa estrutura física, intelectual e espiritual. Objetivos: Avaliar o nível de Investimento na vida pessoal percecionado pelos idosos institucionalizados e analisar a sua relação com as variáveis socio demográficas, clínicas, e psicossociais. Métodos: Trata-se de um estudo não experimental, transversal, descritivo-correlacional e de caráter quantitativo, que foi realizado numa amostra não probabilística por conveniência, constituída por 90 pessoas idosas a residir nas ERPI do concelho de Vila Nova de Paiva. Para a mensuração das variáveis utilizou-se um instrumento de colheita de dados que integra uma secção de caraterização sócio demográfica, e uma secção de caraterização clínico-funcional (índice de Barthel), caraterização familiar (Escala de Apgar Familiar) e situacional, lazer (Índice de Atividades de Lazer), espiritualidade (Escala da Espiritualidade), perceção da vida atual (Escala de Satisfação com a Vida) e futura, e por fim a Escala de Avaliação de Investimento na Vida Pessoal. Resultados: Os dados mostram que a perceção dos idosos sobre o investimento na sua vida pessoal se distribui de uma forma relativamente equitativa por três níveis. Contudo, o maior grupo percentual (37,8%) perceciona o seu investimento como elevado, enquanto 32,2% o entende como baixo e o grupo mais reduzido (30,0%) o considera moderado. A análise por género mostra que os homens tendem a avaliar o investimento de uma forma mais positiva que as mulheres; também os idosos com habilitações académicas superiores (p= 0,041) e com maior nível de independência funcional (p= 0,037) são os que percecionam um maior investimento na vida pessoal. Constatamos ainda que a família tem um efeito significativo (p= 0,020) no nível do investimento na vida do idoso, à semelhança da existência de mais esperança (p= 0,002), maior satisfação com a vida (p= 0,013) e do desenvolvimento de planos para o futuro (p= 0,032). Conclusão: As evidências encontradas neste estudo mostram que há níveis diferenciados de Investimento na vida pessoal entre os idosos. Este Investimento correlaciona-se de forma significativa com diversas variáveis independentes que depois de devidamente identificadas devem ser promovidas para assegurar aos idosos um envelhecimento ativo e com qualidade. As competências atribuídas ao enfermeiro especialista em reabilitação são de uma mais-valia inegualável no desenvolvimento do referido envelhecimento com qualidade, quando inserido numa equipa multidisciplinar, nas Estruturas Residenciais Para Idosos. Palavras-chave: idosos, institucionalização, satisfação com a vida, investimento na vida pessoal.