Concepts and objects of awareness in Alzheimer’s disease: an updated systematic review

ABSTRACT Objectives To compare and discuss the objects of awareness in Alzheimer’s disease (AD): awareness of cognitive deficits, of functional activities, of social-emotional functioning and behavioral impairment. Methods A search in the PsycINFo, Pilots, PubMed/Medline and ISI electronic databases according to Prisma methodology was performed. We included studies about awareness in people with AD published between 2010 and 2015, with the combination of keywords: “Alzheimer AND awareness of deficits”, “Alzheimer AND anosognosia”, “Alzheimer AND insight”, “dementia AND awareness of deficits”, “dementia AND anosognosia”, “dementia AND insight”. The articles were categorized according to the specific object of awareness. Results Seven hundred and ten records were identified and, after application of the exclusion criteria, 191 studies were retrieved for potential use. After excluding the duplicates, 46 studies were included. Most studies assessed the cognitive domain of awareness, followed by the functional, social-emotional, and behavioral impairment domains. Memory deficits were not sufficient to explain impaired awareness in AD. Longitudinal studies did not find discrepancies between patients and caregivers’ reports, indicating that awareness is not related to cognition. Conflicting findings were observed, including the relation between awareness, mood, severity of disease, and personal characteristics. Conclusions The studies show lack of conceptual consensus and significant methodological differences. The inclusion of samples without differentiation of dementia etiology is associated to symptomatic differences, which affect awareness domains. Awareness in AD is a complex and multidimensional construct. Different objects elicit different levels of awareness.

Breastfeeding and depression: a systematic review of the literature

Background: Research has separately indicated associations between pregnancy depression and breastfeeding, breastfeeding and postpartum depression, and pregnancy and postpartum depression. This paper aimed to provide a systematic literature review on breastfeeding and depression, considering both pregnancy and postpartum depression. Methods: An electronic search in three databases was performed using the keywords: “breast feeding”, “bottle feeding”, “depression”, “pregnancy”, and “postpartum”. Two investigators independently evaluated the titles and abstracts in a first stage and the full-text in a second stage review. Papers not addressing the association among breastfeeding and pregnancy or postpartum depression, non-original research and research focused on the effect of antidepressants were excluded. 48 studies were selected and included. Data were independently extracted. Results: Pregnancy depression predicts a shorter breastfeeding duration, but not breastfeeding intention or initiation. Breastfeeding duration is associated with postpartum depression in almost all studies. Postpartum depression predicts and is predicted by breastfeeding cessation in several studies. Pregnancy and postpartum depression are associated with shorter breastfeeding duration. Breastfeeding may mediate the association between pregnancy and postpartum depression. Pregnancy depression predicts shorter breastfeeding duration and that may increase depressive symptoms during postpartum. Limitations: The selected keywords may have led to the exclusion of relevant references. Conclusions: Although strong empirical evidence regarding the associations among breastfeeding and pregnancy or postpartum depression was separately provided, further research, such as prospective studies, is needed to clarify the association among these three variables. Help for depressed pregnant women should be delivered to enhance both breastfeeding and postpartum psychological adjustment.

Ajustamento da criança à separação ou divórcio dos pais

Objetivo: O presente artigo procura relacionar e analisar evidências empíricas e teóricas sobre o impacto e os fatores associados ao impacto da separação ou divórcio dos pais no ajustamento da criança. Método: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave “divorce adjustment”, “child divorce” e “divorce impact”, nas bases de dados JSTOR, PsycInfo, SciELO e Medline e em livros da especialidade. Resultados: Respostas adaptativas e desadaptativas da criança são descritas, assim como potenciais resultados positivos. São principalmente discutidos os fatores mediadores e moderadores frequentemente referenciados na literatura no impacto da separação ou divórcio dos pais no ajustamento da criança. Entre esses estão: características da criança, problemas financeiros, sintomatologia psicopatológica dos pais, qualidade das práticas parentais e conflito interparental. Conclusão: Com base nas evidências empíricas e perspectivando o divórcio como uma transição desenvolvimental, levantamos a hipótese de que os problemas de ajustamento apresentados pelas crianças com pais divorciados possam ser mais bem explicados por outros fatores do que pelo divórcio/separação per se. Finalmente assumimos uma inovação conceptual de que essa transição familiar pode significar uma oportunidade de crescimento e de promoção desenvolvimental.

A estruturação metafórica na concetualização de "Hora" na poesia de Fernando Pessoa ortónimo

Dissertação de mestrado em Ciências da Linguagem

Treatment of Dyslipidemia with Statins and Physical Exercises: Recent Findings of Skeletal Muscle Responses

Statin treatment in association with physical exercise practice can substantially reduce cardiovascular mortality risk of dyslipidemic individuals, but this practice is associated with myopathic event exacerbation. This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords “statin” AND “exercise” AND “muscle”, restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises. Moderate physical training, in turn, when associated to statins does not increase creatine kinase levels or pain reports, but improves muscle and metabolic functions as a consequence of training. Therefore, it is suggested that dyslipidemic patients undergoing statin treatment should be exposed to moderate aerobic training in combination to resistance exercises three times a week, and the provision of physical training prior to drug administration is desirable, whenever possible.

Vergleich zweier Gruppen von Sexualstraftätern hinsichtlich klinischer und forensischer Variablen : Eine empirische Untersuchung

SexualstraftäterstelleneineheterogeneGruppedar,derenUnterschiedesichaufeinerganzenReihevonEbenenabbilden.DasZieldervorliegendenArbeitbestandinderAna-­‐lysezweierGruppenvonSexualstraftäternhinsichtlichklinischer(=Prävalenzpsychiat-­‐rischerStörungen)undforensischer(=AusprägungforensischerPrognoseinstrumente,u.a.)Variablen.EswurdenzweiGruppen-­‐(1)sexuelleMissbrauchstätervonKindern(SMK)und(2)PersonenmitVergewaltigungsdelikt(V)-­‐gebildet;diesenwurdendieProbandenvordemHintergrundderDeliktartzugeordnet.Datengrundlagewarenpsy-­‐chiatrischePrognose-­‐undSchuldfähigkeitsgutachtenausdenJahren2006-­‐2014.DieStichprobesetztesichzusammenausN=35Sexualstraftätern(SMK:n=20;V:n=15).ZurAnalysederDatenwurdeeinequantitativ-­‐empirischeMethodegewählt.DieErgebnissezeigteninsbesondere,dassSMKhäufigervoneinerParaphilieDiagnosebetroffenwaren(p<.037).WeiterhinzeigtesicheinehohePrävalenzanPersönlichkeitsstörungeninbei-­‐denGruppen(SMK:65%;V:73,33%).AufEbenestatischerRisikofaktoren(z.B.Static-­‐99)warendieUnterschiedeehergering.Eszeigtesichauf(kriminal-­‐)biographischerEbene,dassVhinsichtlichersterDelinquenzsowieersterInhaftierungtendenzielljün-­‐gerwarenalsSMK.BeibeidenGruppensindmultipleDelinquenzformeninderVergan-­‐genheitfeststellbar.InsbesonderezeigtenbeideGruppeneinehoheZahlansexualitäts-­‐spezifischenVorstrafen(SMK:40%;V:46%).DieVariable„Heimaufenthalt“wurdebe-­‐züglichsexuellerDevianzwieauchallgemeinerDelinquenzalswichtigerFaktoridentifi-­‐ziert;hieristweitereForschungmitgrößerenStichprobenerforderlich.Keywords:Sexualstraftäter;Paraphilie;SexuelleDevianz;PsychiatrischeGutachten

Feeding ecology in the small neotropical amphisbaenid Amphisbaena munoai (Amphisbaenidae) in southern Brazil

We analyzed the alimentary tract of 66 specimens of Amphisbaena munoai Klappenbach, 1969 from the Serra do Sudeste, state of Rio Grande do Sul, southern Brazil. Forty specimens (60.6%) had prey items in their gut. The diet consisted mainly of small invertebrate prey, such as termites, insect larvae and ants. The most abundant prey item was termites, found in 62.5% of the non empty stomachs. The high number of individual prey items in the majority of stomachs, the small size of the regular prey items, and the absence of gut content in specimens of A. munoai kept alive for about two days, indicate that this species forages very frequently. The predominance of fossorial prey items and the occasional records of nomadic ants lead us to suggest that A. munoai usually feeds underground, and occasionally forages on the surface.

Diet and microhabitat use by two Hylodinae species (Anura, Cycloramphidae) living in sympatry and syntopy in a Brazilian Atlantic Rainforest area

We analyzed the diet and microhabitat use for two Hylodinae anurans (Cycloramphidae), Hylodes phyllodes Heyer & Cocroft, 1986 and Crossodactylus gaudichaudii Duméril & Bibron, 1841, living in sympatry at an Atlantic Rainforest area of Ilha Grande, in southeastern Brazil. The two species live syntopically at some rocky streams. The two species differed strongly in microhabitat use. Hylodes phyllodes occurred mainly on rocks, whereas C. gaudichaudii was observed mostly on the water. Regarding diet, coleopterans, hymenopterans (ants), and larvae were the most important prey item consumed by both species. Data suggest that microhabitat use appears to be an important parameter differentiating these frogs with respect to general resource utilization.

Seasonality, age structure and reproduction of Leptodactylus (Lithodytes) lineatus (Anura, Leptodactylidae) in Rondônia state, southwestern Amazon, Brazil

Leptodactylus(Lithodytes) lineatus (Schneider, 1799) is an Amazonian leaf litter frog considered rare or uncommon in several studies on anuran communities. Despite being a widely distributed frog in Amazonian forests, knowledge of the biology and ecology of this species is relatively scarce. This species has been reported to live in association with leaf-cutter ant nests (Atta spp.) during the breeding period. In this paper we present data on the seasonality of this species and some reproductive information gathered at a locality of Rondônia state, northwestern Brazil. Field work was carried out between April 2001 and March 2002, with the use of pitfall traps with drift fences as a survey method. Leptodactylus (L.) lineatus had a higher capture frequency in this locality compared to that of other studies carried out in other Amazonian localities, possibly because this species has secretive habits, such as calling and breeding from nests of leaf-cutting ants, and are difficult to find during visual encounter surveys. The breeding period occurs between October and March. Calling males and egg-bearing females were found between September and February and juvenile recruitment occurred mainly from the end of the rainy season to the beginning of the dry season (February to June). Males and females show sexual dimorphism in SVL, females being significantly larger than males. The number of ovarian eggs per female varies from 110 to 328 and analyses indicate that there is a significant correlation with SVL.

The diet of the black widow spider Latrodectus mirabilis (Theridiidae) in two cereal crops of central Argentina

The spider Latrodectus mirabilis (Holmberg, 1876) is commonly found in cereals crops of central Argentina. We studied its diet composition at the field and capture rate on leaf-cutting ants based on laboratory experiments. This study comprises the first approach that documents the diet of L. mirabilis in wheat and oat fields of central Argentina. We identified 1,004 prey items collected from its webs during the last phenological stages of both cereal crops. The prey composition was variable but the spiders prey mainly on ants (Formicidae, Hymenoptera), who represented more than 86% of the total. Meanwhile, in the capture rate experiences we registered a high proportion of ants captured by spiders at the beginning of experiences, capturing the half of the ants from total in the first four hours. Summarizing, we reported a polyphagous diet of this spider species in wheat and oat fields. Ants were the most important prey item of this spider, as found in other Latrodectus spiders around the world.

Composition of Greenhouse Gas Emissions in Spain: an Input-Output Analysis

Extending the traditional input-output model to account for the environmental impacts of production processes reveals the channels by which environmental burdens are transmitted throughout the economy. In particular, the environmental input-output approach is a useful technique for quantifying the changes in the levels of greenhouse emissions caused by changes in the final demand for production activities. The inputoutput model can also be used to determine the changes in the relative composition of greenhouse gas emissions due to exogenous inflows. In this paper we describe a method for evaluating how the exogenous changes in sectorial demand, such as changes in private consumption, public consumption, investment and exports, affect the relative contribution of the six major greenhouse gases regulated by the Kyoto Protocol to total greenhouse emissions. The empirical application is for Spain, and the economic and environmental data are for the year 2000. Our results show that there are significant differences in the effects of different sectors on the composition of greenhouse emissions. Therefore, the final impact on the relative contribution of pollutants will basically depend on the activity that receives the exogenous shock in final demand, because there are considerable differences in the way, and the extent to which, individual activities affect the relative composition of greenhouse gas emissions. Keywords: Greenhouse emissions, composition of emissions, sectorial demand, exogenous shock.

Ecological and Economic Impacts within the Environmental Input-Output Framework

The environmental input-output approach reveals the channels through which the environmental burdens of production activities are transmitted throughout the economy. This paper uses the input-output framework and analyses the changes in Spanish emission multipliers during the period 1995-2000. By decomposing the global changes in multipliers into different components, it is possible to evaluate separately the economic and ecological impacts captured by the environmental input-output model. Specifically, in this study we distinguish between the effects on multipliers caused by changes in emission coefficients (the ecological impacts) and the effects on multipliers caused by changes in technical coefficients (the economic impacts). Our results show a significant improvement in the ecological impacts of production activities, which contributed negatively to changes in emission multipliers. They also show a deterioration in the economic impacts, which contributed positively to changes in emission multipliers. Together, these two effects lead to a small reduction in global multipliers during the period of analysis. Our results also show significant differences in the individual behaviour of different sectors in terms of their contribution to multiplier changes. Since there are considerable differences in the way individual sectors affect the changes in emission levels, and in the intensity of these effects, this means that the final effects will basically depend on the activity considered. Keywords: emission multipliers, multipliers' changes, ecological impacts, economic impacts.

Firm Size and Geographical Aggregation: An Empirical Appraisal in Industrial Location

This paper assesses empirically the importance of size discrimination and disaggregate data for deciding where to locate a start-up concern. We compare three econometric specifications using Catalan data: a multinomial logit with 4 and 41 alternatives (provinces and comarques, respectively) in which firm size is the main covariate; a conditional logit with 4 and 41 alternatives including attributes of the sites as well as size-site interactions; and a Poisson model on the comarques and the full spatial choice set (942 municipalities) with site-specific variables. Our results suggest that if these two issues are ignored, conclusions may be misleading. We provide evidence that large and small firms behave differently and conclude that Catalan firms tend to choose between comarques rather than between municipalities. Moreover, labour-intensive firms seem more likely to be located in the city of Barcelona. Keywords: Catalonia, industrial location, multinomial response model. JEL: C250, E30, R00, R12