Emotional and relational problems of adolescents with and without a migrant background in Europe: a systematic review.

Mental health of migrant adolescents is a topic that has been widely studied in the past decades. Emotional and behavioural problems are amongst the most explored areas; however, little attention has been paid to the relational sphere, which represents another key aspect of mental health and is paramount during adolescence. This systematic review analysed the available evidence on emotional and relational problems comparing adolescents with and without a migrant background in Europe between 2010 and 2021. The search was conducted in four databases using a common search strategy composed of terms addressing adolescence, migrant population, and emotional and relational problems. Three rounds of screening produced 36 eligible studies. Factors affecting both types of problems were identified and categorised using thematic synthesis, dividing them into factors affecting both types of problems jointly or separately and analysing them according to three systemic levels affecting the adolescents' lives (intrapersonal, interpersonal and external). Critical analysis of the results pointed to mixed findings, with a mild tendency in migrant-background adolescents to portray more emotional problems than their native peers and a stronger tendency for relational problems in the same direction. Several limitations were identified and, along with the conclusions, point to suggestions for future research focusing on studying relational problems as a key component of mental health and its link to emotional problems. Further suggestions entail designing studies that target adolescents with different migrant-background profiles and cultural origins to establish differences between them and identify additional factors affecting emotional and relational problems during the pre-migration and transit phases of the migratory journey to help prevent the onset of these problems.

Neuropsychological Rehabilitation Improves Memory and Action Naming in Patients With Post-COVID-19 Syndrome.

PURPOSE: Post-COVID-19 syndrome (PCS-19) is a condition characterized by both physical and cognitive alterations in patients who have overcome COVID-19. Despite the high incidence of this disorder and the inconveniences it produces to those affected, there are few studies investigating the efficacy of cognitive stimulation in these patients. The aim of this study was to compare two groups of patients with PCS-19. One of them was treated with neuropsychological intervention for 6 months, whereas the other did not receive treatment. Both groups shared similar clinical characteristics and cognitive profiles. METHOD: The study included 15 participants. Eight (seven women and one man, with a mean age of 50.13 years) made up the experimental group and received neuropsychological rehabilitation sessions once a week with the aim of recovering or compensating for their impaired functions. The control group consisted of seven patients (six women and one man, with a mean age of 52.86 years) who did not undergo neuropsychological rehabilitation sessions. The neuropsychological assessment protocol included tests for all cognitive domains. RESULTS: In comparison with the assessment prior to the neuropsychological intervention, significant differences were found in the experimental group both in verbal memory and in the action naming task. As for the control group, improvements in action fluency performance were observed. Neither group showed significant improvement in pre- versus posttest Stroop scores. However, the control group did perform higher than the treatment group in the final assessment. CONCLUSION: Despite the small sample size, our results suggest that patients with PCS-19 may benefit from neuropsychological rehabilitation, as it may help them to improve several cognitive functions that do not recover spontaneously.

Applying quality improvement tools to the Reaching Every District strategy: a mixed-methods examination of a systems strengthening approach to building the capacity of immunization managers and service providers in Ethiopia.

The Reaching Every District (RED) strategy, implemented in Ethiopia for over 15 years, has helped to improve immunization performance. However, recent demographic and health survey data indicate wide variations in immunization coverage. To address these disparities, quality improvement (QI) tools and methods were applied in phases to the RED strategy between 2011 and 2018 and were ultimately scaled to 103 districts in Ethiopia. Quantitative and qualitative data were collected from 2015-2018 to examine RED-QI uptake, practices, sustainability, and effects on Ethiopia´s routine immunization (RI) system. Qualitative interviews examined how RED-QI practices were carried out in each district, and quantitative data from a sample of health facilities provided information on the effects of RED-QI on the RI system. The RED-QI intervention increased the capacity of immunization managers and health workers to plan, implement, and monitor immunization activities, achieving expanded reach and enhancing the quality of services. RED-QI strengthened health workers´ capacity to identify and target communities for immunization, including in hard-to-reach areas. Improved planning resulted in expanded reach and greater equity in services. Immunization staff experienced enhanced capacity to plan immunization services, design approaches to address local challenges, reach target populations, and use data to monitor program performance. While challenges were noted with certain QI tools, assessments indicate that the RED-QI approach can be used in diverse contexts to strengthen RI.

Cognitive impairment in young adults with post COVID-19 syndrome.

In this study, we aimed to examine different cognitive domains in a large sample of patients with post COVID-19 syndrome. Two hundred and fourteen patients, 85.04% women, ranged 26 to 64 years (mean = 47.48 years) took part in this investigation. Patients' processing speed, attention, executive functions and various language modalities were examined online using a comprehensive task protocol designed for this research. Alteration in some of the tasks was observed in 85% of the participants, being the attention and executive functions tests the ones that show the highest percentage of patients with severe impairment. Positive correlations were observed between the age of the participants in almost all the tasks assessed, implying better performance and milder impairment with increasing age. In the comparisons of patients according to age, the oldest patients were found to maintain their cognitive functions relatively preserved, with only a mild impairment in attention and speed processing, while the youngest showed the most marked and heterogeneous cognitive impairment. These results confirm the subjective complaints in patients with post COVID-19 syndrome and, thanks to the large sample size, allow us to observe the effect of patient age on performance, an effect never reported before in patients with these characteristics.

Development of criteria for cognitive dysfunction in post-COVID syndrome: the IC-CoDi-COVID approach.

BACKGROUND: We aimed to develop objective criteria for cognitive dysfunction associated with the post-COVID syndrome. METHODS: Four hundred and four patients with post-COVID syndrome from two centers were evaluated with comprehensive neuropsychological batteries. The International Classification for Cognitive Disorders in Epilepsy (IC-CoDE) framework was adapted and implemented. A healthy control group of 145 participants and a complementary data-driven approach based on unsupervised machine-learning clustering algorithms were also used to evaluate the optimal classification and cutoff points. RESULTS: According to the developed criteria, 41.2% and 17.3% of the sample were classified as having at least one cognitive domain impaired using -1 and -1.5 standard deviations as cutoff points. Attention/processing speed was the most frequently impaired domain. There were no differences in base rates of cognitive impairment between the two centers. Clustering analysis revealed two clusters, although with an important overlap (silhouette index 0.18-0.19). Cognitive impairment was associated with younger age and lower education levels, but not hospitalization. CONCLUSIONS: We propose a harmonization of the criteria to define and classify cognitive impairment in the post-COVID syndrome. These criteria may be extrapolated to other neuropsychological batteries and settings, contributing to the diagnosis of cognitive deficits after COVID-19 and facilitating multicenter studies to guide biomarker investigation and therapies.

A Tale of 2 Countries: Implementation of the Cold Chain Equipment Optimization Platform in Guinea and Kenya.

In 2016, the Gavi Cold Chain Equipment Optimization Platform (CCEOP) was approved and launched in recognition of the fact that functional cold chain equipment (CCE) is essential to strengthening vaccine supply chains and ultimately achieving Gavi's immunization equity and coverage goals. Through CCEOP, Gavi committed to investing US$250 million between 2016 and 2021 to commission CCE in more than 63,000 facilities to upgrade and expand their CCE footprint while stimulating the market to provide affordable, technologically advanced, and accessible equipment. We present case studies from Guinea and Kenya, both of which received CCEOP support, that highlight 2 ways for countries to prioritize investments and implement activities through a large funding and support mechanism. The studies explore the different ways that each country implemented CCEOP and consider how aspects of leadership and technical capacity influence country priorities and results. They also uncover key lessons on sustainability of a large immunization supply chain effort. The experiences of Guinea and Kenya can help other countries embarking on similarly large health system interventions, especially related to supply chain strengthening and immunization programs. In particular, these experiences offer important lessons in leadership, processes and systems, country ownership, technical capacity, and sustainability.

Neuropsychological follow-up of a case of encephalitis by anti-nmda receptor.

Anti-NMDA receptor encephalitis is an autoimmune disease with psychiatric and cognitive symptoms. Our aim is to describe the cognitive follow-up of a patient diagnosed with the disease for 4 years. The results revealed severe cognitive impairment at the initial evaluation. At 3 months, memory and executive function deficits prevailed. At 9 months, only a deficit in verbal memory was found. At 4 years, she presented a mild memory deficit. These results revealed a significant short-term cognitive deficit. Subsequently, executive functions, memory and verbal fluency recovered, while a mild deficit in verbal memory persisted.

Parkinson's disease compromises the appraisal of action meanings evoked by naturalistic texts.

The linguistic profile of Parkinson's disease (PD) is characterized by difficulties in processing units which denote bodily movements. However, the available evidence has low ecological validity, as it stems from atomistic tasks which are never encountered in real life. Here, we assessed whether such deficits also occur for meanings evoked by context-rich narratives, considering patients with and without mild cognitive impairment (PD-MCI and PD-nMCI, respectively) and matched controls for each group. Participants read two naturalistic stories (an action text and a neutral text) and responded to questions tapping the appraisal of verb-related and circumstantial information. In PD-MCI, impairments in the appraisal of action meanings emerged alongside difficulties in other categories, but they were unique in their independence from general cognitive dysfunction. However, in PD-nMCI, deficits were observed only for action meanings, irrespective of the patients' domain-general skills (executive functions and general cognitive state). Also, using multiple group discriminant function analyses, we found that appraisal of action meanings was the only discourse-level variable that robustly contributed to classifying PD-MCI patients from controls (with an accuracy of 88% for all participants and for each sample separately). Moreover, this variable actually superseded a sensitive executive battery in discriminating between PD-nMCI and controls (with a combined accuracy of 83% for all participants, correctly classifying 79.2% of patients and 87.5% of controls). In sum, action appraisal deficits seem to constitute both a hallmark of naturalistic discourse processing in PD and a sensitive subject-level marker for patients with and without MCI. Such findings highlight the relevance of ecological measures of embodied cognitive functions in the assessment of this population.

A third-person perspective on co-speech action gestures in Parkinson's disease.

A combination of impaired motor and cognitive function in Parkinson's disease (PD) can impact on language and communication, with patients exhibiting a particular difficulty processing action verbs. Co-speech gestures embody a link between action and language and contribute significantly to communication in healthy people. Here, we investigated how co-speech gestures depicting actions are affected in PD, in particular with respect to the visual perspective-or the viewpoint - they depict. Gestures are closely related to mental imagery and motor simulations, but people with PD may be impaired in the way they simulate actions from a first-person perspective and may compensate for this by relying more on third-person visual features. We analysed the action-depicting gestures produced by mild-moderate PD patients and age-matched controls on an action description task and examined the relationship between gesture viewpoint, action naming, and performance on an action observation task (weight judgement). Healthy controls produced the majority of their action gestures from a first-person perspective, whereas PD patients produced a greater proportion of gestures produced from a third-person perspective. We propose that this reflects a compensatory reliance on third-person visual features in the simulation of actions in PD. Performance was also impaired in action naming and weight judgement, although this was unrelated to gesture viewpoint. Our findings provide a more comprehensive understanding of how action-language impairments in PD impact on action communication, on the cognitive underpinnings of this impairment, as well as elucidating the role of action simulation in gesture production.

Verbal fluency in Parkinson's disease patients on/off dopamine medication.

INTRODUCTION: Parkinson's disease (PD) is associated with dopamine depletion in the fronto-striatal network which affects some language aspects such as verb processing. Some experiments have demonstrated that dopamine deficiency plays a role in the normal functioning of the lexico-semantic system. As a result, the verbal fluency task could be a useful tool to assess the function of the semantic system, by examining both the number of words generated and the frequency of use of those words. OBJECTIVE: The aim of this study was to find out how dopamine affects the performance of PD patients using a verbal fluency task, focussing on action-word fluency. METHOD: A group of 20 PD patients and 20 controls participated in the study. Participants were assessed with four different verbal fluency tasks: phonological, semantic (animal and supermarket words) and action fluency. PD patients were tested twice (on/off medication) and controls only once. RESULTS: For the number of words, there were significant differences between PD patients on and off medication in the phonological and action fluency tasks. Compared to controls, PD off medication produced significantly fewer words in phonological, and actions. Regarding frequency, differences were found between PD patients off medication and controls for the action-word category. DISCUSSION: Our data showed a specific deficit in PD patients off medication in categories mainly depending on frontal lobe function (phonological and actions) while these differences were restored with dopamine treatment. Moreover, PD patients off medication produced higher frequency verbs than controls, suggesting that dopamine affects the normal functioning within the lexico-semantic network of verbs.

Action naming in Parkinson's disease patients on/off dopamine.

Growing evidence supports the notion that the same brain areas involved in planning and execution of movements are also involved in verb processing. Recent studies have pointed out the existence of verb impairment in patients with Parkinson's disease (PD), a neurodegenerative disorder typically characterized by motor disturbance related to dopamine deficiency in the nigrostriatal system. The aim of this study was to test the influence of dopaminergic treatment in a group of non-demented PD patients on the performance of action naming. The action pictures belonged to two categories: pictures with high and low degree of motor content. A group of 20 PD patients without dementia and 15 controls performed the task. PD patients were assessed twice, on and off medication, controls only once. A repeated measures ANOVA was carried out on the reaction times. The results showed a main effect of group and a significant interaction between group×motor content when comparing the three groups. When the comparison was made only on the PD groups (on vs. off medication) the interaction group×motor content was also significant, indicating that PD patients off medication had longer reaction times for pictures with a high degree of motor content compared to PD patients on medication. These results suggest a selective deficit in naming pictures associated with high motor content in PD patients without dopamine medication. This effect could be due to the relations between brain motor areas and verb processing associated with dopamine depletion.

The effect of motion content in action naming by Parkinson's disease patients.

INTRODUCTION: The verb-specific impairment present in patients with motion-related neurological diseases has been argued to support the hypothesis that the processing of words referring to motion depends on neural activity in regions involved in motor planning and execution. We presented a group of Parkinson's disease (PD) patients with an action-naming task in order to test whether the prevalence of motion-related semantic content in different verbs influences their accuracy. METHODS: Forty-nine PD patients and 19 healthy seniors participated in the study. All of PD participants underwent a neurological and neuropsychological assessment to rule out dementia. Subjective ratings of the motion content level of 100 verbs were obtained from 14 young voluntaries. Then, pictures corresponding to two subsets of 25 verbs with significantly different degrees of motor component were selected to be used in an action-naming task. Stimuli lists were matched on visual and psycholinguistic characteristics. RESULTS: ANOVA analysis reveals differences between groups. PD patients obtained poor results in response to pictures with high motor content compared to those with low motor association. Nevertheless, this effect did not appear on the control group. The general linear mixed model analytic approach was applied to explore the influence of the degree of motion-related semantic content of each verb in the accuracy scores of the participants. The performance of PD patients appeared to be negatively affected by the level of motion-related semantic content associated to each verb. CONCLUSIONS: Our results provide compelling evidence of the relevance of brain areas related to planning and execution of movements in the retrieval of motion-related semantic content.

Efícacia clínica de la Homeopatia aplicada em cirugía ambulatorial / Clinical efficacy of surgery em Homeopathy applied outpatient

El trabajo visa evaluar la eficacia del tratamiento homeopático em lasdiversas patologías en pacientes que asisten a consultas de cirugía ambulatoria, utilizando a terapéutica homeopática. Los resultados el tratamiento con homeopatía en las consultas de cirugía, lo que ayuda a mejorar el estado de salud del paciente y en caso de una intervención quirúrgica encontrarse en mejores codiciones.

Emotion recognition impairment in Parkinson's disease patients without dementia.

PURPOSE: Previous research has shown dementia and mild cognitive impairment to be present in some Parkinson's disease (PD) patients. Nevertheless, it is still not clear whether PD patients are also impaired on facial emotion recognition, nor it is whether this possible deficit is independent other cognitive impairment. The aim of this study is to assess the presence of emotion recognition deficits in a sample of PD patients with normal cognitive abilities, evaluated with several cognitive tasks widely used to detect cognitive impairment in this patient group. METHOD: 40 non-demented (MMSE scores>25) PD patients and 19 healthy older adults matched on demographic characteristics took part in the study. All of them were evaluated with a neuropsychological battery including tests aimed to assess the cognitive domains mainly affected by PD, as well as a facial emotion recognition task. RESULTS: t-test analysis showed significant differences between PD and control groups in 6 cognitive tasks which were introduced in a sequential logistic regression analysis. The results confirmed the existence of a facial emotion recognition deficit in PD patients after controlling for demographic and cognitive characteristics of the participants. CONCLUSION: Although none of the PD patients fulfilled criteria for dementia, many of them appeared to present deficits on recognition of facial emotions. This task should therefore be incorporated into future research to study the full range of early cognitive dysfunctions and non-motor symptoms presents in PD patients, and inclusion of this task in assessment protocols should be considered.

Cognitive impairment in Parkinson's disease without dementia.

Some degree of cognitive impairment appears frequently in Parkinson's disease (PD) patients, even at the onset of the disease. However, due to the heterogeneity of the patients and the lack of standardized assessment batteries, it remains unclear which capacities are primarily affected by this disease. Fifty PD patients were assessed with 15 tests including executive functions, attention, temporal and spatial orientation, memory, and language tasks. Their results were compared with those of 42 age- and education-matched healthy seniors. Semantic fluency, along with visual search appeared to be the most discriminant tasks, followed by temporal orientation and face naming, as well as action naming and immediate recall. PD patients studied showed an impairment of frontal- to posterior-dependent capacities. Executive functions, attention, and recall tasks appeared to be significantly impaired in the patients. Nevertheless, significantly poor scores in tasks like action and face naming, as well as semantic fluency, also reveal a mainly semantic deficit.

Effect of synthetic peptides belonging to E2 envelope protein of GB virus C on human immunodeficiency virus type 1 infection.

The use of synthetic peptides as HIV-1 inhibitors has been subject to research over recent years. Although the initial therapeutic attempts focused on HIV-coded enzymes, structural HIV proteins and, more specifically, the mechanisms that the virus uses to infect and replicate are now also considered therapeutic targets. The interest for viral fusion and entry inhibitors is growing significantly, given that they are applicable in combined therapies or when resistance to other antiretroviral drugs is seen and that they act before the virus enters the cell. The 124 synthetic sequences of the GBV-C E2 envelope protein have been obtained by SPPS. The interaction of certain GBV-C peptide sequences with the HIV-1 fusion peptide has been proven through the use of biophysical techniques. We also show how GBV-C E2 domains notably decrease cellular membrane fusion and interfere with the HIV-1 infectivity in a dose-dependent manner, highlighting their potential utility in future anti-HIV-1 therapies.

Impaired word recognition in Alzheimer's disease: the role of age of acquisition.

Studies of word production in patients with Alzheimer's disease have identified the age of acquisition of words as an important predictor of retention or loss, with early acquired words remaining accessible for longer than later acquired words. If, as proposed by current theories, effects of age of acquisition reflect the involvement of semantic representations in task performance, then some aspects of word recognition in patients with Alzheimer's disease should also be better for early than later acquired words. We employed a version of the lexical decision task which we term the lexical selection task. This required participants to indicate which of four items on a page was a real word (the three 'foils' being orthographically plausible nonwords). Twenty-two patients with probable Alzheimer's disease were compared with an equal number of matched controls. The controls made few errors on the test, demonstrating that the controls were cognitively intact, and that the words were familiar to participants of their age and level of education. The Alzheimer patients were impaired overall, and recognized fewer late than early acquired words correctly. Performance of the Alzheimer patients on the lexical selection task correlated significantly with their scores on the mini mental state examination. Word recognition becomes impaired as Alzheimer's disease progresses, at which point effects of age of acquisition can be observed on the accuracy of performance.

Synthetic peptides of hepatitis G virus (GBV-C/HGV) in the selection of putative peptide inhibitors of the HIV-1 fusion peptide.

The GB virus C or hepatitis G virus (GBV-C/HGV) is a single-stranded positive sense RNA virus that belongs to the Flaviviridae family. Recent years have seen the publication of numerous works in which coinfection with GBV-C/HGV and HIV has been associated with slower progression of the illness and a higher survival rate of patients once AIDS has developed. The mechanism by which the GBV-C/HGV virus has a "protective effect" in patients with HIV has still not been defined. Study of the interaction of the GBV-C/HGV and HIV viruses could lead to the development of new therapeutic agents for the treatment of AIDS. Given that the mechanism responsible for the beneficial effect exercised by the GBV-C/HGV virus in the course of HIV infection has not been defined, the present work is intended as a study of the structure and interactions between the fusion peptide of HIV-1, gp41(1-23), and synthetic peptide sequences of the E2 envelope protein of GBV-C/HGV using biophysical techniques. Our results highlight that the E2(269-286) sequence interacts with the target fusion peptide of HIV-1 and modifies its conformation.

Liposome destabilization induced by synthetic lipopeptides corresponding to envelope and non-structural domains of GBV-C/HGV virus. Conformational requirements for leakage.

Liposomes have been used primarily as a model system for studying biological membranes. Numerous chemical, biochemical and biophysical methods have been used to elucidate the various aspects of the interaction between proteins or peptides and phospholipids. Having in mind the potential use of synthetic lipopeptides as antiviral therapies and aiming for a better understanding of the molecular interaction of the GBV-C/HGV with liposomes as model membranes, epitopes of GBV-C/HGV located at the E2 (99-118) and NS3(440-460) regions were selected. Peptides were modified at the N-terminus with acyl chains of different length (C(14) and C(16)) yielding the corresponding myristoil and palmytoil lipopeptides. The main aim of the present study was to get insight into the membrane-interacting properties of the above-described synthetic lipopeptides and to study their inhibition of the capacity of perturbing model membranes of fusion peptide of HIV-1 using fluorescence spectroscopy. In an attempt to establish a relationship between peptide membrane activity and structure, we use Circular Dichroism (CD) and Fourier-Transform Infrared Spectroscopy (FTIR).