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1.
J Exp Child Psychol ; 189: 104697, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31561149

RESUMO

The purpose of this study was to explore whether children with autism display selectivity in social learning. We investigated the processing of word mappings provided by speakers who differed on previously demonstrated accuracy and on potential degree of reliability in three groups of children (children with autism spectrum disorder, children with developmental language disorder, and typically developing children) aged 4-9 years. In Task 1, one speaker consistently misnamed familiar objects and the second speaker consistently gave correct names. In Task 2, both speakers provided correct information but differed on how they could achieve this accuracy. We analyzed how the speakers' profiles influenced children's decisions to rely on them in order to learn novel words. We also examined how children attended to the speakers' testimony by tracking their eye movements and comparing children' gaze distribution across speakers' faces and objects of their choice. Results show that children rely on associative trait attribution heuristics to selectively learn from accurate speakers. In Task 1, children in all groups preferred the novel object selected by accurate speakers and directly avoided information provided by previously inaccurate speakers, as revealed by the eye-tracking data. In Task 2, where more sophisticated reasoning about speakers' reliability was required, only children in the typically developing group performed above chance. Nonverbal intelligence score emerged as a predictor of children's preference for more reliable informational sources. In addition, children with autism exhibited reduced attention to speakers' faces compared with children in the comparison groups.


Assuntos
Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Movimentos Oculares/fisiologia , Percepção Social/psicologia , Confiança , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Transtornos do Desenvolvimento da Linguagem/fisiopatologia , Transtornos do Desenvolvimento da Linguagem/psicologia , Masculino , Reprodutibilidade dos Testes
2.
Dev Med Child Neurol ; 61(12): 1368-1376, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30968406

RESUMO

Sleep disturbances are frequent and varied in autism spectrum disorder (ASD). Growing evidence suggests that sleep problems in children with ASD are driven by their clinical characteristics and psychiatric comorbidities. Therefore, the wide range of reported sleep disturbances reflects the marked heterogeneity of clinical pictures in ASD. Whether sleep disturbances and their various forms may, in turn, account for at least part of the phenotypical variability of ASD is a crucial question discussed in this review. We first outline studies both validating and challenging a bidirectional theoretical framework for sleep disorders in children with ASD. We then propose to extend this model by including cognition and sensory processing as key factors in the vicious circle linking sleep disorders and autistic symptoms. WHAT THIS PAPER ADDS: There is a bidirectional interplay between autism symptoms and sleep disturbances. Sleep influence on daytime cognitive and sensory skills should be further investigated.


RELACIÓN ENTRE EL SUEÑO Y LA CONDUCTA EN NIÑOS CON TRASTORNO DEL ESPECTRO AUTISTA: DIFICULTADES METODOLÓGICAS Y CONOCIMIENTOS DE LA COGNICIÓN Y EL PROCESAMIENTO SENSORIAL: Los trastornos del sueño son frecuentes y variados en el trastorno del espectro autista (TEA). La creciente evidencia sugiere que los problemas del sueño en niños con TEA se deben a sus características clínicas y comorbilidades psiquiátricas. Por lo tanto, la amplia gama de trastornos del sueño reportados refleja la marcada heterogeneidad de los cuadros clínicos en TEA. En esta revisión se analiza si las alteraciones del sueño y sus diversas formas pueden, a su vez, explicar al menos parte de la variabilidad fenotípica del TEA. Primero, resumimos los estudios que validan y desafían un marco teórico bidireccional para los trastornos del sueño en niños con TEA. Luego, proponemos extender este modelo incluyendo la cognición y el procesamiento sensorial como factores clave en el círculo vicioso que vincula los trastornos del sueño y los síntomas presentes en el TEA.


RELAÇÃO ENTRE SONO E COMPORTAMENTO EM CRIANÇAS COM TRANSTORNO DO ESPECTRO AUTISTA: DESAFIOS METODOLÓGICOS E DESCOBERTAS A PARTIR DO PROCESSAMENTO SENSORIAL E COGNIÇÃO: Distúrbios do sono são frequentes e variados no transtorno do espectro autista (TEA). Crescente evidência sugere que problemas de sono em crianças com TEA são causados por características clínicas e comorbidades psiquiátricas. Portanto, a ampla variedade de distúrbios do sono reportados refletem a notável heterogeneidade dos quadros clínicos em TEA. Se os distúrbios do sono podem, por sua vez, responder por pelo menos uma parte da variabilidade fenotípica do TEA é uma questão crucial a ser discutida nesta revisão. Primeiro, nós delineamos estudos que validam e outros que desafiam uma abordagem teórica bidirectional para os distúrbios do sono em crianças com TEA. Então, propomos uma extensão deste modelo, incluindo a cognição e o processamento sensorial como fatores chave no ciclo vicioso que liga desordens do sono e sintomas autísticos.


Assuntos
Transtorno do Espectro Autista , Transtornos do Sono-Vigília , Transtorno do Espectro Autista/genética , Transtorno do Espectro Autista/metabolismo , Transtorno do Espectro Autista/fisiopatologia , Criança , Pré-Escolar , Humanos , Lactente , Transtornos do Sono-Vigília/genética , Transtornos do Sono-Vigília/metabolismo , Transtornos do Sono-Vigília/fisiopatologia
3.
J Sleep Res ; 27(2): 175-183, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29024188

RESUMO

Total sleep deprivation (TSD) is known to alter cognitive processes. Surprisingly little attention has been paid to its impact on social cognition. Here, we investigated whether TSD alters levels-1 and -2 visual perspective-taking abilities, i.e. the capacity to infer (a) what can be seen and (b) how it is seen from another person's visual perspective, respectively. Participants completed levels-1 and -2 visual perspective-taking tasks after a night of sleep and after a night of TSD. In these tasks, participants had to take their own (self trials) or someone else's (other trials) visual perspective in trials where both perspectives were either the same (consistent trials) or different (inconsistent trials). An instruction preceding each trial indicated the perspective to take (i.e. the relevant perspective). Results show that TSD globally deteriorates social performance. In the level-1 task, TSD affects the selection of relevant over irrelevant perspectives. In the level-2 task, the effect of TSD cannot be unequivocally explained. This implies that visual perspective taking should be viewed as partially state-dependent, rather than a wholly static trait-like characteristic.


Assuntos
Estimulação Luminosa/métodos , Desempenho Psicomotor/fisiologia , Privação do Sono/fisiopatologia , Privação do Sono/psicologia , Percepção Visual/fisiologia , Adulto , Atenção/fisiologia , Feminino , Humanos , Masculino , Distribuição Aleatória , Privação do Sono/diagnóstico , Adulto Jovem
4.
J Sleep Res ; 24(6): 666-72, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26173051

RESUMO

Sleep deprivation is known to exert detrimental effects on various cognitive domains, including attention, vigilance and working memory. Seemingly at odds with these findings, prior studies repeatedly failed to evidence an impact of prior sleep deprivation on cognitive interference in the Stroop test, a hallmark paradigm in the study of cognitive control abilities. The present study investigated further the effect of sleep deprivation on cognitive control using an adapted version of the Stroop test that allows to segregate top-down (attentional reconfiguration on incongruent items) and bottom-up (facilitated processing after repetitions in responses and/or features of stimuli) components of performance. Participants underwent a regular night of sleep or a night of total sleep deprivation before cognitive testing. Results disclosed that sleep deprivation selectively impairs top-down adaptation mechanisms: cognitive control no longer increased upon detection of response conflict at the preceding trial. In parallel, bottom-up abilities were found unaffected by sleep deprivation: beneficial effects of stimulus and response repetitions persisted. Changes in vigilance states due to sleep deprivation selectively impact on cognitive control in the Stroop test by affecting top-down, but not bottom-up, mechanisms that guide adaptive behaviours.


Assuntos
Adaptação Psicológica , Cognição , Privação do Sono/psicologia , Teste de Stroop , Atenção , Feminino , Humanos , Masculino , Memória de Curto Prazo , Sono/fisiologia , Privação do Sono/fisiopatologia , Adulto Jovem
5.
Epilepsy Behav ; 43: 16-23, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25546732

RESUMO

OBJECTIVE: Declarative memory is consolidated during sleep in healthy children. We tested the hypothesis that consolidation processes are impaired in idiopathic focal epilepsies (IFE) of childhood in association with frequent interictal epileptiform discharges (IEDs) during sleep. METHODS: A verbal (word-pair association) and a nonverbal (2D object location) declarative memory task were administrated to 15 children with IFEs and 8 control children 6-12 years of age. Patients had either centrotemporal (11 patients) or occipital (4 patients) IEDs. All but 3 patients had a history of unprovoked seizures, and 6 of them were treated with valproate (VPA). The learning procedure (location of object pairs presented on a grid; association of word pairs) was executed in the evening. Retrieval was tested immediately after learning and on the next morning after a night of sleep. Participants were tested twice, once in natural home conditions and one month later in the unfamiliar conditions of the sleep unit under EEG monitoring. RESULTS: Overnight recall performance was lower in children with IFE than in control children on both tasks (ps<0.05). Performance in home conditions was similar to that in hospital conditions. Higher spike-wave index (SWI) during nonrapid eye movement (NREM) sleep was associated with poorer performance in the nonverbal task (p<0.05). Valproate treatment was not associated with overnight recall performance for both tasks (ps>0.05). CONCLUSION: Memory consolidation is impaired in IFE of childhood. The association between higher SWI during NREM sleep and poorer nonverbal declarative memory consolidation supports the hypothesis that interictal epileptic activity could disrupt sleep memory consolidation.


Assuntos
Epilepsias Parciais/complicações , Epilepsias Parciais/psicologia , Transtornos da Memória/etiologia , Transtornos da Memória/psicologia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/psicologia , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Criança , Eletroencefalografia , Epilepsia Rolândica/complicações , Epilepsia Rolândica/psicologia , Feminino , Humanos , Deficiências da Aprendizagem/etiologia , Deficiências da Aprendizagem/psicologia , Masculino , Rememoração Mental , Polissonografia , Desempenho Psicomotor , Convulsões/psicologia , Sono , Ácido Valproico/efeitos adversos , Ácido Valproico/uso terapêutico , Testes de Associação de Palavras
6.
Exp Brain Res ; 232(5): 1403-14, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24449011

RESUMO

How emotions interact with cognitive processes has been a topic of growing interest in the last decades, as well as studies investigating the role of sleep in cognition. We review here evidence showing that sleep and emotions entertain privileged relationships. The literature indicates that exposure to stressful and emotional experiences can induce changes in the post-exposure sleep architecture, whereas emotional disturbances are likely to develop following sleep alterations. In addition, post-training sleep appears particularly beneficial for the consolidation of intrinsically emotional memories, suggesting that emotions modulate the off-line brain activity patterns subtending memory consolidation processes. Conversely, sleep contributes unbinding core memories from their affective blanket and removing the latter, eventually participating to habituation processes and reducing aversive reactions to stressful stimuli. Taken together, these data suggest that sleep plays an important role in the regulation and processing of emotions, which highlight its crucial influence on human's abilities to manage and respond to emotional information.


Assuntos
Emoções/fisiologia , Memória/fisiologia , Sono/fisiologia , Humanos
7.
J Vis ; 14(1)2014 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-24464162

RESUMO

Several studies suggest that sleep improves perceptual skills in the visual texture discrimination task (TDT). Here we report that besides consolidation, sleep also generalizes the learned perceptual abilities to the untrained eye. Healthy volunteers (n = 32) were trained on the TDT, in which they had to discriminate between horizontal and vertical target textures briefly presented in the periphery of the visual field (left upper quadrant). After a 10-hr interval filled with either sleep or wakefulness, they were retested first on the trained eye in the trained quadrant and then on the untrained eye and quadrant. In line with prior findings, visual discrimination was globally higher after sleep than after wakefulness, as compared to performance levels at the end of training. Furthermore, discrimination performance was significantly improved only in the sleep condition for the untrained eye in the same quadrant, but also showed a trend to generalize to the untrained eye and untrained quadrant. Our results suggest that sleep-dependent perceptual skills continue developing at a later visual-process stage than the V1 area, where learning is not monocular anymore.


Assuntos
Memória/fisiologia , Sono/fisiologia , Percepção Visual/fisiologia , Adulto , Feminino , Voluntários Saudáveis , Humanos , Aprendizagem/fisiologia , Masculino , Adulto Jovem
8.
Cogn Emot ; 28(4): 698-706, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24160465

RESUMO

Neutral memories unbind from their emotional acquisition context when sleep is allowed the night after learning and testing takes place after two additional nights of sleep. However, mood-dependent memory (MDM) effects are not abolished after a restricted sleep episode mostly featuring non rapid-eye-movement (NREM) or rapid-eye-movement (REM) sleep. Here, we tested whether (1) one night of sleep featuring several NREM-REM sleep cycles is sufficient to suppress MDM effects and (2) a neutral mood is a sufficiently contrasting state to induce MDM effects, i.e. interfere with the recall of information learned in happy or sad states. Results disclosed MDM effects both in the post-learning sleep and wake conditions, with better recall in congruent than incongruent emotional contexts. Our findings suggest that the emotional unbinding needs several consecutive nights of sleep to be complete, and that even subtle mood changes are sufficient to produce MDM effects.


Assuntos
Afeto , Memória , Sono , Feminino , Humanos , Rememoração Mental , Vigília , Adulto Jovem
9.
Behav Res Methods ; 46(4): 1098-107, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24519495

RESUMO

Through this study, we aimed to validate a new tool for inducing moods in experimental contexts. Five audio stories with sad, joyful, frightening, erotic, or neutral content were presented to 60 participants (33 women, 27 men) in a within-subjects design, each for about 10 min. Participants were asked (1) to report their moods before and after listening to each story, (2) to assess the emotional content of the excerpts on various emotional scales, and (3) to rate their level of projection into the stories. The results confirmed our a priori emotional classification. The emotional stories were effective in inducing the desired mood, with no difference found between male and female participants. These stories therefore constitute a valuable corpus for inducing moods in French-speaking participants, and they are made freely available for use in scientific research.


Assuntos
Afeto/classificação , Pesquisa Comportamental/instrumentação , Bases de Dados Factuais , Emoções/classificação , Narração , Adulto , Análise de Variância , Medo/psicologia , Feminino , Felicidade , Humanos , Idioma , Masculino , Motivação , Valores de Referência , Fatores Sexuais , Inquéritos e Questionários
10.
J Sleep Res ; 22(6): 656-62, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23790010

RESUMO

Sleep unbinds memories from their emotional learning context, protecting them from emotional interference due to a change of mood between learning and recall. According to the 'sleep to forget and sleep to remember' model, emotional unbinding takes place during rapid eye movement sleep. To test this hypothesis, we investigated emotional contextual interference effects after early versus late post-learning sleep periods, in which slow wave and rapid eye movement sleep, respectively, predominate. Participants learned a list of neutral word pairs after induction of a happy or a sad mood, then slept immediately afterwards for 3 h of early or late sleep under polysomnographic recording, in a within-subject counterbalanced design. They slept for 3 h before learning in the late sleep condition. Polysomnographic data confirmed more rapid eye movement sleep in the late than in the early sleep condition. After awakening, half the list was recalled after induction of a similar mood than during the encoding session (non-interference condition), and the other half of the list was recalled after induction of a different mood (interference condition). The results disclosed an emotional interference effect on recall both in the early and late sleep conditions, which does not corroborate the hypothesis of a rapid eye movement sleep-related protection of recent memories from emotional contextual interference. Alternatively, the contextual demodulation process initiated during the first post-learning night might need several consecutive nights of sleep to be achieved.


Assuntos
Emoções/fisiologia , Memória/fisiologia , Sono REM/fisiologia , Afeto/fisiologia , Nível de Alerta/fisiologia , Feminino , Felicidade , Humanos , Idioma , Masculino , Rememoração Mental , Polissonografia , Adulto Jovem
11.
Behav Brain Sci ; 36(6): 613-4; discussion 634-59, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24304753

RESUMO

Llewellyn suggests that episodic memories undergo "elaborative encoding" during rapid eye movement (REM) dreams, generating novel associations between recent and remote memories that are then instantiated during non-REM (NREM) sleep. This hypothesis conflicts with our knowledge of the physiology of NREM and then REM sleep stages and their ordered succession. Moreover, associations during sleep might also involve the extraction of hidden patterns rather than de novo associations.


Assuntos
Córtex Cerebral/fisiologia , Sonhos/fisiologia , Sonhos/psicologia , Hipocampo/fisiologia , Memória Episódica , Sono REM/fisiologia , Humanos
12.
J Exp Psychol Gen ; 150(10): 2137-2157, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34138602

RESUMO

Low integration of speech sounds with the mouth movements likely contributes to language acquisition disabilities that frequently characterize young autistic children. However, the existing empirical evidence either relies on complex verbal instructions or merely focuses on preferential gaze on in-synch videos. The former method is clearly unadapted for young, minimally, or nonverbal autistic children, while the latter has several biases, making it difficult to interpret the data. We designed a Reinforced Preferential Gaze paradigm that allows to test multimodal integration in young, nonverbal autistic children and overcomes several of the methodological challenges faced by previous studies. We show that autistic children have difficulties in temporally binding the speech signal with the corresponding articulatory gestures. A condition with structurally similar nonsocial video stimuli suggests that atypical multimodal integration in autism is not limited to speech stimuli. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtorno Autístico , Criança , Gestos , Humanos , Desenvolvimento da Linguagem , Fala
13.
Autism Res ; 14(6): 1186-1196, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33484063

RESUMO

This study examined whether the atypical speech style that is frequently reported in autistic adults is underpinned by an inflexible production of phonetic targets. In a first task, 20 male autistic adults and 20 neuro-typicals had to read and produce native vowels. To assess the extent to which phonetic inflexibility is due to an overall fine-grained control of phonetic behavior or to a lack of flexibility in the realization of one's phonological repertoire, the second task asked participants to reproduce artificial vowel-like sounds. Results confirmed the presence of a greater articulatory stability in the production of native vowels in autistic adults. When instructed to imitate artificial vowel-like sounds, the autistic group did not better approximate the targets' acoustic properties relative to neuro-typicals but their performance at reproducing artificial vowels was less variable and influenced to a greater extent by the articulatory properties of their own vocalic space. These findings suggest that the greater articulatory stability observed in autistic adults arises from a lack of flexibility in the production of their own native vowels. The two phonetic tasks are devoid of any pragmatic constraint, which indicates that phonetic inflexibility in autism is partly independent of register selection. LAY SUMMARY: Autistic and neuro-typical adults took part in two tasks: one in which they produced vowels from French, their native tongue, and the other where they imitated unfamiliar vowels. Autistic adults displayed significantly less variation in their production of different French vowels. In imitating unfamiliar vowels, they were more influenced by the way they pronounce French vowels. These results suggest that the atypical speech style, frequently attested in autistic individuals, could stem from an unusually stable pronunciation of speech sounds.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Acústica , Adulto , Transtorno Autístico/complicações , Humanos , Masculino , Fonética , Fala , Acústica da Fala
14.
J Autism Dev Disord ; 51(1): 255-266, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32419043

RESUMO

Autism Spectrum Disorder (ASD) is often associated with impaired perspective-taking skills. Deception is an important indicator of perspective-taking, and therefore may be thought to pose difficulties to people with ASD (e.g., Baron-Cohen in J Child Psychol Psychiatry 3:1141-1155, 1992). To test this hypothesis, we asked participants with and without ASD to play a computerised deception game. We found that participants with ASD were equally likely-and in complex cases of deception even more likely-to deceive and detect deception, and learned deception at a faster rate. However, participants with ASD initially deceived less frequently, and were slower at detecting deception. These results suggest that people with ASD readily engage in deception but may do so through conscious and effortful reasoning about other people's perspective.


Assuntos
Transtorno do Espectro Autista/psicologia , Enganação , Resolução de Problemas/fisiologia , Jogos de Vídeo/psicologia , Adulto , Transtorno do Espectro Autista/diagnóstico , Feminino , Humanos , Aprendizagem/fisiologia , Masculino , Tempo de Reação/fisiologia , Jogos de Vídeo/tendências
15.
J Exp Psychol Learn Mem Cogn ; 45(8): 1387-1397, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30284869

RESUMO

An ongoing debate in the literature on language acquisition is whether preschool children process reference in an egocentric way or whether they spontaneously and by-default take their partner's perspective into account. The reported study implements a computerized referential task with a controlled trial presentation and simple verbal instructions. Contrary to the predictions of the partner-specific view, entrained referential precedents give rise to faster processing for 3- and 5-year-old children, independently of whether the conversational partner is the same as in the lexical entrainment phase or not. Additionally, both age groups display a processing preference for the interaction with the same partner, be it for new or previously used referential descriptions. These results suggest that preschool children may adapt to their conversational partner; however, partner-specificity is encoded as low-level auditory-phonological priming rather than through inferences about a partner's perspective. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Egocentrismo , Desenvolvimento da Linguagem , Fatores Etários , Pré-Escolar , Feminino , Humanos , Relações Interpessoais , Masculino , Fonética , Semântica , Percepção da Fala
16.
Sleep ; 41(2)2018 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-29244170

RESUMO

STUDY OBJECTIVES: This study investigates the impact of sleep deprivation (SD) on task-goal switching, a key component of cognitive flexibility. METHODS: Task-goal switching performance was tested after one night of regular sleep (n = 17 participants) or of total SD (n = 18). To understand the relationships between task-switching performance and other cognitive processes following SD, participants were tested for other key attentional (alertness and vigilance) and executive (inhibition and working memory) functions. Spontaneous eye blink rate (EBR) was also measured as an indirect marker of striatal dopaminergic function. RESULTS: SD negatively affects task-goal switching as well as attentional and inhibition measures, but not working memory. Changes in task-goal switching performance were not significantly correlated with changes in objective and subjective markers of fatigue and sleepiness, response inhibition, or spontaneous EBR. CONCLUSIONS: Altogether, our results show differentiated effects of SD on key executive functions such as working memory, inhibition, and task-goal switching.

17.
J Autism Dev Disord ; 48(9): 2938-2952, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29633109

RESUMO

Autism Spectrum Disorder (ASD) is often described as being characterised by a uniform pragmatic impairment. However, recent evidence suggests that some areas of pragmatic functioning are preserved. This study seeks to determine to which extent context-based derivation of non-linguistically encoded meaning is functional in ASD. We compare the performance of 24 adults with ASD, and matched neuro-typical adults in two act-out pragmatic tasks. The first task examines generation of indirect request interpretations, and the second the comprehension of irony. Intact contextual comprehension of indirect requests contrasts with marked difficulties in understanding irony. These results suggest that preserved pragmatics in ASD is limited to egocentric processing of context, which does not rely on assumptions about the speaker's mental states.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Compreensão/fisiologia , Função Executiva/fisiologia , Habilidades Sociais , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa/métodos , Desempenho Psicomotor/fisiologia , Adulto Jovem
18.
J Geriatr Oncol ; 7(6): 463-470, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27238734

RESUMO

OBJECTIVES: The aim of this study was to assess the prevalence of potentially inappropriate medication (PIM) use upon admission and at discharge in a geriatric oncology unit after involving a clinical pharmacist. Although the few studies conducted in geriatric oncology units used the 2003 Beers criteria, this study used START and STOPP criteria, a more appropriate tool for European formularies. MATERIALS AND METHODS: Prospective study in older (≥70years) patients consecutively admitted to a geriatric oncology unit in a cancer center from July 2011 to April 2012. Clinical pharmacist conducted a complete comprehensive medication review including non-prescription and complementary (herbals) medications. This information coupled with the patient's medical history allows identifying PIMs using the STOPP and START criteria. The number of PIMs at admission and at discharge from the hospital was compared after clinical pharmacist intervention. RESULTS: Ninety-one older patients with cancer (mean age±SD=79±6years) were included in the study. START criteria identified 41 PIMs for 31 persons (34%) at admission compared to 7 PIMs for 6 persons (7%) at discharge. STOPP criteria identified 50 PIMs at admission for 29 persons (32%) compared to 16 PIMs at discharge for 14 persons (16%). Results showed significantly lower START scores at discharge than at admission (p<0.001); similarly, STOPP criteria demonstrated fewer PIMs at discharge than at admission (p<0.001). CONCLUSION: The use of START and STOPP criteria by a clinical pharmacist allows identifying PIMs and changing prescriptions for older patients with cancer in agreement with the oncologist and geriatrician of the team.


Assuntos
Antineoplásicos/uso terapêutico , Prescrição Inadequada , Neoplasias/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Institutos de Câncer , Cateteres de Demora , Feminino , Idoso Fragilizado , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/normas , Lista de Medicamentos Potencialmente Inapropriados/estatística & dados numéricos , Prática Profissional , Estudos Prospectivos
19.
Sleep ; 38(5): 707-15, 2015 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25348128

RESUMO

STUDY OBJECTIVES: A link between sleep loss and increased risk for the development of diabetes is now well recognized. The current study investigates whether sleep extension under real-life conditions is a feasible intervention with a beneficial impact on glucose metabolism in healthy adults who are chronically sleep restricted. DESIGN: Intervention study. PARTICIPANTS: Sixteen healthy non-obese volunteers (25 [23, 27.8] years old, 3 men). INTERVENTIONS: Two weeks of habitual time in bed followed by 6 weeks during which participants were instructed to increase their time in bed by one hour per day. MEASUREMENTS AND RESULTS: Continuous actigraphy monitoring and daily sleep logs during the entire study. Glucose and insulin were assayed on a single morning blood sample at the end of habitual time in bed and at the end of sleep extension. Home polysomnography was performed during one weekday of habitual time in bed and after 40 days of sleep extension. Sleep time during weekdays increased (mean actigraphic data: +44 ± 34 minutes, P < 0.0001; polysomnographic data: +49 ± 68 minutes, P = 0.014), without any significant change during weekends. Changes from habitual time in bed to the end of the intervention in total sleep time correlated with changes in glucose (r = +0.53, P = 0.041) and insulin levels (r = -0.60, P = 0.025), as well as with indices of insulin sensitivity (r = +0.76, P = 0.002). CONCLUSIONS: In healthy adults who are chronically sleep restricted, a simple low cost intervention such as sleep extension is feasible and is associated with improvements in fasting insulin sensitivity.


Assuntos
Jejum/fisiologia , Resistência à Insulina/fisiologia , Insulina/metabolismo , Privação do Sono/metabolismo , Sono/fisiologia , Actigrafia , Adulto , Peso Corporal , Doença Crônica , Feminino , Glucose/análise , Glucose/metabolismo , Voluntários Saudáveis , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Polissonografia , Privação do Sono/fisiopatologia , Fatores de Tempo , Adulto Jovem
20.
PLoS One ; 10(5): e0125359, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26016658

RESUMO

Beneficial effects of napping or bright light exposure on cognitive performance have been reported in participants exposed to sleep loss. Nonetheless, few studies investigated the effect of these potential countermeasures against the temporary drop in performance observed in mid-afternoon, and even less so on cognitive flexibility, a crucial component of executive functions. This study investigated the impact of either an afternoon nap or bright light exposure on post-prandial alterations in task switching performance in well-rested participants. Twenty-five healthy adults participated in two randomized experimental conditions, either wake versus nap (n=15), or bright light versus placebo (n=10). Participants were tested on a switching task three times (morning, post-lunch and late afternoon sessions). The interventions occurred prior to the post-lunch session. In the nap/wake condition, participants either stayed awake watching a 30-minute documentary or had the opportunity to take a nap for 30 minutes. In the bright light/placebo condition, participants watched a documentary under either bright blue light or dim orange light (placebo) for 30 minutes. The switch cost estimates cognitive flexibility and measures task-switching efficiency. Increased switch cost scores indicate higher difficulties to switch between tasks. In both control conditions (wake or placebo), accuracy switch-cost score increased post lunch. Both interventions (nap or bright light) elicited a decrease in accuracy switch-cost score post lunch, which was associated with diminished fatigue and decreased variability in vigilance. Additionally, there was a trend for a post-lunch benefit of bright light with a decreased latency switch-cost score. In the nap group, improvements in accuracy switch-cost score were associated with more NREM sleep stage N1. Thus, exposure to bright light during the post-lunch dip, a countermeasure easily applicable in daily life, results in similar beneficial effects as a short nap on performance in the cognitive flexibility domain with possible additional benefits on latency switch-cost scores.


Assuntos
Cognição/fisiologia , Luz , Almoço , Sono/fisiologia , Vigília/fisiologia , Adolescente , Adulto , Ritmo Circadiano/fisiologia , Cognição/efeitos da radiação , Fadiga/fisiopatologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Vigília/efeitos da radiação , Adulto Jovem
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