bluuebunny/crossref_metadata_2025 huggingface dataset:
Donner Sens à l'Expérience du Geste en Classe Technique: regard sur la pratique de quatre enseignantes au Québec
Authors: Bienaise Johanna , Levac Manon
Published: July 2016

Résumé : Cet article examine l'enseignement de la classe technique contemporaine dans la formation préprofessionnelle au Québec dans un contexte d'hétérogénéité des pratiques chorégraphiques. Les auteures y analysent plus spécifiquement le témoignage de quatre artistes enseignantes: Kelly Keenan, Manon Levac, Sandrine Vachon et Jamie Wright. Cette analyse met en lumière leur philosophie d'enseignement et leurs choix pédagogiques qui les amènent à une mise en mouvement à la fois structurée et sensible du corps, dans une relation toujours renouvelée avec leurs étudiants.
Dimensões nasofaríngeas em indivíduos sem anomalias craniofaciais: dados normativos
Authors: Araújo Laryssa Lopes de , Silva Andressa Sharllene Carneiro da , Araújo Bruna Mara Adorno Marmontel , Yamashita Renata Paciello , Trindade Inge Elly Kiemle , Fukushiro Ana Paula
Published: July 2016

RESUMO Objetivo Determinar os valores controles da área de secção transversa mínima nasofaríngea de indivíduos sem anomalias craniofaciais e em diferentes faixas etárias. Material e Método Participaram do estudo 96 indivíduos sem anomalias craniofaciais, de ambos os sexos, com índice de massa corpórea e circunferência cervical normais, subdivididos em 4 grupos etários: crianças com idade entre 6 e 10 anos (G1), adolescentes de 11 a 17 anos (G2), adultos jovens entre 18 e 39 anos (G3) e adultos de meia-idade entre 40 e 59 anos (G4). A área seccional transversa mínima nasofaríngea (área nasofaríngea – ANF) foi determinada por meio de rinomanometria anterior modificada (técnica fluxo-pressão), utilizando o sistema PERCI-SARS (versão 3.50 – Microtronics Corp.). Resultados Os valores médios±DP da ANF foram de 1,025±0,054cm2, 1,055±0,081cm2, 1,050±0,083cm2 e 1,054±0,081cm2, respectivamente, para G1, G2, G3 e G4, não havendo diferença entre as 4 faixas etárias. Conclusão Os valores controles da ANF foram determinados para indivíduos sem anomalias craniofaciais de diferentes faixas etárias e servirão de referência na rotina clínica e em estudos envolvendo diagnóstico de obstrução nasofaríngea, principalmente na presença de anomalias craniofaciais.
La brecha de género en la educación tecnológica
Authors: Jiménez Rafael González-Palencia , Fernández Carmen Jiménez
Published: July 2016

Resumo Los datos del sistema educativo y los del ámbito empresarial indican que la presencia femenina en los estudios y profesiones relacionadas con las TIC sigue siendo minoritaria. Además señalan que en el paradigma tecnológico imperante los hombres crean y gestionan la innovación digital y las mujeres son usuarias de dichas innovaciones, persistiendo el riesgo de que aumente la brecha de género. Recordemos que las TIC sustentan la comunicación, la ciencia, la cultura, la economía y la innovación, de forma ubicua y a nivel planetario. La hipótesis de la socialización diferencial de los géneros goza de plausibilidad científica como explicación del menor interés de las mujeres por este ámbito del saber desde edades tempranas. Este estudio analiza las barreras de género en la educación tecnológica, las sinergias que las sostienen y el papel de la educación para que mujeres y hombres sean corresponsablemente agentes activos de la creación y desarrollo de las TIC.
Racionalidade e gerencialismo na política educacional paulista de 1995 a 2014: muito além das conjunturas
Authors: Ramos Géssica Priscila
Published: July 2016

Resumo Este artigo objetiva apresentar o modelo de gestão que embasa a política educacional paulista de 1995 a 2014, reconstruindo, para tanto, a lógica que sustenta e entrelaça os principais programas, projetos e ações implementados no período. A partir de análise bibliográfica e documental, verificou-se que, nesse período, os eixos racionalização organizacional, mudança nos padrões de gestão e melhoria na qualidade do ensino, mantiveram-se como base da reforma educacional no Estado. Sob essa configuração, o material analisado revela que tal processo sustenta-se num modelo gerencialista e de racionamento da educação e, por conseguinte, da própria qualidade do ensino.
Dez escolas, dois padrões de qualidade. Uma pesquisa em dez escolas públicas de Ensino Médio do Estado do Ceará
Authors: Haguette André , Pessoa Márcio Kleber Morais , Vidal Eloísa Maia
Published: July 2016

Resumo Tomando por base os resultados no Enem de 2011, realizou-se, ao longo de 2013 e 2014, uma pesquisa comparativa de cinco das dez escolas de Ensino Médio da rede estadual do Estado do Ceará com melhor desempenho, e de cinco entre as dez com rendimento mais fraco, quatro do interior e seis da capital. Os instrumentos de coleta de dados foram: visitas às escolas, entrevistas com um membro do núcleo gestor, com professores, alunos e funcionários e aplicação de um questionário numa turma de alunos e com professores. O objetivo era descobrir o que as escolas de melhor desempenho tinham que as de desempenho nitidamente insuficiente não tinham. A partir dos resultados, foi construído um “retrato falado” de cada escola, apontando suas principais características. Logo ficou evidenciado que existem dois padrões escolares mutuamente excludentes e irreconciliáveis, o que foi traduzido em duas tipologias ideal-típicas reveladoras da situação e susceptíveis de fornecer elementos para a elaboração de políticas educacionais. Este artigo omite os “retratos falados” de cada escola por falta de espaço, e concentra-se na apresentação e discussão das duas tipologias de maneira a explicitar e explicar o duplo padrão, verdadeiro dualismo, existente entre estabelecimentos de uma mesma rede escolar pública. A conclusão levanta questionamentos provocados pela pesquisa.
Políticas públicas educacionais: vozes que emergem no trabalho docente na Educação Infantil
Authors: Paulino Verônica Belfi Roncetti , Côco Valdete
Published: July 2016

Resumo Este artigo, decorrente de pesquisa de mestrado, aborda as políticas públicas no campo da Educação Infantil (EI) focalizando a constituição da docência na perspectiva da afirmação da indissociabilidade do educar e cuidar. Discute a questão da presença de diferentes grupos de profissionais docentes atuando com o mesmo grupo de crianças. Sustenta-se no desenvolvimento de pesquisa de abordagem qualitativa de orientação sócio-histórica, com procedimentos metodológicos de observação participante e entrevistas. Os dados sinalizam, no bojo das políticas públicas educacionais, que a constituição da docência na EI interage com um repertório hierárquico oficial composto de aspectos referentes à formação requisitada, atribuições demandadas e delineamento das carreiras, com suas políticas de reconhecimento e valorização, enfraquecendo a perspectiva da indissociabilidade do educar e cuidar nesse campo.
Content validity of the Geriatric Health Assessment Instrument
Authors: Pedreira Rhaine Borges Santos , Rocha Saulo Vasconcelos , Santos Clarice Alves dos , Vasconcelos Lélia Renata Carneiro , Reis Martha Cerqueira
Published: July 2016

ABSTRACT Objective Assess the content validity of the Elderly Health Assessment Tool with low education. Methods The data collection instrument/questionnaire was prepared and submitted to an expert panel comprising four healthcare professionals experienced in research on epidemiology of aging. The experts were allowed to suggest item inclusion/exclusion and were asked to rate the ability of individual items in questionnaire blocks to encompass target dimensions as “not valid”, “somewhat valid” or “valid”, using an interval scale. Percent agreement and the Content Validity Index were used as measurements of inter-rater agreement; the minimum acceptable inter-rater agreement was set at 80%. Results The mean instrument percent agreement rate was 86%, ranging from 63 to 99%, and from 50 to 100% between and within blocks respectively. The Mean Content Validity Index score was 93.47%, ranging from 50 to 100% between individual items. Conclusion The instrument showed acceptable psychometric properties for application in geriatric populations with low levels of education. It enabled identifying diseases and assisted in choice of strategies related to health of the elderly.
Assessment of physicians’ addressing sexuality in elderly patients with chronic pain
Authors: Cherpak Guilherme Liausu , Santos Fânia Cristina dos
Published: July 2016

ABSTRACT Objective To determine the frequency with which physicians address their older adult patients with chronic pain about the issue of sexuality. Methods It is a cross sectional, descriptive, analytical study in which physicians answered a questionnaire comprising questions related to addressing the issue of sexuality during appointments. Results A sample of 155 physicians was obtained, 63.9% stated they did not address sexuality in medical interviews and 23.2% did it most of the time. The main reasons for not addressing were lack of time, fear of embarrassing the patient and technical inability to address the issue. Conclusion There is a need to develop strategies to increase and improve addressing of sexuality in elderly patients with chronic pain, in order to have better quality of life.
Overweight effect on spirometric parameters in adolescents undergoing exercise
Authors: Costa Rayana de Oliveira , Silva Juliana Pereira , Lacerda Eliana Mattos , Dias Rodrigo , Pezolato Vitor Alexandre , Silva Carlos Alberto da , Krinski Kleverton , Correia Junior Marco Aurélio de Valois , Cieslak Fabrício
Published: July 2016

ABSTRACT Objective To evaluate effects of overweight on spirometric parameters in adolescents who underwent bronchial provocation test for exercise. Methods We included 71 male adolescents. The diagnosis of asthma was done based on participants’ clinical history and on the International Study Questionnaire Asthma and Allergies in Childhood, and the diagnosis of obesity was based on body mass index above 95th percentile. The bronchospasm induced by exercise was assessed using the run-walk test on a treadmill for eight minutes. The decrease in forced expiratory volume in one second > or equal to 10% before exercise was considered positive, and to calculate the intensity in exercise-induced bronchospasm we measured the maximum percentage of forced expiratory volume in one second and above the curve area. Data analysis was carried out using the Mann-Whitney U test and Friedman test (ANOVA), followed by Wilcoxon test (p<0.05). In addition, we used Fisher’s exact test to analyze the exercise-induced bronchospasm frequency. Results Significant differences were observed among obese adolescents in exercise-induced bronchospasm frequency (p=0,013) and in relation to time required for recovery after exercise (p=0,007). Conclusion Overweight can influence the increase in the exercise-induced bronchospasm frequency in non-asthmatic adolescents compared with eutrophic adolescents.
Correlation of Thyroid Imaging Reporting and Data System [TI-RADS] and fine needle aspiration: experience in 1,000 nodules
Authors: Rahal Junior Antonio , Falsarella Priscila Mina , Rocha Rafael Dahmer , Lima João Paulo Bacellar Costa , Iani Matheus Jorge , Vieira Fábio Augusto Cardillo , Queiroz Marcos Roberto Gomes de , Hidal Jairo Tabacow , Francisco Neto Miguel José , Garcia Rodrigo Gobbo , Funari Marcelo Buarque de Gusmão
Published: July 2016

ABSTRACT Objective To correlate the Thyroid Imaging Reporting and Data System (TI-RADS) and the Bethesda system in reporting cytopathology in 1,000 thyroid nodules. Methods A retrospective study conducted from November 2011 to February 2014 that evaluated 1,000 thyroid nodules of 906 patients who underwent ultrasound exam and fine needle aspiration. Results A significant association was found between the TI-RADS outcome and Bethesda classification (p<0.001). Most individuals with TI-RADS 2 or 3 had Bethesda 2 result (95.5% and 92.5%, respectively). Among those classified as TI-RADS 4C and 5, most presented Bethesda 6 (68.2% and 91.3%, respectively; p<0.001). The proportion of malignancies among TI-RADS 2 was 0.8%, and TI-RADS 3 was 1.7%. Among those classified as TI-RADS 4A, proportion of malignancies was 16.0%, 43.2% in 4B, 72.7% in 4C and 91.3% among TI-RADS 5 (p<0.001), showing clear association between TI-RADS and biopsy results. Conclusion The TI-RADS is appropriate to assess thyroid nodules and avoid unnecessary fine needle aspiration, as well as to assist in making decision about when this procedure should be performed.
Condom use and alcohol consumption in adolescents and youth
Authors: Mola Rachel , Pitangui Ana Carolina Rodarti , Barbosa Sháyra Anny Moura , Almeida Layane Sá , Sousa Mayara Ruth Marinho de , Pio Wellypâmela Pauliny de Lima , Araújo Rodrigo Cappato de
Published: July 2016

ABSTRACT Objective To determine the association between not using the male condom and alcohol consumption in adolescents and schoolchildren. Methods An epidemiological study, with a cross-sectional, descriptive, and correlation design carried out from March to July 2014. The sample consisted of students in public primary and secondary education, aged between 12 and 24 years. The social and demographic survey and the Youth Risk Behavior Survey questionnaire were used. Results The study included 1,275 students, of these; 37.0% reported having had sexual relations. The prevalent age of sexual initiation was 14-16 years 55.7% and 65.6% used condom in the last sexual intercourse. Regarding the lack of condom use at the last intercourse, girls showed an association with drunkenness in the previous 30 days (2.19; 95%CI: 1.06-4.54). Conclusion In females, the non-use of condoms was associated with drunkenness in the previous 30 days.
Potential intravenous drug incompatibilities in a pediatric unit
Authors: Leal Karla Dalliane Batista , Leopoldino Ramon Weyler Duarte , Martins Rand Randall , Veríssimo Lourena Mafra
Published: July 2016

ABSTRACT Objective To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit. Methods A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student’s t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval. Results A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility. Conclusion Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities.
Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews
Authors: Costa Marcelle Barrueco , Melnik Tamara
Published: July 2016

ABSTRACT Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy.
Neural correlates of lexical-semantic memory: A voxel-based morphometry study in mild AD, aMCI and normal aging
Authors: Balthazar Marcio L.F. , Yasuda Clarissa L. , Lopes Tátila M. , Pereira Fabrício R.S. , Damasceno Benito Pereira , Cendes Fernando
Published: July 2016

Abstract Neuroanatomical correlations of naming and lexical-semantic memory are not yet fully understood. The most influential approaches share the view that semantic representations reflect the manner in which information has been acquired through perception and action, and that each brain area processes different modalities of semantic representations. Despite these anatomical differences in semantic processing, generalization across different features that have similar semantic significance is one of the main characteristics of human cognition. Methods: We evaluated the brain regions related to naming, and to the semantic generalization, of visually presented drawings of objects from the Boston Naming Test (BNT), which comprises different categories, such as animals, vegetables, tools, food, and furniture. In order to create a model of lesion method, a sample of 48 subjects presenting with a continuous decline both in cognitive functions, including naming skills, and in grey matter density (GMD) was compared to normal young adults with normal aging, amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). Semantic errors on the BNT, as well as naming performance, were correlated with whole brain GMD as measured by voxel-based morphometry (VBM). Results: The areas most strongly related to naming and to semantic errors were the medial temporal structures, thalami, superior and inferior temporal gyri, especially their anterior parts, as well as prefrontal cortices (inferior and superior frontal gyri). Conclusion: The possible role of each of these areas in the lexical-semantic networks was discussed, along with their contribution to the models of semantic memory organization.
Cognitive performance of long-term institutionalized elderly patients with schizophrenia: A case control study
Authors: Diaz Alexandre Paim , Scalco Monica Zavaloni , Schwarzbold Marcelo Libório , Formolo Douglas Affonso , Stoppe Júnior Alberto
Published: July 2016

Abstract Cognitive impairment is inherent to the ageing process. Several studies suggest that patients with late-life schizophrenia have more marked cognitive impairment. Objective: The aim of this study was to compare the cognitive performance of elderly institutionalized patients with schizophrenia and institutionalized elderly control patients without neurological or psychiatric diseases, matched for age, educational level and institutionalization time. Methods: The Cambridge Examination for Mental Disorders of the Elderly (CAMCOG) was used to test 10 institutionalized elderly patients with schizophrenia. Results were compared with those of 10 institutionalized control patients with history of Hansen's disease. Results: Patients with schizophrenia showed a worse performance in terms of total CAMCOG score and on its subtests of orientation, language, abstraction, and memory (p≤0.05). Patients with schizophrenia also disclosed a non-significant trend toward lower scores on the MMSE and on calculus. Conclusion: Findings demonstrated that schizophrenia was associated to worse cognitive impairment in long-term institutionalized elderly patients compared with institutionalized patients without neurological or psychiatric diseases.
Worries about memory loss and knowledge on Alzheimer's disease in community-dwelling elderly from Brazil
Authors: Matioli Maria Niures P.S. , Etzel Arnaldo , Prats João A.G.G. , Medeiros Wares F. de O. , Monteiro Taiguara R. , Soares Alberto de M.
Published: July 2016

Abstract Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Efforts to determine risk factors for the development of AD are important for risk stratification and early diagnosis. Furthermore, there are no standardized practices for memory screening. Lack of knowledge on AD, perception of memory loss as part of normal aging, and poor socioeconomic conditions may also be implicated in the current situation of dementia. Objective: To evaluate knowledge of AD in a literate population of elders and correlate these findings with sociodemographic characteristics. Methods: A descriptive survey design study enrolled 994 volunteers from September 2007 to May 2008 in the city of Santos, São Paulo, Brazil, to answer a brief questionnaire consisting of 8 simple questions about knowledge of AD and worries about memory loss. Results: Greater knowledge about AD was associated with eight or more years of education, female gender and age between 60 and 70 years. Also, 52.8% of responders (95% CI - 49.5-56.0%) answered that memory loss is part of normal aging and 77.5% (95% CI - 74.7-80.1%) had never sought a doctor to evaluate their memories. Conclusion: Our study results reinforced that the first line of preventing late diagnosis of dementia is to act in health promotion, especially by targeting subjects older than 70 years of male gender and with lower educational level. It also provided evidence that strategies to promote physician initiative in treating memory problems are also paramount.
Deaf individuals who work with computers present a high level of visual attention
Authors: Ribeiro Paula Vieira , Ribas Valdenilson Ribeiro , Ribas Renata de Melo Guerra , Melo Teresinha de Jesus Oliveira Guimarães de , Marinho Carlos Antonio de Sá , Silva Kátia Karina do Monte , Albuquerque Elizabete Elias de , Ribas Valéria Ribeiro , Lima Renata Mirelly Silva de , Santos Tuthcha Sandrelle Botelho Tavares
Published: July 2016

Abstract Some studies in the literature indicate that deaf individuals seem to develop a higher level of attention and concentration during the process of constructing of different ways of communicating. Objective: The aim of this study was to evaluate the level of attention in individuals deaf from birth that worked with computers. Methods: A total of 161 individuals in the 18-25 age group were assessed. Of these, 40 were congenitally deaf individuals that worked with computers, 42 were deaf individuals that did not work, did not know how to use nor used computers (Control 1), 39 individuals with normal hearing that did not work, did not know how to use computers nor used them (Control 2), and 40 individuals with normal hearing that worked with computers (Control 3). Results: The group of subjects deaf from birth that worked with computers (IDWC) presented a higher level of focused attention, sustained attention, mental manipulation capacity and resistance to interference compared to the control groups. Conclusion: This study highlights the relevance sensory to cognitive processing.
Cognitive, functional and behavioral assessment: Alzheimer's disease
Authors: Chaves Márcia L.F. , Godinho Claudia C. , Porto Claudia S. , Mansur Leticia , Carthery-Goulart Maria Teresa , Yassuda Mônica S. , Beato Rogério
Published: July 2016

Abstract A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State Examination has clinical utility as a screening test, as do the multifunctional batteries (CAMCOG-R, ADAS-COG, CERAD and MDRS) for brief evaluations of several cognitive domains. There was sufficient evidence to recommend the CDR scale for clinical and severity assessment of dementia. Tests for Brazilian Portuguese are recommended by cognitive domain based on available data.
Diagnosis of Alzheimer's disease in Brazil: Supplementary exams
Authors: Caramelli Paulo , Teixeira Antonio Lúcio , Buchpiguel Carlos Alberto , Lee Hae Won , Livramento José Antônio , Fernandez Liana Lisboa , Anghinah Renato
Published: July 2016

Abstract This article presents a review of the recommendations on supplementary exams employed for the clinical diagnosis of Alzheimer's disease (AD) in Brazil published in 2005. A systematic assessment of the consensus reached in other countries, and of articles on AD diagnosis in Brazil available on the PUBMED and LILACS medical databases, was carried out. Recommended laboratory exams included complete blood count, serum creatinine, thyroid stimulating hormone (TSH), albumin, hepatic enzymes, Vitamin B12, folic acid, calcium, serological reactions for syphilis and serology for HIV in patients aged younger than 60 years with atypical clinical signs or suggestive symptoms. Structural neuroimaging, computed tomography or - preferably - magnetic resonance exams, are indicated for diagnostic investigation of dementia syndrome to rule out secondary etiologies. Functional neuroimaging exams (SPECT and PET), when available, increase diagnostic reliability and assist in the differential diagnosis of other types of dementia. The cerebrospinal fluid exam is indicated in cases of pre-senile onset dementia with atypical clinical presentation or course, for communicant hydrocephaly, and suspected inflammatory, infectious or prion disease of the central nervous system. Routine electroencephalograms aid the differential diagnosis of dementia syndrome with other conditions which impair cognitive functioning. Genotyping of apolipoprotein E or other susceptibility polymorphisms is not recommended for diagnostic purposes or for assessing the risk of developing the disease. Biomarkers related to the molecular alterations in AD are largely limited to use exclusively in research protocols, but when available can contribute to improving the accuracy of diagnosis of the disease.
Effects of motor and cognitive dual-task performance in depressive elderly, healthy older adults, and healthy young individuals
Authors: Moraes Helena , Deslandes Andrea , Silveira Heitor , Arcoverde Cynthia , Alve Heloisa , Laks Jerson
Published: July 2016

Abstract Impairments in dual-task performance can be observed in healthy older adults when motor and cognitive assignments are applied simultaneously. According to the hypofrontality hypothesis, there may be a reduction in frontal cognitive function during exercise. Objective: The aim of the present study was to compare the performance changes on cognitive tests of depressive elderly (n=10), healthy older adults (n=10), and healthy young individuals (n=10) during cycle ergometer exercise. Methods: The groups were submitted to a working memory test, a short memory test and a semantic memory test, before and during a 20-minute cycle ergometer exercise at 80% of their age-predicted maximal heart rate. Results: Significant differences (p=0.04) were observed in scores on the digit backward test during exercise when young individuals were compared to healthy older adults. This result indicates that young subjects, as expected, had better performance than elderly. No significant differences were found among the groups for the digit forward subtest (p=0.40) or the vocabulary test (p=0.69). Conclusion: Data from this study showed that healthy older adults had impaired performance on higher cognitive tasks when these assignments were applied together with motor tasks.
Neuropsychiatric symptoms as the main determinant of caregiver burden in Alzheimer's disease
Authors: Kochhann Renata , Borba Ericksen , Cerveira Maria Otília , Onyszko Diego , Jesus Alyne de , Forster Letícia , Franciscatto Luisa , Godinho Cláudia , Camozzato Ana Luiza , Chaves Márcia Lorena F.
Published: July 2016

Abstract Caregiver burden is common in Alzheimer's disease (AD), decreasing the quality of life among caregivers and patients. Projections of aging and aging-related diseases such as AD in developing countries justify additional data about this issue because people living in these countries have shown similarly high levels of caregiver strain as in the developed world. Objective: The aim of this study was to analyze the association of AD caregivers' burden with patients' neuropsychiatric symptoms (NPS), cognitive status, severity of dementia, functional capacity, caregiver sociodemographic characteristics, and the characteristics of care provided by caregivers. Methods: A cross-sectional study was conducted in a sample of 39 consecutive AD patients and their primary caregivers. NPS were evaluated using the Neuropsychiatric Inventory (NPI). Severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. Functional capacity was assessed using the Katz and Lawton scales. The burden level was rated using the Burden Interview (BI). Sociodemographic characteristics of caregivers and the characteristics of care provided by them were evaluated. The Mann-Whitney U-test, Kruskal-Wallis test and Spearman's rho coefficient were performed. Results: The BI had a moderate correlation with NPI intensity (rho=0.563), p<001. Female caregivers reported a greater level of burden (p=0.031) than male caregivers. The other variables were not significantly associated to caregiver burden. Conclusion: NPS were the main determinant of burden in primary caregivers of AD patients. This result underscores the need for prevention and treatment of these symptoms. Sex also had an effect on caregiver burden, but the small male sample in this study precludes the generalization of this finding.
Brazilian air traffic controllers exhibit excessive sleepiness
Authors: Ribas Valdenilson Ribeiro , Almeida Cláudia Ângela Vilela de , Martins Hugo André de Lima , Alves Carlos Frederico de Oliveira , Alves Marcos José Pinheiro Cândido , Carneiro Severino Marcos de Oliveira , Ribas Valéria Ribeiro , Vasconcelos Carlos Augusto Carvalho de , Sougey Everton Botelho , Castro Raul Manhães de
Published: July 2016

Abstract Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times. Objective: The objective of this study was to assess ES in air traffic controllers (ATCo). Methods: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo³10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS³10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05. Results: ATCo³10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*. Conclusion: Brazilian air traffic controllers exhibit excessive sleepiness.
Subjective and psychological well-being of students of a University of the Third Age: Benefits of continuing education for psychological adjustment in the elderly
Authors: Ordonez Tiago Nascimento , Lima-Silva Thaís Bento , Cachioni Meire
Published: July 2016

Abstract Objectives: The present study sought to characterize the degree of general satisfaction with life and degree of satisfaction on four domains: health, physical capacity, mental capacity and social involvement, and to determine the characteristics of self-reports of individuals enrolled on the program in relation to their psychological well-being focusing on the dimensions: autonomy, personal growth, control, positive relationships with others, purpose, personal acceptance and generativity, and to analyse the effect of time studying on level of well-being. Method: A total of 140 elderly students of a University for the Third Age took part in the study. The Global Satisfaction With Life Scale and the Self Development Scale (with six psychological well-being subscales) were applied. Continuous variables for the two groups were compared using the Mann-Whitney test. Spearman's correlation coefficient was used to analyze the relationship among numeric variables. Internal consistency of the instrument scales was analysed by calculating Cronbach's alpha coefficient. Results: Results showed that students who had attended the University of the Third Age for six months or longer had a higher level of satisfaction with life and greater psychological adjustment compared with new entrants to the same institution. Conclusion: The study results confirmed the positive effects of continuing education on the well-being of elderly and its contribution to successful aging.
Effects of a psychoeducational intervention in family caregivers of people with Alzheimer's disease
Authors: Ponce Cinthia Costa , Ordonez Tiago Nascimento , Lima-Silva Thaís Bento , Santos Glenda Dias dos , Viola Luciane de Fátima , Nunes Paula Villela , Forlenza Orestes Vicente , Cachioni Meire
Published: July 2016

Abstract Psychoeducational activities are a way of promoting help for caregivers of patients with Alzheimer's disease, representing a forum for knowledge sharing, and in which the primary focus is on psychological themes aimed at carers developing coping skills and strategies. Objective: The main objective of this study was to gauge perceptions about care and its impact among family caregivers of patients with AD participating in a psychoeducational group intervention, as well as the possible positive and negative aspects associated with this role. The subjective impact of AD on the lives of these caregivers was assessed on each of the dimensions of the Caregiver Burden Scale using a semi-directed interview on perceptions about care. Methods: This was a prospective study, in which information was collected twice, before and after, psychoeducational intervention. Through the application of the scale, benefits were evident for all dimensions assessed in the instrument (general strain, isolation, disappointment, emotional involvement and environment). Results: The results showed that after the psychoeducational intervention, caregivers felt less burdened by care compared to pre-intervention. Conclusion: These findings confirm that expanded implementation of psychoeducational interventions for caregivers of patients with AD can be beneficial for both caregivers and patients.
The possibility of physicalism
Authors: Giannetti Eduardo
Published: July 2016

Abstract Modern science has undermined belief in countless imaginary causalities. What is the nature of the relation between mind and brain? Philosophers have debated the issue for millennia, but it is only in the last twenty years that empirical evidence has begun to uncover some of the secrets of this ancient riddle. This lecture explores the possiblity that advances in neuroscience will undermine and subvert our intuitive, mentalist understanding of the mind-body relationship. Recent findings in neuroscience seem to support the notions that (i) mental events are a subclass of neurophysiological events, and (ii) they are devoid of causal efficacy upon the workings of the brain. If physicalism is true then the belief in the causal potency of conscious thoughts and free will are bound to join company with countless other imaginary causalities exploded by the progress of science.
Vascular dementia Cognitive, functional and behavioral assessment Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Part II.
Authors: Engelhardt Eliasz , Tocquer Carla , André Charles , Moreira Denise Madeira , Okamoto Ivan Hideyo , Cavalcanti José Luiz de Sá
Published: July 2016

Abstract Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia) using an evidence-based approach. The material was retrieved and selected from searches of databases (Medline, Scielo, Lilacs), preferentially from the last 15 years, to propose a systematic way to assess cognition, function and behavior, and disease severity staging, with instruments adapted for our milieu, and diagnosis disclosure. The present proposal contributes to the definition of standard diagnostic criteria for VaD based on various levels of evidence. It is noteworthy that only around half of the population of patients with vascular cognitive impairment present with dementia, which calls for future proposals defining diagnostic criteria and procedures for this condition.
Influence of Rivastigmine transdermal on butyrylcholinesterase levels in patients with Alzheimer's disease
Authors: Santos Gustavo Alves Andrade dos , Canineu Paulo Renato , Gonçalves Ivair Donizette , Pardi Paulo Celso
Published: July 2016

Abstract Cholinesterase inhibitors (ChE-Is) are among the main drugs approved for the treatment of Alzheimer's disease (AD). Rivastigmine in the form of a transdermal patch is an alternative delivery method, and can give greater treatment compliance. Objectives: To conduct a preliminary assessment of the neurocognitive and biological effects of oral and transdermal Rivastigmine in patients with AD and to identify a potential biological marker and demonstrate a possible relationship between esterase levels and behavioral scores of AD patients. Methods: Forty patients with AD were treated with cholinesterase inhibitors (ChE-Is), evaluated using the MMSE and NPI, and simultaneously sampled to determine their serum levels of AChE and BuChE for 180 days. Results: The differences obtained between oral and transdermal forms, as assessed by the MMSE and NPI scores of the AD patients, were not significant at the three time points examined (0, 90, and 180 days). However, serum BuChE levels of the transdermal group differed significantly (p<0.0004) compared with those of the oral group at 90 days. Conclusion: Use of a transdermal ChE-I, rivastigmine tartrate significantly reduced BuChE levels in the AD patients studied.
Pragmatic and executive functions in traumatic brain injury and right brain damage: An exploratory comparative study
Authors: Zimmermann Nicolle , Gindri Gigiane , Oliveira Camila Rosa de , Fonseca Rochele Paz
Published: July 2016

Abstract Objective: To describe the frequency of pragmatic and executive deficits in right brain damaged (RBD) and in traumatic brain injury (TBI) patients, and to verify possible dissociations between pragmatic and executive functions in these two groups. Methods: The sample comprised 7 cases of TBI and 7 cases of RBD. All participants were assessed by means of tasks from the Montreal Communication Evaluation Battery and executive functions tests including the Trail Making Test, Hayling Test, Wisconsin Card Sorting Test, semantic and phonemic verbal fluency tasks, and working memory tasks from the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Z-score was calculated and a descriptive analysis of frequency of deficits (Z< -1.5) was carried out. Results: RBD patients presented with deficits predominantly on conversational and narrative discursive tasks, while TBI patients showed a wider spread pattern of pragmatic deficits. Regarding EF, RBD deficits included predominantly working memory and verbal initiation impairment. On the other hand, TBI individuals again exhibited a general profile of executive dysfunction, affecting mainly working memory, initiation, inhibition, planning and switching. Pragmatic and executive deficits were generally associated upon comparisons of RBD patients and TBI cases, except for two simple dissociations: two post-TBI cases showed executive deficits in the absence of pragmatic deficits. Discussion: Pragmatic and executive deficits can be very frequent following TBI or vascular RBD. There seems to be an association between these abilities, indicating that although they can co-occur, a cause-consequence relationship cannot be the only hypothesis.
Neural correlates of behavioural symptoms in behavioural variant frontotemporal dementia and Alzheimer's disease: Employment of a visual MRI rating scale
Authors: Go Christopher , Mioshi Eneida , Yew Belinda , Hodges John R. , Hornberger Michael
Published: July 2016

ABSTRACT Frontotemporal dementia (FTD) patients often present with severe behavioural disturbances and concomitant lack of insight. The underlying neural correlates of these disturbances are mostly attributed to prefrontal cortex dysfunction, but are still poorly understood. Objectives: The current study explores whether a simple visual magnetic resonance imaging (MRI) rating scale in combination with the Frontal System Behaviour Scale (FrSBe) can be used to identify the prefrontal correlates of behavioural symptoms in behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). Methods: Forty-eight patients with a clinical diagnosis of bvFTD and AD participated in the study. Their behavioural profiles were assessed using the Frontal System Behaviour Scale (FrSBe) and cross-correlated to the atrophy of the sub-regions in the prefrontal cortex using a 5-point visual rating scale of MRI scans. Results: Patients with bvFTD showed higher incidence of behavioural disturbances than AD with apathy being the most significant. BvFTD patients also showed the highest incidence of atrophy in the orbital frontal cortex and this atrophy was correlated with the apathetic features. Conclusions: Employment of a simple visual MRI rating scale can be used in combination with a behavioural screening test to identify reliably the behavioural symptoms in bvFTD and AD. These findings will inform the diagnostic accuracy of the neural correlates of behavioural dysfunction in bvFTD in the future.
Screening of cognitive impairment by general internists using two simple instruments
Authors: Jacinto Alessandro Ferrari , Brucki Sonia Maria Dozzi , Porto Claudia Sellitto , Martins Milton de Arruda , Nitrini Ricardo
Published: July 2016

ABSTRACT General internists (GIs) tend to overlook cognitive impairment in the elderly. Lack of time to diagnose and/or poor knowledge on how to use screening instruments may be the reasons for this shortcoming. Objectives: To verify the efficacy of simple instruments in the screening of cognitive impairment in elders. Methods: In a previous study, 248 patients aged ≥65 that had been assisted by GIs within outpatient services of a public university hospital in São Paulo, Brazil, were evaluated. The Mini-Mental State Examination and/or the Informant Questionnaire on Cognitive Decline in the Elderly (short-IQCODE) were employed to classify patients into probable cognitively impaired cases or otherwise. Other tests and questionnaires were also applied, but were not used to perform this classification. After full assessment and consensus meetings, cases were classified into dementia, cognitively impaired not demented, and without cognitive impairment. In this study, the sensitivity and specificity of the combined use of the category fluency test (CFT) and the Functional Activities Questionnaire (FAQ) was evaluated as if used as screening instruments for the whole sample. Results: The combined use of the CFT and/or FAQ showed sensitivity of 88.3% and specificity of 76.5% in the screening of cognitive impairment for the whole sample. Conclusions: Two simple and easy-to-apply instruments showed high sensitivity and reasonable specificity, and are probably useful for the screening of cognitive impairment in the elderly in outpatient services.
Early and severe cognitive impairment in multiple sclerosis
Authors: Mendes Maria Fernanda , Finkelsztejn Alessandro , Gomes Sidney , Fragoso Yára Dadalti
Published: July 2016

ABSTRACT Objectives: To report on four new cases of severe cognitive impairment in the early stages of multiple sclerosis (MS) and to review data on the subject since few cases have been reported worldwide. Methods: Retrospective evaluation of medical records of patients with severe cognitive impairment within the first five years of MS diagnosis. Results on neuropsychological tests and magnetic resonance imaging (MRI) were disclosed. Results: Four patients from different Brazilian neurological departments in Brazil were evaluated, all presenting with severe cognitive dysfunction classified as rapidly developing dementia. MRI images showed severe brain atrophy and basal ganglia lesions in all patients. Conclusions: Although rare, severe cognitive impairment in MS represents an important disability and may ultimately constitute another form of the disease.