Atividade física e sintomas neuropsiquiátricos em pacientes com demência de Alzheimer

Is common the presence of neuropsychiatric symptoms in Alzheimer's disease (AD), this is resulted of anatomical and biochemical changes in the brain. The objective of present study was to look for papers relating physical activity and neuropsychiatric symptoms through a systematic review. The following data bases was accessed: Academic Search Premier, Biological Abstracts, Medline, PsycINFO, Pubmed, Scielo, Science direct on line, Sport Discus and Web of Science, using the following key-words: (Neuropsychiatric disturbances OR Neuropsychiatric symptoms OR Neuropsychological disturbances OR Aberrant behavior OR Aberrant behaviour OR Behavior disturbances OR Behaviour disturbances OR Behavior management OR Behaviour management OR Disruptive behavior OR Disruptive behaviour) and (Alzheimer) and (Exercise OR Motor intervention OR training OR Physical activity OR fitness), besides crossing the references in the selected articles. Eight studies had filled the inclusion criteria. It was possible to conclude there are evidences of positive results for agitation and sleep disturbances in patients with AD. However, there's no consensus of what kind of activity is better for these patients.

Molecular and Cytogenetic Analyses on Brazilian Youths with Pervasive Developmental Disorders

The Pervasive Developmental Disorders (PDDs) constitute a group of behavioral and neurobiological impairment conditions whose main features are delayed communicative and cognitive development. Genetic factors are reportedly associated with PDDs and particular genetic abnormalities are frequently found in specific diagnostic subgroups such as the autism spectrum disorders. This study evaluated cytogenetic and molecular parameters in 30 youths with autism or other PDDs. The fragile X syndrome was the most common genetic abnormality detected, presented by 1 patient with autism and 1 patient with PPD not-otherwise specified (PPD-NOS). One girl with PDD-NOS was found to have tetrasomy for the 15q11-q13 region, and one patient with autism exhibited in 2/100 metaphases an inv(7)(p15q36), thus suggesting a mosaicism 46,XX/46,XX,inv(7)(p15q36) or representing a coincidental finding. The high frequency of chromosomopathies support the hypothesis that PDDs may develop as a consequence to chromosomal abnormalities and justify the cytogenetic and molecular assessment in all patients with PDDs for establishment of diagnosis.

Growth and developmental outcomes of the extremely preterm infant

Objetive: To provide information for pediatricians and neonatologists to create realistic outcome expectations and thus help plan their actions. Sources of data: Searches were made of the Cochrane Library, MEDLINE, and Lilacs databases. Summary of the findings: The assessment of growth and development over the first 2-3 years must adjust chronological age with respect of the degree of prematurity. There is special concern regarding the prognoses of small for gestational age preterm infants, and for those with bronchopulmonary dysplasia. Attention must be directed towards improving the nutrition of extremely low birth weight infants during their first years of life; these infants have high prevalence levels of failure to catch-up on growth, diseases and rehospitalizations during their first 2 years. They are frequently underweight and shorter than expected during early childhood, but delayed catch-up growth may occur between 8 and 14 years. Extremely low birth weight infants are at increased risk of neurological abnormalities and developmental delays during their first years of life. Educational, psychological, and behavioral problems are frequent during school years. Teenage and adult outcomes show that although some performance differences persist, social integration is not impaired. Conclusions: The growth and neurodevelopment of all ELBW infants must be carefully monitored after discharge, to ensure that children and their families receive adequate support and intervention to optimize prognoses. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Velocardiofacial syndrome with a rare t(2;22)

Rearrangements involving chromosomes 2 and 22 were described not only as acquired abnormalities in a variety of human neoplasias but also in the constitutional karyotype suggesting the existence of a greater fragility in some specific regions in these chromosomes. Patients with DiGeorge and Velocardiofacial syndromes have a deletion on 22q11 leading to haploinsufficiency for one or more gene(s). We report a patient with velocardiofacial syndrome in which cytogenetic and fluorescence in situ hybridization analysis showed a rare t(2;22) and deletion in the 22q11 region. © 2007 Lippincott Williams & Wilkins, Inc.

Construction and validation of the brazilian questionário de respostas socialmente habilidosas segundo relato de professores (QRSH-PR)

Behavioral problems in preschool children are one of the most frequent motives for seeking psychological care by parents and caregivers. Instruments are considered necessary, created from a Social Skills Training theoretical-practical perspective, which may systematically assist the identification of social skills and behavioral deficits, helping professionals in the prevention and/or reduction of behavioral problems. The purpose of this study was to test the psychometric validity and reliability of an instrument for evaluation of Socially Skilled Responses, from a teacher's perspective (QRSH-PR For this purpose, 260 preschool children were evaluated, differentiated in subgroups without and without behavioral difficulties, based on the Child Behavior Scale (Escala de Comportamento Infantil/ECI-Professor Studies were conducted for construct, discrimination, concurrent and predictive validity. The Cronbach Alpha was calculated to evaluate internal consistency. The obtained results pointed to positive indicators in reference to construct, discrimination, and predictive validity, and even for good internal consistency, indicating that the items consistently measure the construct of social skills, and differentiated children with and without behavioral problems. The questionnaire is considered to be gauged for evaluation of socially skilled responses from preschool children, and applicable in educational and clinical environments. Copyright 2009 by The Spanish Journal of Psychology.

Visual symptoms in Parkinson's disease and Parkinson's disease dementia

Visual symptoms are common in PD and PD dementia and include difficulty reading, double vision, illusions, feelings of presence and passage, and complex visual hallucinations. Despite the established prognostic implications of complex visual hallucinations, the interaction between cognitive decline, visual impairment, and other visual symptoms remains poorly understood. Our aim was to characterize the spectrum of visual symptomatology in PD and examine clinical predictors for their occurrence. Sixty-four subjects with PD, 26 with PD dementia, and 32 age-matched controls were assessed for visual symptoms, cognitive impairment, and ocular pathology. Complex visual hallucinations were common in PD (17%) and PD dementia (89%). Dementia subjects reported illusions (65%) and presence (62%) more frequently than PD or control subjects, but the frequency of passage hallucinations in PD and PD dementia groups was equivalent (48% versus 69%, respectively; P = 0.102). Visual acuity and contrast sensitivity was impaired in parkinsonian subjects, with disease severity and age emerging as the key predictors. Regression analysis identified a variety of factors independently predictive of complex visual hallucinations (e.g., dementia, visual acuity, and depression), illusions (e.g., excessive daytime somnolence and disease severity), and presence (e.g., rapid eye movement sleep behavior disorder and excessive daytime somnolence). Our results demonstrate that different "hallucinatory" experiences in PD do not necessarily share common disease predictors and may, therefore, be driven by different pathophysiological mechanisms. If confirmed, such a finding will have important implications for future studies of visual symptoms and cognitive decline in PD and PD dementia.

Sleepwalking in Parkinson's disease: a questionnaire-based survey

Sleepwalking (SW) corresponds to a complex sleep-associated behavior that includes locomotion, mental confusion, and amnesia. SW is present in about 10% of children and 2-3% of adults. In a retrospective series of 165 patients with Parkinson's disease (PD), we found adult-onset ("de novo") SW "de novo" in six (4%) of them. The aim of this study was to assess prospectively and systematically the frequency and characteristics of SW in PD patients. A questionnaire including items on sleep quality, sleep disorders, and specifically also SW and REM sleep behavior disorder (RBD), PD characteristics and severity, was sent to the members of the national PD patients organization in Switzerland. In the study, 36/417 patients (9%) reported SW, of which 22 (5%) had adult-onset SW. Patients with SW had significantly longer disease duration (p = 0.035), they reported more often hallucinations (p = 0.004) and nightmares (p = 0.003), and they had higher scores, suggestive for RBD in a validated questionnaire (p = 0.001). Patients with SW were also sleepier (trend to a higher Epworth Sleepiness Scale score, p = 0.055). Our data suggest that SW in PD patients is (1) more common than in the general population, and (2) is associated with RBD, nightmares, and hallucinations. Further studies including polysomnographic recordings are needed to confirm the results of this questionnaire-based analysis, to understand the relationship between SW and other nighttime wandering behaviors in PD, and to clarify the underlying mechanisms.

Nonmotor disturbances in Parkinson's disease

Nonmotor disturbances (NMDs) affect most patients with Parkinson's disease (PD) and often have a profound impact on their quality of life. NMDs such as depression, anxiety, fatigue, REM sleep behavior disorder, constipation, delayed gastric emptying, altered olfaction and pain can precede the onset of motor symptoms. Other NMDs, including hallucinations, dementia, excessive daytime sleepiness, insomnia, orthostatic hypotension and bladder disturbances, typically appear later in the course of PD. For most NMDs of PD, nondopaminergic and non-nigrostriatal mechanisms (e.g. neurodegeneration of other transmitter systems in the cortex and brainstem, side effects of medications, genetic and psychosocial factors) are considered more relevant than the 'classical' dopaminergic-nigrostriatal dysfunction. The recognition of NMDs requires a high degree of clinical suspicion, the use of specific questionnaires and ancillary tests. Pharmacological and nonpharmacological approaches can be effective, but for most forms of treatment of NMDs, the scientific evidence is limited.

The relationship between classroom interactions and exclusionary discipline as a social practice: A critical microethnograhy

Exclusionary school discipline results in students being removed from classrooms as a consequence of their disruptive behavior and may lead to subsequent suspension and/or expulsion. Literature documents that nondominant students, particularly Black males, are disproportionately impacted by exclusionary discipline, to the point that researchers from a variety of critical perspectives consider exclusionary school discipline an oppressive educational practice and condition. Little or no research examines specific teacher-student social interactions within classrooms that influence teachers’ decisions to use or not use exclusionary discipline. Therefore, this study set forth the central research question: In relation to classroom interactions in alternative education settings, what accounts for teachers’ use or non-use of exclusionary discipline with students? A critical social practice theory of learning served as the framework for exploring this question, and a critical microethnographic methodology informed the data collection and analysis. ^ Criterion sampling was used to select four classrooms in the same alternative education school with two teachers who frequently and two who rarely used exclusionary discipline. Nine stages of data collection and reconstructive data analysis were conducted. Data collection involved video recorded classroom observations, digitally recorded interviews of teachers and students discussing selected video segments, and individual teacher interviews. Reconstructive data analysis procedures involved hermeneutic inferencing of possible underlying meanings, critical discourse analysis, interactive power analysis and role analysis, thematic analysis of the interactions in each classroom, and a final comparative analysis of the four classrooms. ^ Four predominant themes of social interaction (resistance, conformism, accommodation, and negotiation) emerged with terminology adapted from Giroux’s (2001) theory of resistance in education and Third Space theory (Gutiérrez, 2008). Four types of power (normative, coercive, interactively established contracts, and charm), based on Carspecken’s (1996) typology, were found in the interactions between teacher and students in varying degrees for different purposes. ^ This research contributes to the knowledge base on teacher-student classroom interactions, specifically in relation to exclusionary discipline. Understanding how the themes and varying power relations influence their decisions and actions may enable teachers to reduce use of exclusionary discipline and remain focused on positive teacher-student academic interactions. ^

The Relationship between Classroom Interactions and Exclusionary Discipline as a Social Practice: A Critical Microethnography

Exclusionary school discipline results in students being removed from classrooms as a consequence of their disruptive behavior and may lead to subsequent suspension and/or expulsion. Literature documents that nondominant students, particularly Black males, are disproportionately impacted by exclusionary discipline, to the point that researchers from a variety of critical perspectives consider exclusionary school discipline an oppressive educational practice and condition. Little or no research examines specific teacher-student social interactions within classrooms that influence teachers’ decisions to use or not use exclusionary discipline. Therefore, this study set forth the central research question: In relation to classroom interactions in alternative education settings, what accounts for teachers’ use or non-use of exclusionary discipline with students? A critical social practice theory of learning served as the framework for exploring this question, and a critical microethnographic methodology informed the data collection and analysis. Criterion sampling was used to select four classrooms in the same alternative education school with two teachers who frequently and two who rarely used exclusionary discipline. Nine stages of data collection and reconstructive data analysis were conducted. Data collection involved video recorded classroom observations, digitally recorded interviews of teachers and students discussing selected video segments, and individual teacher interviews. Reconstructive data analysis procedures involved hermeneutic inferencing of possible underlying meanings, critical discourse analysis, interactive power analysis and role analysis, thematic analysis of the interactions in each classroom, and a final comparative analysis of the four classrooms. Four predominant themes of social interaction (resistance, conformism, accommodation, and negotiation) emerged with terminology adapted from Giroux’s (2001) theory of resistance in education and Third Space theory (Gutiérrez, 2008). Four types of power (normative, coercive, interactively established contracts, and charm), based on Carspecken’s (1996) typology, were found in the interactions between teacher and students in varying degrees for different purposes. This research contributes to the knowledge base on teacher-student classroom interactions, specifically in relation to exclusionary discipline. Understanding how the themes and varying power relations influence their decisions and actions may enable teachers to reduce use of exclusionary discipline and remain focused on positive teacher-student academic interactions.

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

Vulnerabilidade ao Stress e Autoestima em Professores do 1.º, 2.º E 3.º Ciclo

Introdução: O stress condiciona o comportamento e desenvolvimento pessoal, podendo ter consequências preocupantes ao nível individual e organizacional. Os professores são uma classe reconhecida como estando sujeita a elevados níveis de stress, fator que prejudica a qualidade do ensino em geral. Objetivos: Avaliar a vulnerabilidade ao stress; identificar os principais fatores de stress e avaliar a correlação entre autoestima e stress, em professores do 1.º, 2.º e 3.º ciclos do ensino básico. Metodologia: Estudo correlacional, com uma amostra constituída por 60 professores do 1.º, 2.º e 3.º ciclos de escolaridade, de escolas do concelho de Leiria. Para a análise das variáveis em estudo foram aplicados: um questionário sociodemográfico; a Rosenberg Self-Esteem Scale (RSES); o Questionário de stress nos professores: ensino básico e secundário (QSPEBS) e a Escala de vulnerabilidade ao stress (23 QVS). Resultados: O estudo revela que 65% dos professores percecionam a profissão como stressante e que 30% são vulneráveis ao stress. O principal fator de stress identificado foi comportamentos inadequados/indisciplina dos alunos. Verificou-se uma correlação negativa entre a autoestima e a vulnerabilidade ao stress dos professores. Conclusão: Conclui-se que, quanto mais elevada é a auto-estima, menor é a vulnerabilidade dos professores ao stress e que, apesar de não se registarem níveis significativos de vulnerabilidade ao stress na população docente, a maioria dos professores perceciona a sua atividade profissional como geradora de elevados níveis de stress, sendo os comportamentos inadequados/indisciplina dos alunos o fator que mais contribui para o stress nos docentes. / Introduction: Stress affects behavior and personal development, and may have severe consequences either at the individual or organizational level. Teachers are identified as a class exposed to high levels of stress, factor that affects the quality of education in general. Objectives: To assess stress vulnerability; identify key stressors and assess the correlation between self-esteem and stress in primary and secondary school teachers. Methodology: A sociodemographic questionnaire and three self-report measures were administered to a sample of 60 primary and secondary teachers from Leiria district: the Rosenberg Self-Esteem Scale (RSES); a teachers stress questionnaire for primary, secondary and high school (QSPEBS) and a scale to access stress vulnerability (23 QVS). Results: The study reveals that 65% of teachers perceive the profession as stressful and that 30% are vulnerable to stress. The main stressor identified is inappropriate/disruptive behavior of students. There is a negative correlation between self-esteem and vulnerability to stress of teachers. Conclusion: We conclude that a higher self-esteem leads to less stress vulnerability in teachers and that, despite the non-significant level of vulnerability determined in this study, most teachers perceive their activity as stressful, being inappropriate/disruptive behavior of students the factor that most contributes for that.

A importância das visitas de estudo na aprendizagem: conceções de alunos e professores

Relatório de Estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º Ciclos do Ensino Básico

Emotional Skills and Promoting School Success in the 3rd Cycle: Students Perception

The perceptions about school play a central role in behavior, performance and learning outcomes. There is evidence that an improvement in emotional skills is associated with a higher school success. The aim of this paper is to know the relationship between internalizing and externalizing behaviors, emotional skills and academic success of students of the 3rd cycle of basic education. In order to promote students social and emotional skills, a pilot study in a School Grouping of the central region (Portugal) was carried out. It was made a diagnosis of disruptive behavior (ASEBA) and identified 6 children aged between 12 and 14 years old and followed by 3 focus groups with students, parents, and teachers, respectively. Six students mostly male were identified, with the predominance of externalizing behaviors and academic failure. They don’t like school and have no motivation for learning. The relationship between parents and teachers is conflictive. All parents have the utmost concern academic success and teachers perceived good practices, but without success. This program is seen in a perspective of empowerment of the educational agents to manage various environments and relationships. The results point to the importance of the systemic intervention program on the improvement of the social and emotional competences and academic achievement.