The Breakfast and Dressing Conflict Task: Preliminary Evidence of Its Validity to Measure Online Self-Awareness After Acquired Brain Injury.

IMPORTANCE: Impaired self-awareness (SA) of deficits after an acquired brain injury (ABI) severely affects patients' independence in activities of daily living (ADLs). However, any assessment tool permits an exhaustive evaluation of SA in the context of ADLs. OBJECTIVE: To study the validity of the Breakfast and Dressing Conflict Task (BD Conflict Task) to assess online SA (awareness of performance in the context of a given task) in patients with ABI; to study its interactions with offline SA (general awareness); and to test the validity of a simplified measure of performance monitoring, the ADL Conflict-Monitoring Index. DESIGN: Convergent validity and correlational study. SETTING: Research laboratory, hospitals, and homes. PARTICIPANTS: Thirty patients with ABI and 28 neurologically healthy controls. OUTCOMES AND MEASURES: Using the BD Conflict Task, measures of emergent awareness, self-regulation, anticipatory awareness, and self-evaluation were assessed and their convergent validity and relationship with offline SA were analyzed. The ADL Conflict-Monitoring Index was calculated, and its convergent validity was tested. RESULTS: The online SA variables of the BD Conflict Task showed convergent validity with traditional online SA measures. Offline SA correlated with emergent and anticipatory awareness in the Breakfast Task. The ADL Conflict-Monitoring Index proved to be a valid measure of patients' performance monitoring. CONCLUSIONS AND RELEVANCE: These preliminary findings suggest that the BD Conflict Task is a valid tool to assess online SA in patients with ABI and provide further understanding of the online SA-offline SA interaction. Furthermore, the ADL Conflict-Monitoring Index may be a valid and easy-to-use monitoring measure in clinical settings. Plain-Language Summary: Patients with acquired brain injury (ABI) and reduced awareness of their cognitive deficits face problems performing activities of daily living (ADLs) and may show signs of unsafe behaviors. Being aware of one's own abilities involves anticipating problems before starting a task, detecting and correcting errors during the task, and evaluating performance afterward. This study provides preliminary validity for the Breakfast and Dressing Conflict Task, a new tool that assesses aspects of self-awareness simultaneously in the context of familiar and significant ADLs. Furthermore, the tool simplifies the assessment of detecting and correcting errors with an easy-to-use index, making it suitable for use in clinical settings.

[Risk of depression in 75 years or older persons, comprehensive geriatric assessment and associated factors in primary care: cross sectional study]. / Riesgo de depresión en personas de 75 años o más, valoración geriátrica integral y factores de vulnerabilidad asociados en Atención Primaria.

OBJECTIVES: To determine the prevalence of the risk of depression, major defining characteristics and factors associated with. DESIGN: Sub-study of comprehensive geriatric assessment cross-study. SETTING: Primary health center. PARTICIPANTS: For an estimated 14% prevalence we need a sample of 288 people. From 3854, 290 people ≥75 years were selected. Excluding terminals, chemotherapy, recent surgery, temporary residence, mental retardation, serious psychiatric illness, or under home care. OUTCOME: risk of depression (≥2 points on the Goldberg depression subscale. DEPENDENT VARIABLES: Sociodemographic and five study areas of the Comprehensive Geriatric Assessment: medical -comorbidity, polypharmacy, falls and hospital admissions-, functional -Up&Go Test, Lawton-Brody and Barthel Index-, nutritional -Mini Nutritional Assessment (MNA)-, mental-affective -Pfeiffer Questionnaire and Goldberg scale-, and social. Descriptive analysis and logistic regression. RESULTS: We obtained 290 interviews, with 102 (35.1%) male and mean age of 79.4 years (SD:3.2). The prevalence of the risk of depression was 37.2%, 26.5% in men and 43.1% in women (p=0.005). Association of risk of depression is observed with arterial hypertension (OR:3.87 95% CI:1.61-9.34), cancer (OR:4.12 95%, CI:1.58-10.76), lack of leisure activity (OR:2.75 95%, CI:1.33-5.67), increase of anxiety scale (OR:1.87 95%, CI:1.57-2.22) and decrease in MNA (OR:0.78 95%, CI:0.68-0.9). CONCLUSIONS: The prevalence of risk of depression is higher than expected, although overestimated until being confirmed with a diagnostic test. We appreciate new associations of comorbidity variables with risk of depression and corroborate other known. The studied factors that were associated with the risk of depression should be included in future studies of geriatric depression.

The Cognitive Awareness Scale for Basic and Instrumental activities of daily living to measure self-awareness after acquired brain injury: preliminary evidence of its validity.

Objective: There is a crucial need for reliable tools to measure impaired self-awareness (ISA) in patients with acquired brain injury (ABI) across cognitive-functional domains. The aim of this study was to assess the psychometric properties of the Cog-Awareness ADL Scale, which is a novel self-proxy discrepancy method for measuring ISA in both basic and instrumental activities of daily living. Methods: This multicenter study included 54 patients (no-low ISA n = 33; severe ISA, n = 21) from four outpatient rehabilitation units in Málaga-Granada, Spain, and 51 healthy controls. The participants and proxy raters completed the Cog-Awareness ADL Scale and the Patient Competency Rating Scale (PCRS). Agreement between both scales was assessed using Spearman's correlations and the Bland-Altman plot. Group comparisons were made on measures of SA, cognitive abilities and demographic variables. Sensitivity and specificity were analysed by ROC curve analysis. Results: Convergent validity was supported by strong correlations with the PCRS and its subscales (rho's ranging from 0.51 to 0.80, p < 0.01 for all). The Bland-Altman plot confirmed measurement agreement (only 3.70% of the scores were outside the 95% limits). External validity was demonstrated by effectively discriminating between healthy controls and ABI patients with no-low and severe ISA on each discrepancy index while controlling for cognitive/demographic variables. The Cog-Awareness ADL Scale showed optimal diagnostic accuracy (AUC = 0.95, sensitivity = 0.90, specificity = 0.90). Conclusions: The Cog-Awareness ADL Scale proved to be a feasible, valid, and clinical tool to assess ISA across different cognitive-functional domains, in Spanish ABI-patients.

Translation, cross-cultural adaptation and validation of the 10-item Weekly Calendar Planning Activity in Spanish-speaking ABI patients: a multicenter study.

We present the process of translation, adaptation, and validation in the Spanish context of the 10-item version of the Weekly Calendar Planning Activity (WCPA-10), a performance-based measure of cognitive instrumental activities of daily living (C-IADL). The study consisted of two phases: I) translation/cultural adaptation of the WCPA, conducted by professional bilingual translators, a panel of experts, and a pilot study, and II) validation in a sample of 42 acquired brain injury patients (ABI) and 42 healthy participants (HC). WCPA primary outcomes showed expected convergent/discriminant validity patterns with socio-demographical and clinical variables and cognitive processes identifying those WCPA outcomes that best predicted executive and memory deficits measured with a battery of traditional neuropsychological tests. In addition, performance on the WCPA was a significant predictor of everyday functioning over variables such as socio-demographics or global cognition when measured with traditional tests. External validity was established by the WCPA's ability to identify everyday cognitive deficits in ABI patients compared to HC, even in those with subtle cognitive impairment based on neuropsychological tests. The Spanish WCPA-10 seems an appropriate and sensitive assessment tool to identify cognitive-functional impairment in ABI-patients, even those with subtle cognitive impairment. The results also highlight the relevance of this kind of test, as they indicate a better prediction of patients' real-world functioning than traditional neuropsychological tests.

What Can Integrated Analysis of Morphological and Genetic Data Still Reveal about the Anastrepha fraterculus (Diptera: Tephritidae) Cryptic Species Complex?

The South American fruit fly Anastrepha fraterculus (Wiedemann) is a complex of cryptic species, the so-called "Anastrepha fraterculus complex", for which eight morphotypes are currently recognized. A previous analysis of ITS1 in samples of the Anastrepha fraterculus complex, while revealing high distinctiveness among samples from different localities of South America, Central America, and Mexico, no direct association was made between sequence type and morphotype. In the present report, a correlated analysis of morphometry and ITS1 data involved individuals belonging to the same population samples. Although showing a low level of intra-populational nucleotide variability, the ITS1 analysis indicated numerous inter-population sequence type variants. Morphotypes identified by morphometric analysis based on female wing shape were highly concordant with ITS1 genetic data. The correlation of genetic divergence and morphological differences among the tested samples gives strong evidence of a robust dataset, thereby indicating the existence of various taxonomic species within the A. fraterculus complex. However, the data revealed genetic and morphological variations in some regions, suggesting that further analysis is still required for some geographic regions.

[Treatment using a hydrocolloid dressing and its influence on the life quality a patient has]. / Tratamiento con un apósito hidrocoloide y su influencia en la calidad de vida del paciente.

The authors analyze the impact chronic skin ulcers have on Life Quality Related to Health in relation with morphological and clinical variables on the evolution of ulcers treated with SureSkin II by means of the Spanish version of the generic health self-administered questionnaire SF-72 Health Survey (SF-12v2). The authors carried out an observational study based on a series of multi-centric, prospective and open clinical cases. The length of application of this dressing was up to 20 applications or until the ulcer under treatment was cured. 593 patients having an average age of 73 years were included in this study. The authors observed total cicatrisation of the lesion in 64% of the cases. The results showed clear, significant differences (p < 0.001) before and after treatment with the dressing under study for the 8 dimensions which the questionnaire SF-12v2 measures on an ordinal scale from 0 to 100; the average measurements of the dimensions at the time of the final visit were greater than those obtained on the first visit.

Body fat percentage is more associated with low physical fitness than with sedentarism and diet in male and female adolescents.

BACKGROUND: Obesity is a multifactorial disease and our understanding of this disease is still incomplete. PURPOSE: The aim of this investigation was to examine the associations between body fat percentage and physical fitness, diet and active/sedentary behaviors in female and male adolescents. METHODS: A cross-sectional study was carried out on a sample of 1389 Spanish adolescents (706 boys and 683 girls) aged between 14 and 17years. Individual body fat percentage was measured by means of bioelectrical impedance analysis and participants' physical fitness was determined by measuring cardiorespiratory fitness (20-m shuttle run test), muscular strength (handgrip dynamometry), muscular endurance (curl-up and 90° push up repetition tests) and muscular flexibility (sit-and-reach test). Daily physical activity, sedentary time and diet were estimated using validated and self-reported questionnaires. The participants were divided into quartiles based on their body fat percentage. RESULTS: Boys and girls included in Q3 and Q4 presented lower values for cardiorespiratory fitness than Q1 (P<0.05). Boys and girls included in Q4 also presented lower values for muscular endurance than Q1 (P<0.05). Only boys in Q4 presented lower levels of physical activity than Q1 (P<0.05). Physical activity, physical fitness and diet can explain 30% of the variance for body fat percentage in boys and 17% in girls. CONCLUSIONS: Female and male adolescents with a higher body fat percentage presented lower cardiorespiratory and muscular endurance fitness than leaner counterparts.

Morphology of immature stages in the neotropical nonfrugivorous Tephritinae fruit fly species Rachiptera limbata Bigot (Diptera: Tephritidae) on Baccharis linearis (R. et Pav.) (Asteraceae).

Rachiptera limbata Bigot develops on Baccharis linearis (R. et Pav.) in the areas around Santiago, Chile. The larvae feed on stem tissues and secrete a liquid that hardens to form a protective feeding and pupation chamber. The immature stages of Neotropical species of Tephritinae are poorly known. In this paper, the morphology of the immature stages of R. limbata are described and compared, in a phylogenetic context, with other Tephritinae species. Antennomaxillary complex, pads, oral ridge, cephalopharyngeal skeleton, anterior and posterior spiracles and anal lobes of first-, second-, third-instar larvae and pupae were studied with optical and scanning electron microscopy. The cephalopharyngeal skeleton is darkly sclerotized and shows an opening or window in the ventral cornua. This trait seems to be plesiomorphic in R. limbata and in other Neotropical species. First-instar larvae anterior spiracles are absent; whereas in second and third instars spiracles are developed as a row of five short tubules. In first- and second-instar larvae, the posterior spiracular slit has only a single hair per bundle; whereas third-instar larvae lack hairs. This last trait seems to be consequence of a larval development delay and an apomorphic trait in R. limbata, compared to other Neotropical and Neartical species.

Morphology of immature stages in the neotropical nonfrugivorous Tephritinae Fruit Fly Species Rachiptera limbata Bigot (Diptera: Tephritidae) on Baccharis linearis (R. et Pav.) (Asteraceae) / Morfologia dos estados imaturos da espécie de mosca das frutas neotropical não frugívora Rachiptera limbata bigot (Diptera: Tephritidae) em Baccharis linearis (R. et. Pav) (Asteraceae)

Rachiptera limbata Bigot desenvolve-se em Baccharis linearis (R. et Pav) na região de Santiago, Chile. As larvas alimentam-se dos caules e secretam um líquido, que em contato com o ar, forma uma câmara larval, onde ocorre a passagem para o estádio de pupa. Os estádios larvais das espécies neotropicais de Tephritinae são pouco conhecidos. O presente estudo descreve a morfologia dos estádios larvais de R. limbata, comparando-os com outras espécies de Tephritinae, em uma abordagem filogenética. Foram analisados, em microsopia de luz e de varredura, o complexo antenomaxilar, as dobras da cutícula, as margens da abertura oral, o esqueleto cefalofaríngeo, os espiráculos anterior e posterior e os lóbulos anais das larvas de primeiro, segundo, terceiro estádios e da pupa. O esqueleto cefalofaríngeo é altamente esclerotizado e apresenta um orifício ou abertura na cornua ventral, característica essa que parece ser plesiomórfica em R. limbata e outras espécies neotropicais. Os espiráculos anteriores estão ausentes nas larvas de primeiro estádio. Nas larvas de segundo e terceiro estádios são desenvolvida formando cinco túbulos curtos dispostos em fileira única. Nas larvas de primeiro e segundo estádios, as aberturas dos espiráculos têm cerdas únicas; nas larvas de terceiro estádio não há cerdas. Essa última característica parece decorrer de uma atraso no desenvolvimento (neotenia) da larva de R. limbata, quando comparada a outras espécies neotropicais e neárticas.

Rachiptera limbata Bigot develops on Baccharis linearis (R. et Pav.) in the areas around Santiago, Chile. The larvae feed on stem tissues and secrete a liquid that hardens to form a protective feeding and pupation chamber. The immature stages of Neotropical species of Tephritinae are poorly known. In this paper, the morphology of the immature stages of R. limbata are described and compared, in a phylogenetic context, with other Tephritinae species. Antennomaxillary complex, pads, oral ridge, cephalopharyngeal skeleton, anterior and posterior spiracles and anal lobes of first-, second-, third-instar larvae and pupae were studied with optical and scanning electron microscopy. The cephalopharyngeal skeleton is darkly sclerotized and shows an opening or window in the ventral cornua. This trait seems to be plesiomorphic in R. limbata and in other Neotropical species. First-instar larvae anterior spiracles are absent; whereas in second and third instars spiracles are developed as a row of five short tubules. In first- and second-instar larvae, the posterior spiracular slit has only a single hair per bundle; whereas third-instar larvae lack hairs. This last trait seems to be consequence of a larval development delay and an apomorphic trait in R. limbata, compared to other Neotropical and Neartical species.