Genetic Rescue of Mitochondrial and Skeletal Muscle Impairment in an Induced Pluripotent Stem Cells Model of Coenzyme Q10 Deficiency.

Coenzyme Q10 (CoQ10 ) plays a crucial role in mitochondria as an electron carrier within the mitochondrial respiratory chain (MRC) and is an essential antioxidant. Mutations in genes responsible for CoQ10 biosynthesis (COQ genes) cause primary CoQ10 deficiency, a rare and heterogeneous mitochondrial disorder with no clear genotype-phenotype association, mainly affecting tissues with high-energy demand including brain and skeletal muscle (SkM). Here, we report a four-year-old girl diagnosed with minor mental retardation and lethal rhabdomyolysis harboring a heterozygous mutation (c.483G > C (E161D)) in COQ4. The patient's fibroblasts showed a decrease in [CoQ10 ], CoQ10 biosynthesis, MRC activity affecting complexes I/II + III, and respiration defects. Bona fide induced pluripotent stem cell (iPSCs) lines carrying the COQ4 mutation (CQ4-iPSCs) were generated, characterized and genetically edited using the CRISPR-Cas9 system (CQ4ed -iPSCs). Extensive differentiation and metabolic assays of control-iPSCs, CQ4-iPSCs and CQ4ed -iPSCs demonstrated a genotype association, reproducing the disease phenotype. The COQ4 mutation in iPSC was associated with CoQ10 deficiency, metabolic dysfunction, and respiration defects. iPSC differentiation into SkM was compromised, and the resulting SkM also displayed respiration defects. Remarkably, iPSC differentiation in dopaminergic or motor neurons was unaffected. This study offers an unprecedented iPSC model recapitulating CoQ10 deficiency-associated functional and metabolic phenotypes caused by COQ4 mutation. Stem Cells 2017;35:1687-1703.

Clinical Profile of Patients with Psychogenic Non-epileptic Seizures in Puerto Rico.

OBJECTIVE: Specialized epilepsy clinics receive many cases (20%-30% of total cases) in which the patients are diagnosed with psychogenic non-epileptic seizures (PNES). In Puerto Rico, there has been a lack of research on and data about patients with PNES. This study examined the clinical profile of 34 patients with a confirmed diagnosis of PNES. METHODS: A secondary analysis of 34 clinical records of patients with PNES was conducted. The resulting profile was based on clinical interviews, the behavioral presentation of seizures, the history of traumatic experiences or abuse, and the relationship between PNES events and life stressors. Also, the Beck Depression Inventory-II was used to explore depressive symptoms. RESULTS: Seventy six percent (n = 26) of the patients were female, with an average age of 34.32. All the patients in this sample experienced a PNES episode that was induced in the office through hypnotic imagery. In most cases, seizures consistently manifested PNES semiology: 82% presented unsynchronized and violent limb movements and featured vocalizations, pronounced ictal pelvic thrusting, and sideto-side head movements. Furthermore, 47% of the patients reported histories of trauma related to sexual, physical or emotional abuse. Moreover, 94% stated that most of their convulsions were triggered by stressful life events. Additionally, 50% of the patients presented symptoms of depression. CONCLUSION: The clinical profile of patients with PNES reveals that a considerable number of them presented a history of multiple traumatic experiences and most seizures seemed to be induced by stressful events. It is recommended that additional clinical research be conducted on PNES, with the aim of achieving the effective detection and diagnosis of the disorder, as well as increasing the focus of the healthcare industry on developing evidence-based interventions.

Selective accumulation of biotin in arterial chemoreceptors: requirement for carotid body exocytotic dopamine secretion.

KEY POINTS: Biotin, a vitamin whose main role is as a coenzyme for carboxylases, accumulates at unusually large amounts within cells of the carotid body (CB). In biotin-deficient rats biotin rapidly disappears from the blood; however, it remains at relatively high levels in CB glomus cells. The CB contains high levels of mRNA for SLC5a6, a biotin transporter, and SLC19a3, a thiamine transporter regulated by biotin. Animals with biotin deficiency exhibit pronounced metabolic lactic acidosis. Remarkably, glomus cells from these animals have normal electrical and neurochemical properties. However, they show a marked decrease in the size of quantal dopaminergic secretory events. Inhibitors of the vesicular monoamine transporter 2 (VMAT2) mimic the effect of biotin deficiency. In biotin-deficient animals, VMAT2 protein expression decreases in parallel with biotin depletion in CB cells. These data suggest that dopamine transport and/or storage in small secretory granules in glomus cells depend on biotin. ABSTRACT: Biotin is a water-soluble vitamin required for the function of carboxylases as well as for the regulation of gene expression. Here, we report that biotin accumulates in unusually large amounts in cells of arterial chemoreceptors, carotid body (CB) and adrenal medulla (AM). We show in a biotin-deficient rat model that the vitamin rapidly disappears from the blood and other tissues (including the AM), while remaining at relatively high levels in the CB. We have also observed that, in comparison with other peripheral neural tissues, CB cells contain high levels of SLC5a6, a biotin transporter, and SLC19a3, a thiamine transporter regulated by biotin. Biotin-deficient rats show a syndrome characterized by marked weight loss, metabolic lactic acidosis, aciduria and accelerated breathing with normal responsiveness to hypoxia. Remarkably, CB cells from biotin-deficient animals have normal electrophysiological and neurochemical (ATP levels and catecholamine synthesis) properties; however, they exhibit a marked decrease in the size of quantal catecholaminergic secretory events, which is not seen in AM cells. A similar differential secretory dysfunction is observed in CB cells treated with tetrabenazine, a selective inhibitor of the vesicular monoamine transporter 2 (VMAT2). VMAT2 is highly expressed in glomus cells (in comparison with VMAT1), and in biotin-deficient animals VMAT2 protein expression decreases in parallel with the decrease of biotin accumulated in CB cells. These data suggest that biotin has an essential role in the homeostasis of dopaminergic transmission modulating the transport and/or storage of transmitters within small secretory granules in glomus cells.

Chronic and progressive Parkinson's disease MPTP model in adult and aged mice.

Despite the different animal models of Parkinson's disease developed during the last years, they still present limitations modelling the slow and progressive process of neurodegeneration. Here, we undertook a histological, neurochemical and behavioural analysis of a new chronic parkinsonian mouse model generated by the subcutaneous administration of low doses of MPTP (20 mg/kg, 3 times per week) for 3 months, using both young adult and aged mice. The MPTP-induced nigrostriatal neurodegeneration was progressive and was accompanied by a decrease in striatal dopamine levels and motor impairment. We also demonstrated the characteristic neuroinflammatory changes (microglial activation and astrogliosis) associated with the neurodegenerative process. Aged animals showed both a faster time course of neurodegeneration and an altered neuroinflammatory response. The long-term systemic application of low MPTP doses did not induce any increase in mortality in either young adult or aged mice and better resembles the slow evolution of the neurodegenerative process. This treatment could be useful to model different stages of Parkinson's disease, providing a better understanding of the pathophysiology of the disease and facilitating the testing of both protective and restorative treatments. Here, we show a new chronic and progressive parkinsonian mouse model, in young and aged mice. This model produces a stable degeneration of the dopaminergic nigrostriatal pathway, continuous neuroinflammatory reaction and motor deficits. Aged animals showed a faster neurodegeneration and an altered neuroinflammatory response. This treatment could be useful to model different stages of PD and to test both protective and restorative therapeutic approaches.

Metabolic correction: a functional biochemical mechanism against disease--Part 2: mechanisms and benefits.

A healthy physiology depends on a plethora of complex interdependent biochemical reactions. In order for these reactions to occur suitably, the enzymes and cofactors that regulate their flow must be present in the proper balance. The term metabolic correction is used to describe a biochemical-physiological process that improves cellular biochemistry as a means to an individual's achieving metabolic or physiological optimization. Part 2 discusses how metabolic correction, through the increase of cofactors, can supply unmet enzyme needs and compensate for nutritional deficiencies induced by improper nutritional intake or by the increased demand for nutrients caused by genetics, health conditions, medications, or physical or environmental stressors. Nutrient insufficiencies are causing an increase in morbidity and mortality, at great cost to our society. In summary, metabolic correction improves enzymatic function and satisfies the increasing demand for nutrients. Metabolic correction can have a significant impact on the reduction of morbidity and mortality and their financial cost to our society and contribute to improving health and well-being.

Metabolic correction: a functional biochemical mechanism against disease--Part 1: concept and historical background.

Human physiology depends on countless biochemical reactions, numerous of which are co-dependent and interrelated. The speed and level of completion of reactions usually depend on the availability of precursors and enzymes. The enzymatic activity depends on the bioavailability of micronutrient cofactors such as vitamins and minerals. In order to achieve a healthy physiological state, the organism requires that biochemical reactions occur at a controlled rate. To achieve this state it is required that metabolic reactions reach what can be considered an optimal metabolic equilibrium. A combination of genetic makeup, dietary patterns, trauma, disease, toxins, medications, and environmental stressors can elevate the demand for the nutrients needed to reach this optimal metabolic equilibrium. In this, part 1, the general concept of metabolic correction is presented with an elaboration explaining how this concept is increasing in importance as we become aware of the presence of genetic variants that affect enzymatic reactions causing metabolic disturbances that themselves favor or promote the disease state. In addition, part 1 reviews how prominent scientists have contributed in fundamental ways to our understanding of the importance of micronutrients in health and disease and in the development of the metabolic correction concept.

[Achondroplasia: a pilot study on the psychosocial and medical features of a sample in Puerto Rico]. / Acondroplasia: Un Estudio Pionero Sobre Las Características Psicosociales Y Médicas De Una Muestra En Puerto Rico.

This study explores the psychological wellbeing of twenty-two (n = 22) adults with achondroplasia. The sample was composed of seven (n = 7) males and fifteen (n = 15) females between the ages of 21 and 75 (mean age = 39.6). Each individual completed four self-administered questionnaires: the Beck Depression Inventory (BDI-l), the Beck Anxiety Inventory (BAI), the Beck Hopelessness Scale (BHS), and Derogatis Symptom Check-list-90-Revisited (SCL-90-R). They also filled out a socio-demographic questionnaire. We found that 31.8% of the sample reported at least one comorbid condition such as, hypertension, diabetes, rheumatoid arthritis, asthma, scoliosis, thyroid problems, neuropathy, psoriasis, gastritis and/or sleep apnea; 32% reported mild to severe depressive symp- toms; 55% reported mild to severe symptoms associated to anxiety and 18% reported mild to severe symptoms associated with hopelessness; 22.7% reported mild to severe symptoms in at least one of the sub-scales in Derogatis Symptom Checklist-90-Revisited (SCL-90-R) particularly the obsessive-compulsive, paranoid and depressive subscales. Chi Square correlations (X2) were made to observe if there was interdependence between the socio-demographic variables and the administered tests. In general, no significant correlations were found between BDI-Il, BAI, BHS, SCL-90-R and civil status, gender, income and age. However, a significant correlation was found between age and the somatization sub-scale of the SCL-90-R (rs = 0.510, p < 0.05). Our findings suggest that this particular sample is at risk for developing psycho-medical conditions. There is a marked lack of research in Puerto Rico associated to achondroplasia. The development of preventive and cultural sensitive interventions is suggested in order to protect and treat individuals with the condition.

[Metabolic correction: a biochemical option against diseases]. / Corrección metabólica: Una opción bioquímica contra las enfermedades.

Human development and its physiology depends on a number of complex biochemical body processes, many of which are interactive and codependent. The speed and the degree in which many physiological reactions are completed depend on enzyme activity, which in turn depends on the bioavailability of co-factors and micronutrients such as vitamins and minerals. To achieve a healthy physiological state, organism need that biochemical reactions occur in a controlled and specific way at a particular speed and level or grade fully completed. To achieve this, is required an optimal metabolic balance. Factors such as, a particular genetic composition, inadequate dietary consumption patterns, traumas, diseases, toxins and environmental stress all of these factors rising demands for nutrients in order to obtain optimal metabolic balance. Metabolic correction is a biochemical and physiological concept that explains how improvements in cellular biochemistry of an organism can help the body achieve metabolic and physiological optimization. We summarize the contribution of several pioneers in understanding the role of micronutrients in health management. The concept of metabolic correction is becoming a significant term due to the presence of genetic variants that affect the speed of reactions of enzymes, causing metabolic alterations that enhance or promote the state/development of multiple diseases. Decline in the nutritional value of the food we eat, the increase in demand for certain nutrients caused by normal development, diseases and medications induce, usually, nutrients consumption. These nutritional deficiencies and insufficiencies are causing massive economic costs due to increased morbidity and mortality in our society. In summary, metabolic correction improves the enzymatic function, which favors the physiological normal functions, thus, contributing to improving health and the welfare of the human being. The purpose of this paper is to describe and introduce the concept of optimal metabolic correction as a functional cost-effective mechanism against disease, in addition, to contribute to diseases prevention and regeneration of the body and health.

[Psychological and resilient characteristics of a sample of Puerto Rican women who had undergone breast cancer reconstruction]. / Características psicológicas y resilientes de una muestra de mujeres puertorriqueñas con cirugía de reconstruccción mamaria por cáncer.

The purpose of this pioneer study was to describe the socio-demographics, psychopathological and resilient characteristics in a sample of Puerto Rican women who opted for breast reconstruction surgery after breast cancer. This research was done in order to provide information and increase research knowledge about breast reconstruction that could be used by public and private breast cancer psycho-psychiatry support programs for patients in Puerto Rico. Research participants were ten Puerto Rican women, aged twenty-one years or older. A socio-demographic questionnaire, The Symptom Checklist- 36, Internal Factors of Resilience Scale, and a Semi-structured interview (qualitative approach) were administered. Main sample findings included psychopathological characteristics such as somatization and depression, and resilient characteristics such as, high spirituality, autonomy, introspection and satisfaction.

Description and Analysis of Research on Death and Dying during the COVID-19 Pandemic, Published in Nursing Journals Indexed in SCOPUS.

AIM: To offer an overall picture of the research published regarding the different aspects of death and dying during the COVID-19 pandemic in journals covering the field of nursing in the Scopus database. DESIGN: bibliometric analysis. METHODS: The metadata obtained were exported from Scopus for subsequent analysis through Bibliometrix. Using the VOSviewer co-word analysis function, the conceptual and thematic structure of the publications was identified. RESULTS: A total of 119 papers were retrieved, with the participation of 527 authors. The publications were found in 71 journals covering the nursing area. The main lines of research revolved around the keywords "palliative care" and "end-of-life care" in regard to the ethical, psychological, and organizational challenges faced by the health professionals who cared for these patients. CONCLUSION: The results obtained offer a range of data and images that characterize the scientific production published on this topic, coming to the conclusion that, due to the multifaceted and multidisciplinary approach to the experience of death, care, and accompaniment in the dying process, bibliometric maps improve the comprehensive understanding of the semantic and conceptual structure of this field of research. This study was retrospectively registered with the OSF Registries on the 14 March 2024.

α-Haemoglobin regulates sympathoadrenal cell metabolism to maintain a catecholaminergic phenotype.

Discovery of haemoglobin A expression outside of the erythroid cell lineage suggests that oxygen transport is the main, but not the unique, function of adult haemoglobin chains in mammals. The contribution of haemoglobin A to antioxidant defences has been proposed in the territories where it is expressed. Catecholaminergic cells rely on an active oxidative metabolism to accomplish their biological function, but are exposed to strong oxidative stress due to metabolism of catecholaminergic transmitters. We show in the present study that peripheral catecholaminegic cells express the α- and not the ß-haemoglobin A chains, and that α-haemoglobin expression could modulate the antioxidant capabilities of these cells. We also show that α-haemoglobin overexpression in PC12 cells leads to a selective increase of tyrosine hydroxylase synthesis and activity. This is achieved by means of a reorganization of antioxidant defences, decreasing cytoplasmic glutathione peroxidase and superoxide dismutase, and increasing mitochondrial peroxidase. Moreover, α-haemoglobin induces a decrease in lipogenesis and increase in lipid degradation, situations that help save NAD(P)H and favour supply of acetyl-CoA to the tricarboxylic acid cycle and production of reducing equivalents in the cell. All of these results point to a role for α-haemoglobin as a regulator of catecholaminergic cell metabolism required for phenotype acquisition and maintenance.

The RAS-24: Development and validation of an adherence-to-medication scale for severe mental illness patients.

Introduction: Several studies have found that most patients with severe mental illness (SMI) and comorbid (physical) conditions are partially or wholly nonadherent to their medication regimens. Nonadherence to treatment is a serious concern, affecting the successful management of patients with SMIs. Psychiatric disorders tend to worsen and persist in nonadherent patients, worsening their overall health. The study described herein aimed to develop and validate a scale (the Ralat Adherence Scale) to measure nonadherence behaviors in a culturally sensitive way. Materials and Methods: Guided by a previous study that explored the primary reasons for nonadherence in Puerto Rican patients, we developed a pool of 147 items linked to the concept of adherence. Nine experts reviewed the meaning, content, clarity, and relevance of the individual items, and a content validity ratio was calculated for each one. Forty items remained in the scale's first version. This version was administered to 160 patients (21-60 years old). All the participants had a diagnosis of bipolar disorder, major depressive disorder, or schizoaffective disorder. The STROBE checklist was used as the reporting guideline. Results: The scale had very good internal consistency (Cronbach's alpha = 0.812). After a factor analysis, the scale was reduced to 24 items; the new scale had a Cronbach's alpha of 0.900. Conclusions: This adherence scale is a self-administered instrument with very good psychometric properties; it has yielded important information about nonadherence behaviors. The scale can help health professionals and researchers to assess patient adherence or nonadherence to a medication regimen.

Comparison between self-concept, self-perception, physical exercise and lifestyle variations from 1st to 4th grade students of nursing in Tenerife, Spain.

The aim of this study was to describe and compare the self-concept, self-perception, physical exercise, and lifestyle of students from 1st to 4th year of the Nursing university studies. Descriptive observational cross-sectional study with analytical components. The study sample consisted of 1st and 4th year undergraduate Nursing students. Five questionnaires were used: a sociodemographic survey, the RSES, the GHQ-12, the PAQ-A and the HBSC. The sample consisted of 197 subjects. 44.2% had a low self-concept and a perception of self-value that improved as they progressed academically, while confidence decreased. The PAQ-A showed that 65.5% performed moderate physical activity and 15.7% were sedentary, 58.9% reported a fair lifestyle and 20.8% of the subjects reported an inadequate diet. In the GHQ-12, the perception of self-value subscale showed an improvement with respect to the academic year. The SOC-13 data showed fair coping with traumatic situations, which worsened in the 4th year, being 88.9% in males and 84.6% in females. The study identified low self-concept, an adequate self-perception, moderate physical activity with a tendency towards sedentary lifestyles, and a fair lifestyle. It is significant that adolescents do not perceive the poor figures they obtain in self-concept, physical exercise, diet, sleep, and violence as reflected in their health. It is known that the changes adopted in adolescence will be perpetuated in adulthood. Therefore, influencing this population group, and even more so, if they are potential future health professionals, is deemed necessary.

Research, Reading, and Publication Habits of Nurses and Nursing Students Applied to Impact Journals: International Multicentre Study.

Publishing in JCR and SJR journals has become crucial for curricular development. Results from nursing investigations "compete" for publication in journals which are not specific to the field of care, affecting the academic development of these investigators. This phenomenon may lead to an ongoing adverse effect on nursing researchers and academics engaged in research in nursing care. The aim of this study was to evaluate habits regarding scientific literature consulting, the transfer of published material, and the citation of nursing investigations. A cross-sectional descriptive study by means of questionnaires was carried out, focusing on both Spanish and Portuguese nurses. The findings of the study reveal the following reasons for reading the scientific literature: that the language was understood; for learning and applying what was learnt; that the journal was of open access; for elaborating protocols and work procedures; and that the journal was indexed in scientific databases and in nursing databases. The reasons for reading, using, and publishing in journals were related to knowledge of the language and the associated usefulness of learning and applying knowledge. Creating a specific index of research publications in nursing will have a positive effect on the scientific production of caring methodologies.

T-type Ca2+ channels in mouse embryonic stem cells: modulation during cell cycle and contribution to self-renewal.

Ion channels participate in cell homeostasis and are involved in the regulation of proliferation and differentiation in several cell types; however, their presence and function in embryonic stem (ES) cells are poorly studied. We have investigated the existence of voltage-dependent inward currents in mouse ES cells and their ability to modulate proliferation and self-renewal. Patch-clamped ES cells had inactivating tetrodotoxin (TTX)-sensitive Na(+) currents as well as transient Ca(2+) currents abolished by the external application of Ni(2+). Biophysical and pharmacological data indicated that the Ca(2+) current is predominantly mediated by T-type (Ca(v)3.2) channels. The number of cells expressing T-type channels and Ca(v)3.2 mRNA levels increased at the G1/S transition of the cell cycle. TTX had no effect on ES cell proliferation. However, blockade of T-type Ca(2+) currents with Ni(2+) induced a decrease in proliferation and alkaline phosphatase positive colonies as well as reduced expression of Oct3/4 and Nanog, all indicative of loss in self-renewal capacity. Decreased alkaline phosphatase and Oct3/4 expression were also observed in cells subjected to small interfering RNA-induced knockdown for T-type (Ca(v)3.2) Ca(2+) channels, thus partially recapitulating the pharmacological effects on self-renewal. These results indicate that Ca(v)3.2 channel expression in ES cells is modulated along the cell cycle being induced at late G1 phase. They also suggest that these channels are involved in the maintenance of the undifferentiated state of mouse ES cells. We propose that Ca(2+) entry mediated by Ca(v)3.2 channels might be one of the intracellular signals that participate in the complex network responsible for ES cell self-renewal.

[Study on the resilience internal factors in a sample of Puerto Rican centenarians]. / Estudio sobre los factores internos de resiliencia en una muestra de centenarios Puertorriquenos.

UNLABELLED: Old age is a stage that is usually characterized by lost at the physiological, psychological and social level that generates much distress to individuals. However, the centenaries have been identified as an example of successful aging, within other factors, because they have adequate managed skills that help them to deal with healthy normal losses. Resilience could be one of the factors that may help the Centennials to age successfully. It is necessary more studies with Puerto Rico Centennials since we lack such investigations. METHODOLOGY: This study has an expo facto design; in addition we evaluate psychometrically the Symptoms Check List 90-R (SCL-90-R). The scale of Internal Resilience Factors (EFIR), a semi structured interview and the SCL-90-R were used to identify factors associated with successful aging in the centennials. In addition we explore if there exist gender differences in internal factors of resilience within the sample. SAMPLE: 23 Centennials, 15 men and 8 women, of different parts of Puerto Rico (average age = 101. 5 years). RESULTS: Internal resilience factors associated with the aging process were identifying, those were: emotional stability, optimism, behavioral factor and behavioral and emotional skills component. These factors are consistent with the revised literature on positive emotions and adaptive ageing. On the other hand, no statistically significant difference was identified (p <. 05) for the internal factors of resilience on the basis of gender, a finding agreed with the revised literature. The multiple tests administered showed adequate internal consistency (EFIR: (=. 726); SCL-90-R: (=. 941). The Symptoms Check list 90-R (SCL-90-R) was valid with a Cronbach's alpha of. 941. CONCLUSIONS AND LIMITATIONS: We identified internal resilience factors that could be linked with successfully aging: those factors are encouraging the elderly population. In addition used tests showed adequate internal consistency. Limitations in relation to the size of the sample and the distribution of gender were identified, thus we suggest further research with larger samples.

[Alzheimer-type dementia in a sample of Puerto Rican elderly: pilot study on the usefulness and assessment of a screening battery]. / Demencia tipo Alzheimer en una muestra de ancianos puertorriqueños: estudio piloto sobre la utilidad y evaluación de una batería de cernimiento.

Dementia is one of the most prevalent conditions in the elderly. Dementia is defined as a decrease in memory, thinking and reasoning having its most common form as Alzheimer dementia. Alzheimer dementia (AD) economic cost to society is around 100 billion dollars annually. Unfortunately, at this point Puerto Rico, have neuro-psychopathology instruments limitations to perform valid and sensitive screening of DA. This study was directed to evaluate a battery of neuropsychological screening instruments for Puerto Rican elderly (60 to 100 years, n = 50) with Alzheimer's dementia. In addition, calculate the sensitivity and specificity of the instruments. The tests where composed as screening battery and included CERAD (Instruments created by the Consortium to Establish a Registry for Alzheimer's Disease), MMSE (Mini mental Status Evaluation), EIWA-III (specifically the digit retention and similarities subtest that try to evaluated memory, concentration and abstract thinking) and the Tuokkos' test (clock drawing in order to evaluated visual-constructional skills). As show by ROC Curve (Receiver Operating Characteristic Curve) for our research, the sensitivity for CERAD was 95.7% with an specificity of 49%; MMSE (Mini Mental Status Evaluation) account for 89 sensitivity and 60% specificity; EIWA-III and subtest (specifically the digit retention and similarities subtest) respectively was 80.4% sensitivity and 44.7% specificity; and sensitivity of 82.6% and specificity of 44.7%. Tuokkos' Clock Test accounted for 76.1% sensitivity, and 23.4% specificity. Reported indexes were within acceptable limits for screening tests. We suggest a sample increment and new testing with additional instruments.

International Comparison of Self-Concept, Self-Perception and Lifestyle in Adolescents: A Systematic Review.

Objectives: Adolescence is considered a vital time to address healthy attitudes and values towards an effective transition to adulthood. The aim of this review was to analyse self-concept, self-perception, physical exercise, and lifestyle in the late adolescent population. Methods: Systematic review of studies assessing the results by the Rosenberg Self-Esteem Scale, the General Health Questionnaire, the Activity Questionnaire for Adolescents, and the Health Behaviour in School-aged Children questionnaires in late adolescents. The PRISMA recommendations were followed. The CASPe quality-check system was applied, excluding articles with a score <8. Results: 1589 studies were found, and 69 articles were selected. Adolescents with high self-concept and self-perception tend to be emotionally stable, sociable, and responsible. No significant differences were found regarding self-concept and self-perception between different countries, but there were differences between men and women. Physical activity and healthy diet improve self-concept and perception of body image. Conclusion: Self-concept and self-perception are associated with responsibility, stability, and mental strength. Most healthy behaviours during adolescence are followed during adulthood. Socio-cultural level of Health Science students is a differential factor for overweight and obesity.

Questionnaires Assessing Adolescents' Self-Concept, Self-Perception, Physical Activity and Lifestyle: A Systematic Review.

INTRODUCTION: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires is an optimal resource for gathering information and thus useful for this study. OBJECTIVES: The objectives of the study were to: (1). identify the questionnaires that assess self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; (2). analyse the psychometric measures of the questionnaires used to assess the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; and (3). determine which questionnaires are the most reliable and valid for assessing the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents. METHOD: A bibliographic search was carried out in the following databases: Virtual Health Library, Cochrane, Medline, Cuiden, Scielo, Dialnet, PubMed and Ministry of Health, Consumption and Social Welfare following the PICO method. The recommendations of the PRISMA statement were followed. RESULTS: A total of 71 scientific articles were collected. Within the self-perception/self-concept questionnaires, the Rosenberg Self-Esteem Scale stands out for being an optimal and widely used resource in adolescents. Regarding the questionnaires that evaluate self-perception, the General Health Questionnaire is the most used; it is used in numerous national health surveys in different countries. The Physical Activity Questionnaire for Adolescents ranks first with respect to the rest of the tools. It is a widely used resource internationally and provides enough information on the physical activity carried out by the subject in a given week. Although there are several questionnaires that measure lifestyle, the Health Behavior in School-aged Children instrument was selected. This instrument is at the European level and involves the collaboration of 48 countries and allows us to compare the lifestyle habits of adolescents from different countries. DISCUSSION: The questionnaire that stands out in the assessment of self-esteem/self-concept is the Rosenberg Self-Esteem Scale. The General Health Questionnaire has been selected as the best tool for assessing self-perception. To measure physical exercise, the Physical Activity Questionnaire for Adolescents is identified as the ideal instrument because it is widely used and can be completed quickly. Regarding lifestyle, the Health Behavior in School aged Children is shown to be an effective instrument in assessing lifestyle.