The NeuroBel: A Screening Test for Verbal Language Impairment in Spanish-Speaking Elderly People With Cognitive Decline.

PURPOSE: The NeuroBel is a short test that can detect cognitive decline using language tasks. This study replicated previous research using larger clinical samples from three Spanish-speaking countries. METHOD: Eight tasks were used to analyze verbal language functioning using a psycholinguistic approach. A total of 232 elderly, monolingual Spanish speakers from Spain, Cuba, and Colombia participated in this study. Of these, 76 had Alzheimer's disease (AD) in the initial phase, 75 had mild cognitive impairment (MCI), and 81 did not exhibit cognitive impairment (healthy controls). RESULTS: Significant differences were observed among the three clinical groups. The participants with AD and the participants with MCI had significantly lower NeuroBel scores than the control group on most of the tasks. However, repetition (in AD vs. MCI) and auditory lexical decision (in MCI vs. control) tasks were not significant in Tukey's post hoc tests. Discriminant analysis showed that 80.6% of the participants were correctly classified into the original groups and revealed the tasks that were the best and worst for differentiating among groups. The receiver-operating characteristic curves showed high sensitivity for AD and MCI. The area under the curve was .97 in the contrast of AD versus MCI + controls, .96 in the determination of overall cognitive decline (AD + MCI vs. controls), and .93 in the contrast of MCI and control groups. CONCLUSION: This study confirmed that the NeuroBel is a suitable test for detecting cognitive decline based on language impairment in Spanish-speaking elderly people.

Factores tecnológicos-educativos asociados a problemas fisioergonómicos en estudiantes de medicina

Introducción: Existe evidencia sobre el efecto negativo del uso de tecnologías de información y comunicación en estudiantes, sin embargo, poco se conoce sobre problemas fisioergonómicos secundarios a su uso. Objetivo: Identificar los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina. Métodos: Estudio transversal en estudiantes de medicina de 11 países de Latinoamérica y el Caribe. Se utilizó un cuestionario cuyas variables fueron las características socio-educativas y tecnológicas, así como los problemas fisioergonómicos (dolor de cuello, dolor de espalda, ojo seco/rojo y dolor de cabeza). Resultados: De 11 587 estudiantes, 14,5 % reportó presentar 4 problemas fisioergonómicos. La mayoría reportó dolor de cuello (50 %), dolor de espalda (50,5 %) y dolor de cabeza (53,7 %). Tuvieron mayor frecuencia de presentar estos problemas fisioergonómicos las mujeres (RP= 1,06), quienes estudiaron una carrera previa (RP= 1,19), pertenecer a todos los años de estudios (RP= 1,12-1,20), quienes tenían mayor uso de Internet en horas (RP= 1,01) y aquellos que accedían a Twitter en horas de clases (RP= 1,30). La frecuencia de presentar estos problemas disminuyó en quienes tenían menor edad en años (RP= 0,99), procedían de una universidad privada (RP= 0,81), y quienes pertenecían a cualquier grupo extracurricular (RP= 0,67-0,93). Conclusiones: Los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina son ser mujer, tener carrera previa, pertenecer a todos los años de estudios, horas de uso de internet y el acceso a Twitter durante clases.

Introduction: There is evidence on the negative effect of the use of information and communication technologies on students, however, little is known about physio-ergonomic problems secondary to their use. Objective: To identify the technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students. Methods: Cross-sectional study in medical students from 11 countries in Latin America and the Caribbean. A questionnaire was used whose variables were socio-educational and technological characteristics, as well as physio-ergonomic problems (neck pain, back pain, dry/red eye and headache). Results: Of 11 587 students, 14.5% reported presenting 4 physio-ergonomic problems. Most reported neck pain (50%), back pain (50.5%), and headache (53.7%). Women (PR= 1.06), who studied a previous degree (PR= 1.19), who belonged to all years of studies (PR= 1.12-1.20), who had greater use of the Internet, had a higher frequency (in hours) of presenting these physio-ergonomic problems (PR= 1.01) and those who accessed Twitter during school hours (PR= 1.30). They decreased the frequency of presenting these problems, being younger in years (PR= 0.99), coming from a private university (PR= 0.81), and who belonged to any extracurricular group (PR= 0.67-0.93). Conclusions: The technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students were being a woman, having a previous degree, belonging to all the years of study, hours of Internet use and access to Twitter during classes.

Voice feminization in male-to-female transgendered clients after Wendler's glottoplasty with vs. without voice therapy support.

The objective of this study was to evaluate the medium-term results of Wendler's glottoplasty surgery (WG) and the effects of post-operative voice therapy in a group of male-to-female transsexuals. This is a retrospective study of 18 transsexuals who voluntarily underwent WG between 2010 and 2014 at a single hospital. Ten of the subjects underwent an additional voice therapy training. The group was assessed pre- vs. post-treatments with a limited battery of measures consisting of fundamental frequency (Fo), maximum phonation time, the TSEQ transgender self-assessment questionnaire, and perceptual assessment of the voice (Visual Analog Scale and a simplified version of the classical Hirano-GRBAS scale) by inter-rater agreement. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured, and the surface of both vocal folds was vaporized with a laser diode. The results showed a significant increase in vocal tone and feminization of voice in all participants, including a significant increase in Fo 12 months after treatment. Significant improvements were also shown in other evaluated measures, such as self-reported satisfaction and the degree of feminization of the voice. However, no improvements in maximum phonation time were observed. The use of voice therapy appears decisive for optimal improvement of this class of patients. WG applied appropriately by well-trained hands is thus a very effective and less traumatic procedure than other techniques that aim for an acceptable feminization of the voice in MtoF transgendered clients.

Specific Language Impairment: Evaluation and detection of differential psycholinguistic markers in phonology and morphosyntax in Spanish-speaking children.

BACKGROUND: The diagnosis of Specific Language Impairment (SLI) is very complex, given the variety of clinical pictures described in this disorder. Knowledge about the linguistic markers of SLI can facilitate its differentiation from the normal profile of language development. These markers can also be used as tools that may improve diagnostic. AIMS: To determine which psycholinguistic markers best discriminate Spanish-speaking children with SLI from children with typical language development. METHOD AND PROCEDURE: The performance of 31 Spanish-speaking children with SLI was analysed using a battery of 13 psycholinguistic tasks organized into two areas: phonology and morphosyntax. The performance of the SLI group was compared to that of two subgroups of controls: aged matched (CA) and linguistically matched (CL). OUTCOMES AND RESULTS: The data show that the SLI group performed worse than the CA subgroup on all 13 verbal tasks. However, the performance of the SLI group did not significantly differ from that of the CL subgroup on most (11/13) of the tasks. Stepwise discriminant analysis established the canonical function of three tasks (morphologic integration, sentence understanding and diadochokinesis) which significantly discriminated SLI from CA, with sensitivity 84% and specificity 90%. CONCLUSIONS AND IMPLICATIONS: These results contribute to determining the psycholinguistic and clinical characteristics of SLI in Spanish-speaking children and provide some methods for screening assessment.

Comparing voice-therapy and vocal-hygiene treatments in dysphonia using a limited multidimensional evaluation protocol.

PURPOSE: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. METHOD: Forty-two participants with voice disorders were randomly assigned to one of two groups. Participants in group 1 received voice-therapy and participants in group 2 received a vocal-hygiene program. Vocal function was assessed before and after treatment. RESULTS: MANOVA analysis Pillai's trace test shows significant pre-post immediate differences between treatments in favor of direct-intervention. Repeated-measures ANOVAs display significant within subjects main effect for follow-up period in the 8 measures considered. Interaction effects of group×time are also found in five out of the eight continuous variables analyzed (3 aerodynamics-acoustic and 2 self-rating), indicating differences between both treatments. Qualitative dimensions (perceptual, laryngoscopic and spectrographic assessments) also support voice-therapy superiority. CONCLUSIONS: Results of this study suggest superiority of a voice-therapy (direct treatment) approach over a vocal-hygiene program (indirect treatment). This advantage is on the majority of the 8 continuous variables analyzed (aerodynamics, acoustic, and self-rating), including qualitative perceptual, laryngoscopic and spectrographic voice-dimensions. The stability of changes is extended during a post-treatment follow-up period. LEARNING OUTCOMES: (1) The reader should distinguish the advantage using one type of treatment or another in clinical contexts. (2) The reader must know the most important direct techniques used in clinical treatment of voice disorders.