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BACKGROUND: Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. AIM: To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. METHODS & PROCEDURES: An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e-mail lists of researchers and stakeholders. OUTCOMES & RESULTS: A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. CONCLUSIONS & IMPLICATIONS: The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. WHAT THIS PAPER ADDS: What is already known on the subject Many studies confirm the importance of speech and language therapy in the non-pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work? The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings.
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OBJECTIVES: This study aims to examine the feasibility of an intergenerational remote intervention program designed to promote the wellbeing and social connection of vulnerable older adults, mainly people with aphasia and dementia during the COVID-19 pandemic in the south of Brazil. Undergraduate students were guided to lead weekly sessions of clowning, storytelling, dancing, and cooking-related activities for 3 months (from November/2020 to February/2021). METHOD: The mixed-method design of the study addresses the implementation and feasibility of the program. Data analysis considered both quantitative-number of individuals who accepted the invitation to participate, voluntary dropouts, attendance-and qualitative data-participative observation and thematic analysis of evaluative conversations. An inclusive group of 34 older adults with stroke-induced cognitive impairments, dementia and individuals without any neurological conditions enrolled in the program based on social and racial equity principles. Feasibility and acceptability were addressed in terms of recruitment, implementation, remote evaluation, delivery of remote intervention, adherence, and attendance. Activities and participants' perceptions are described. RESULTS: The initial period of the program achieved 83.7% of adherence and sustainability for additional 3 months. Preliminary results suggest feasibility and acceptability, considering formal and informal support in digital inclusion. Participatory observations describe that the structure of sessions and activities were well received. The analysis of participants' perceptions detects the thematic saliency of feelings of social connection and a sense of having learned with the group. CONCLUSIONS: Preliminary results of this study demonstrate the feasibility and acceptability of the program, pointing to its potential mental health benefits.
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PROJECT DESCRIPTION: With the COVID-19 pandemic (WHO, 2020), social distancing became a crucial means to prevent further spread of the disease (Wendy et al, 2020). This raises concerns for dementia care (Wang et al, 2020), as social distancing leads to reduced cognitive stimulation, exercise, social networking and leisure activities (Brown et al, 2020). Active participation in art has shown positive impacts on the psychosocial wellbeing of stroke survivors (Morris et al, 2019). Additionally, engaging with humor potentially improves the memory, communication and self-esteem of people with dementia (PWD) (Stevens, 2012). This study aims at reporting an innovative, interdisciplinary remote intervention targeted at groups of PWD and stroke survivors during the COVID-19 pandemic. These were part of the university community outreach program Playful Living, which aims at promoting digital inclusion, quality of life and equity through artistic group activities. The project began in 2020 and consists of weekly group meetings through online platforms, with different creative practices happening each week. These include dance, gastronomy, storytelling and clowning. There are 32 participants: 13 PWD, 14 stroke survivors and 5 older adults with no diagnosis of neurological conditions. All participants were selected considering social vulnerability determinants: income, race, gender and educational background. Participants were divided into four groups, each with a fixed team (students of Speech Therapy, Psychology, Dance and Dramatic Arts) and moving members. So far, seven meetings took place. The activities have provided different opportunities for sharing memories, experiencing and expressing emotions through art. Participants reported looking forward to the meetings, with increasing participation and bonding. A major concern has been digital inclusion: stable internet access, camera and microphone management. Those aspects directly affect participants' ability to engage in group dynamics and potentially impact their self-esteem and well-being. However, improvements are observed on a daily basis, thanks to the combined efforts of team members and caregivers. The project has provided participants with means for self-expression and social interaction in a safe environment. Perceived difficulties thus far point toward the need for continued efforts in terms of social and digital inclusion for this population currently and beyond the pandemic setting.
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Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
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Demência/terapia , Prática Clínica Baseada em Evidências , Biomarcadores , Demência/epidemiologia , Humanos , América Latina/epidemiologia , Fatores SocioeconômicosRESUMO
Speech-language therapists/pathologists (SLT/Ps) are key professionals in the management and treatment of primary progressive aphasia (PPA), however, there are gaps in education and training within the discipline, with implications for skills, confidence, and clinical decision-making. This survey aimed to explore the areas of need amongst SLT/Ps working with people living with PPA (PwPPA) internationally to upskill the current and future workforce working with progressive communication disorders. One hundred eighty-five SLT/Ps from 27 countries who work with PwPPA participated in an anonymous online survey about their educational and clinical experiences, clinical decision-making, and self-reported areas of need when working with this population. Best practice principles for SLT/Ps working with PwPPA were used to frame the latter two sections of this survey. Only 40.7% of respondents indicated that their university education prepared them for their current work with PwPPA. Competency areas of "Knowing people deeply," "Practical issues," "Connectedness," and "Preventing disasters" were identified as the basic areas of priority and need. Respondents identified instructional online courses (92.5%), sample tools and activities for interventions (64.8%), and concrete training on providing care for advanced stages and end of life (58.3%) as central areas of need in their current work. This is the first international survey to comprehensively explore the perspectives of SLT/Ps working with PwPPA. Based on survey outcomes, there is a pressing need to enhance current educational and ongoing training opportunities to better promote the well-being of PwPPA and their families, and to ensure appropriate preparation of the current and future SLT/P workforce.
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Speech-language therapists/pathologists (SLT/Ps) are key professionals in the management and treatment of primary progressive aphasia (PPA), however, there are gaps in education and training within the discipline, with implications for skills, confidence, and clinical decision-making. This survey aimed to explore the areas of need amongst SLT/Ps working with people living with PPA (PwPPA) internationally to upskill the current and future workforce working with progressive communication disorders. One hundred eighty-six SLT/Ps from 27 countries who work with PwPPA participated in an anonymous online survey about their educational and clinical experiences, clinical decision-making, and self-reported areas of need when working with this population. Best practice principles for SLT/Ps working with PwPPA were used to frame the latter two sections of this survey. Only 40.7% of respondents indicated that their university education prepared them for their current work with PwPPA. Competency areas of "knowing people deeply," "practical issues," "connectedness," and "preventing disasters" were identified as the basic areas of priority and need. Respondents identified instructional online courses (92.5%), sample tools and activities for interventions (64.8%), and concrete training on providing care for advanced stages and end of life (58.3%) as central areas of need in their current work. This is the first international survey to comprehensively explore the perspectives of SLT/Ps working with PwPPA. Based on survey outcomes, there is a pressing need to enhance current educational and ongoing training opportunities to better promote the well-being of PwPPA and their families, and to ensure appropriate preparation of the current and future SLT/P workforce.
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Afasia Primária Progressiva , Humanos , Afasia Primária Progressiva/terapia , Inquéritos e Questionários , Feminino , Patologia da Fala e Linguagem , Masculino , Tomada de Decisão Clínica , AdultoRESUMO
COVID-19 is an infection, primarily respiratory, caused by the SARS-CoV-2, which can also affect the central nervous system, causing neuropsychological damage. There are studies describing post-COVID-19 cognitive deficits, but it is important to know this outcome in populations with different social, biological, and cultural characteristics. Objective: The aim of this study was to assess the self-perception of cognitive sequelae in post-COVID-19 individuals and identify whether there is a possible relationship between the outcome of the participants' self-perception and sociodemographic and clinical data. Methods: This is a cross-sectional study, carried out through an online questionnaire on the Google Forms platform, in which sociodemographic data, general health data, clinical manifestations of COVID-19, and post-COVID-19 self-perception of the cognitive domains of memory, attention, language, and executive functions were collected. Results: The final sample consisted of 137 participants, and it was possible to identify that memory and attention were the domains with the highest impression of worsening post-COVID-19, followed by executive functions and language. In addition, it was identified that being female may be related to a worse self-perception of all cognitive functions and that having depression or other psychiatric diseases and obesity can significantly affect at least half of the cognitive domains evaluated. Conclusions: This study pointed to a post-COVID-19 cognitive worsening of the participants.
A COVID-19 é uma infecção, primariamente respiratória, causada pelo vírus SARS-CoV-2, mas que também pode atingir o sistema nervoso central, ocasionando danos neuropsicológicos. Há estudos que descrevem os déficits cognitivos pós-COVID-19, mas é importante conhecer esse desfecho em populações com diferentes características sociais, biológicas e culturais. Objetivo: Avaliar a autopercepção de sequelas cognitivas em indivíduos pós-COVID-19 e identificar se há uma possível relação entre o desfecho da autopercepção dos participantes e dados sociodemográficos e clínicos. Métodos: Trata-se de um estudo transversal, realizado com o uso de um questionário online na plataforma Google Forms, no qual foram identificados dados sociodemográficos, dados de saúde geral, manifestações clínicas da COVID-19 e a autopercepção dos domínios cognitivos de memória, atenção, linguagem e funções executivas pós-COVID-19. Resultados: A amostra final foi composta de 137 participantes, e pôde-se observar que memória e atenção foram os domínios com maior impressão de piora pós-COVID-19, seguidos por funções executivas e linguagem. Além disso, constatou-se que ser do gênero feminino pode estar relacionado com uma pior autopercepção de todas as funções cognitivas pós-COVID-19 e que ter depressão ou outras doenças psiquiátricas e obesidade pode afetar significativamente pelo menos metade dos domínios cognitivos avaliados. Conclusões: Este trabalho apontou para a piora cognitiva pós-COVID-19 dos participantes.
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PURPOSE: To investigate verb fluency performance in individuals with Alzheimer's disease compared with healthy older adults by analyzing total correct responses, number of clusters, average cluster size, and number of switches. METHODS: This is a case-control study of 39 healthy older adults and 29 older adults with a diagnosis of Alzheimer's disease. Verb fluency performance was analyzed in terms of total number of correct verbs retrieved, number of clusters, average cluster size, and number of switches. To obtain the study outcomes, we previously conducted a procedure for categorization of the verbs that would compose the clusters. The classification of verbs was adapted for this study, including assessment by raters and analysis of inter-rater reliability. RESULTS: Individuals with Alzheimer's disease showed significantly poorer performance than healthy controls in the number of switches and total number of correct verbs retrieved. The two groups did not differ significantly in the other measures. CONCLUSION: In this study, individuals with Alzheimer's disease showed impaired verb fluency, characterized by a reduced number of verbs retrieved and fewer transitions between verb categories. The findings suggest that, in Alzheimer's disease, verb fluency is more sensitive to cognitive deficits resulting from executive dysfunction than from semantic disruption.
OBJETIVO: Investigar o desempenho na tarefa de fluência de verbos de pessoas com doença de Alzheimer em comparação à idosos saudáveis, a partir da análise do número total de palavras corretas evocadas, do número de clusters, do tamanho médio dos clusters e do número de switches. MÉTODO: Este é um estudo de caso-controle no qual participaram 39 idosos saudáveis e 29 participantes com diagnóstico de doença de Alzheimer. O desempenho da fluência de verbos dos participantes foi analisado quanto ao total de verbos gerados corretamente, número de clusters, tamanho médio dos clusters e número de switches. Para a obtenção dos desfechos do estudo foi realizado um processo prévio de definição das categorias de verbos que constituiriam clusters. A classificação dos verbos foi adaptada para a este estudo, incluindo a análise de juízes com investigação do índice de concordância. RESULTADOS: Dentre as variáveis de interesse comparadas entre os grupos estudados, houve um desempenho estatisticamente inferior no grupo de pessoas com doença de Alzheimer quanto ao número de switches e total de verbos gerados corretamente. Nas demais medidas, os grupos foram semelhantes. CONCLUSÃO: Neste estudo pessoas com doença de Alzheimer apresentaram déficit no desempenho da tarefa de fluência verbal de verbos, caracterizado por uma redução do número total de verbos gerados e uma menor variabilidade de categorias de verbos. Os achados sugerem que, na doença de Alzheimer, a fluência de verbos é mais sensível aos déficits cognitivos decorrentes de disfunção executiva do que aos déficits semânticos.
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Doença de Alzheimer , Humanos , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Estudos de Casos e Controles , Reprodutibilidade dos Testes , Semântica , Análise por Conglomerados , Testes NeuropsicológicosRESUMO
Primary Progressive Aphasia (PPA) is a progressive language disorder associated with frontotemporal impairment and mainly affects the left hemisphere of the brain. In general, this condition compromises abilities related to comprehension and expression of language. The diagnosis of PPA depends on in-depth knowledge regarding functions of language, neurology, and neuropsychology. Speech and language therapists (SLTs) have a pivotal role in the diagnosis and rehabilitation of PPA. The absence of these professionals involved in the diagnosis and rehabilitation may reflect on the quality of care of people with PPA. Objective: To identify the sociodemographic, educational, and professional practice characteristics of SLTs who work with people with PPA in Brazil. Methods: An online questionnaire was disseminated to reach SLTs across Brazil. The questionnaire collected information regarding sociodemographics, training and education, practice (time, setting, service provision), and sources of referral. Results: The study included 71 participants (95.8% women). Specialization was the most frequent educational level followed by master's degree, and participants where mainly from the Southeast and South regions of Brazil. Neurologists were the professionals who most referred patients with PPA to SLTs. Finally, SLTs worked primarily in homecare settings and provided mainly individual therapy services. Conclusion: SLTs who work with PPA in Brazil can be characterized mainly as professionals with postgraduate degrees, relatively young, and from the South and Southeast regions of Brazil.
A afasia progressiva primária (APP) é um distúrbio progressivo da linguagem associado à atrofia de regiões frontotemporais predominantemente do hemisfério esquerdo do cérebro. De modo geral, a APP afeta as capacidades compreensivas e expressivas da linguagem. O diagnóstico depende de profissionais com profundo conhecimento das funções da linguagem, neurologia e neuropsicologia. A fonoaudiologia tem papel essencial no diagnóstico e reabilitação da APP, e a ausência de fonoaudiólogos nesses processos pode refletir na qualidade do cuidado das pessoas com APP. Objetivo: Identificar as características sociodemográficas, educacionais e de atuação profissional de fonoaudiólogos que atuam com APP no Brasil. Métodos: Foi distribuído um questionário em formato online para fonoaudiólogos de todo o Brasil. O questionário coletou informações sobre aspectos sociodemográficos, de formação, atuação profissional (tempo, local de atuação, tipo de serviço oferecido) e fontes de encaminhamento. Resultados: O estudo incluiu 71 participantes (95,8% mulheres). O nível educacional mais frequente foi a especialização, e as regiões demográficas com maior incidência de profissionais que atendiam APP foram as Regiões Sudeste e Sul do país. Os neurologistas foram os profissionais que mais encaminhavam pacientes com APP para os fonoaudiólogos. Por fim, os fonoaudiólogos atuavam, principalmente, em homecare e realizando, em sua maioria, terapia individual. Conclusão: Os fonoaudiólogos que atuam com APP no Brasil podem ser caracterizados principalmente como profissionais pós-graduados, relativamente jovens e das Regiões Sul e Sudeste do Brasil.
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PURPOSE: The objective of this research was to obtain the speech and language therapists' point of view about the use of therapeutic lying as a communication strategy in dementia care. METHODS: The present research was a quantitative, qualitative, and descriptive cross-sectional study. Data was collected through an online survey with multiple choices and open answer questions. RESULTS: The quantitative results indicated that the majority of the speech and language therapists have already used therapeutic lying as a communicative strategy and wish to learn more about it, considering the technique as relatively valid, ethical and adequate. The qualitative results indicated the reasons for the usage of the technique: to reassure the patient in case of agitation; to encourage engagement in therapy; to avoid stress-related to memory loss; to manage difficulty or refusal to eat; to manage difficulty or refusal for drug treatment; to prevent patients from leaving the building; to manage delirium, confusion and/or paranoia; to ensure safety; and for use when other strategies do not work. CONCLUSION: The majority of speech and language therapists use therapeutic lying in their clinical practice, taking into consideration the best interest of the person with dementia, although professionals recognize their lack of knowledge on the subject. They have considered the communication strategy as relatively ethical, valid and adequate. The article calls attention to the necessity of education and guidelines for speech and language therapists in the use of therapeutic lying among people with dementia.
OBJETIVO: O objetivo deste estudo foi obter a visão do fonoaudiólogo brasileiro a respeito da utilização da mentira terapêutica como estratégia de comunicação no manejo de pacientes com demência. MÉTODO: Trata-se de uma pesquisa quantitativa e qualitativa, transversal, de caráter descritivo. A coleta de dados foi realizada de modo online através de um questionário contendo questões de múltipla escolha e resposta aberta. RESULTADOS: Os resultados quantitativos indicaram que a maioria dos fonoaudiólogos já fizeram uso da estratégia e desejam aprender mais sobre, julgando a técnica como relativamente válida, ética e adequada. Os dados qualitativos indicaram os motivos para o uso da técnica, sendo estes: tranquilizar o paciente em situação de agitação; estimular o engajamento na terapia; evitar estresse relacionado à perda de memória; manejar dificuldade ou recusa alimentar; manejar dificuldade ou recusa ao tratamento medicamentoso; evitar que paciente evada o local; manejar situações de delírio, confusão e/ou paranoia; garantir a segurança; e quando outras estratégias não funcionam. CONCLUSÃO: A maioria dos fonoaudiólogos brasileiros utilizam a mentira terapêutica em sua prática clínica e o fazem levando em consideração o benefício da pessoa com demência, embora reconheçam a falta de conhecimento e preparo acerca do assunto. Consideraram essa estratégia de comunicação relativamente ética, válida e adequada. O artigo chama atenção para a necessidade de formação e de recomendações sobre o uso da mentira terapêutica entre pessoas com demência pelos fonoaudiólogos.
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Demência , Fonoterapia , Humanos , Fonoterapia/métodos , Brasil , Estudos Transversais , Fala , Terapia da Linguagem/métodos , Comunicação , Demência/complicações , Demência/terapiaRESUMO
Primary Progressive Aphasia (PPA) is a neurological syndrome characterized by impaired language due to neurodegeneration. It is subdivided into three variants: semantic, agrammatic or nonfluent, and logopenic. Pieces of evidence have suggested that learning disabilities in childhood, such as dyslexia, might be susceptibility factors in the occurrence of PPA in adulthood. The objective of this study was to verify the existence of the relationship between PPA and the history of learning disabilities of patients and their children, compared to a control group of individuals with Alzheimer's disease (AD). A questionnaire was applied to investigate the presence of indicators of learning disabilities and difficulties in individuals with PPA and AD and their children. Twenty subjects with PPA and 16 with AD participated in the study. Our findings are presented and discussed in light of the current scientific evidence and the social, educational, and economic Brazilian scenario. Despite the challenges of doing research with individuals with PPA in Brazil, we present the first evidence about the investigation of association between the history of learning disabilities and difficulties and PPA in native Brazilian Portuguese speakers.
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Background: Primary Progressive Aphasia (PPA) is characterized by progressive language impairment due to focal degeneration of brain areas related to linguistic processing. The detection and differential diagnosis of PPA can be difficult with clinical features that may overlap with features of other neurological conditions, such as Alzheimer's disease (AD). The scientific production on PPA in Latin American patients is still scarce. This study investigated the first symptoms in a Brazilian sample of patients with PPA in comparison with AD patients. Method: We compared the first symptoms reported by caregivers of people with PPA (n = 20; semantic variant n = 8, non-fluent variant n = 7, logopenic variant n = 3, and unclassified cases n = 2) and AD (n = 16). Data were collected through the application of a structured questionnaire that was presented in an interview format to the caregiver who knew the patient best. Results: Anomia, paraphasias and motor speech difficulties were the first symptoms capable of differentiating patients with PPA from those with AD, while memory was exclusive of AD. Among the PPA variants, anomia was the initial symptom associated with the semantic variant, while motor speech difficulties were associated with the non-fluent variant. The results are discussed considering the unique cultural and sociodemographic characteristics of this studied population. Conclusion: This study demonstrated that some of the initial symptoms of PPA patients may be unique to clinical variants of PPA and of AD, and their investigation may be useful for the early and differential diagnosis of this population.
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PURPOSE: Subthalamic nucleus deep brain stimulation (STN-DBS) parameters, for example the frequency of stimulation, seem to affect speech and voice aspects. However, this influence is not well understood. This study aimed to investigate the impact of low- and high-frequency STN-DBS on voice and speech for people with Parkinson's disease. METHODS: Nineteen individuals with Parkinson's disease who received bilateral STN-DBS were assessed for motor performance (Unified Parkinson's Disease Rating Scale-III), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain, and instability [GRBASI]), dysarthria assessment, and computerized acoustic analysis of voice upon receiving low-frequency (60 Hz) and high-frequency (130 Hz) STN-DBS. RESULTS: In the GRBASI protocol, asthenia, and instability were significantly better at 130 Hz of stimulation. In the dysarthria evaluation, the phonation aspect, articulation, and grade of dysarthria showed deterioration at the same high-frequency condition. There was no significant difference for any vocal acoustic measures. CONCLUSION: The high-frequency of STN-DBS may affect speech and voice differently, leading to an amelioration of the vocal production, but with adverse effects in the speech control.
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Estimulação Encefálica Profunda , Disartria/fisiopatologia , Disfonia/fisiopatologia , Doença de Parkinson/terapia , Fonação , Núcleo Subtalâmico , Qualidade da Voz , Adulto , Idoso , Estimulação Encefálica Profunda/efeitos adversos , Disartria/diagnóstico , Disartria/etiologia , Disfonia/diagnóstico , Disfonia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Recuperação de Função Fisiológica , Fatores de Risco , Resultado do TratamentoRESUMO
PURPOSE: To determine the level of teaching of neuropsychology within undergraduate courses of speech-language pathology in Brazil using an exploratory document analysis of the curricula of the undergraduate courses. METHODS: It is a quantitative exploratory document analysis. A review of available documents from websites and/or received from course directors (pedagogical course project, course content, and/or syllabus) of public and private universities in Brazil was carried out. Using an agreed consensus checklist, 3 researchers verified which universities offered subjects on neuropsychology by means of a search for the term 'neuropsychology' or neuropsychological'. Associations between type of university and region and the provision of neuropsychology courses were also explored. RESULTS: 72 universities were included in the study and only nine of them offered subjects on neuropsychology. None of the associations tested was statistically significant. CONCLUSION: The provision of neuropsychology for speech-language pathology undergraduate students is limited, and not associated with the type of university, the year of the pedagogical course project, or the region in which the university is located. The findings call attention to the need to adapt undergraduate curricula in speech-language pathology to consider the entire scope of this profession and address the epidemiology of communication disorders.
OBJETIVO: Identificar a presença do ensino da neuropsicologia nos cursos de graduação em fonoaudiologia no Brasil através de uma análise exploratória dos currículos dos cursos de graduação. MÉTODO: Estudo documental exploratório quantitativo. Foi realizada uma busca de documentos (projeto pedagógico de curso, ementário e/ou matriz curricular) nos websites das instituições de ensino superior públicas e privadas, ou via e-mail. A busca das informações necessárias para o estudo foi feita por três pesquisadores através de um checklist elaborado em consenso. Dessa maneira, pôde-se caracterizar as instituições de ensino e, posteriormente, foram investigadas quais delas ofereciam disciplinas que abordassem o tema da neuropsicologia através de uma busca pelo nome da disciplina. Foram exploradas associações entre a natureza da instituição de ensino superior, ano do projeto pedagógico de curso e região demográfica, com a presença de disciplinas sobre neuropsicologia. RESULTADOS: Foram incluídas no estudo 72 instituições de ensino, sendo que destas apenas nove ofereciam a disciplina de neuropsicologia. Nenhuma das associações testadas gerou diferença estatisticamente significativa. CONCLUSÃO: Há uma carência na oferta de disciplinas de neuropsicologia para os estudantes de fonoaudiologia, e esta carência não tem relação nenhuma com a natureza da instituição de ensino superior, o ano do projeto pedagógico de curso ou com a região demográfica. Os achados chamam a atenção para a importância de um currículo que considere todo o escopo de atuação profissional e se ajuste à epidemiologia dos distúrbios da comunicação.
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Currículo , Neuropsicologia/educação , Patologia da Fala e Linguagem/educação , Brasil , Humanos , Estudantes , Ensino , UniversidadesRESUMO
BACKGROUND: Intentionality to remember is associated with better performances in episodic memory retrieval. The practice effect has better performance in memory retrieval. However, little is known about the effect of intentionality on memory over days and the influence of age, gender, and level of education on it as well as on practice effect. OBJECTIVES: To verify the effect of intentionality and practice effect on memory performance over days, using an ecological approach. METHODS: One hundred and twenty subjects from 18 to 81 years of age and free of psychiatric and neurological disorders were evaluated. They were randomized into a "testing effect group" and a "intentionality group" and then were asked to read a text on the FIFA World Cup. The "intentionality group" was instructed to pay careful attention to the text because they would answer a questionnaire with 10 factual items from the text after 2 and 7 days. The "testing effect group" had the same procedure at the same time as the first group but were not instructed about the intentionality, and answered the questionnaire immediately after reading the text. RESULTS: Memory performance was better 2 days after the exposure session than 7 days later in the "intentionality group". On the other hand, there was no difference in memory performance from the "testing effect group" 2 and 7 days later. CONCLUSIONS: Intention to recall may enhance memory over a short period of days, while retaining similar amount of information over days to what was acquired immediately after text exposure.
INTRODUÇÃO: A intencionalidade de lembrar associa-se a melhores desempenhos na recuperação da memória episódica. O efeito da prática também apresenta melhores desempenhos na recuperação da memória. Entretanto, pouco se sabe sobre a intencionalidade na memória ao longo dos dias sob influência da idade, sexo e escolaridade, assim como sob efeito da prática. OBJETIVOS: Verificar o efeito da intencionalidade e de testes no desempenho da memória ao longo dos dias, utilizando abordagem ecológica. MÉTODOS: Foram avaliados 120 sujeitos (idade 18-81 anos) e a ausência de distúrbios psiquiátricos e neurológicos. Eles foram randomizados para o "grupo de efeito de testes" ou para o "grupo de intencionalidade" e expostos ao texto da Copa do Mundo de Futebol. O "grupo de intencionalidade" foi instruído a prestar muita atenção ao texto, pois seria aplicado um questionário com 10 itens factuais do texto 2 e 7 dias depois. O "grupo de efeito de testes" realizou o mesmo procedimento no mesmo tempo que o primeiro grupo, mas não foi instruído em relação à intencionalidade e responderam ao questionário imediatamente após a leitura do texto. RESULTADOS: O desempenho da memória foi melhor 2 dias após a exposição do que 7 dias depois no "grupo de intencionalidade". Por outro lado, não houve diferença no desempenho de memória no "grupo de efeito de testes" 2 e 7 dias depois. CONCLUSÕES: A intenção de recordar pode melhorar a memória por um curto período de dias. Enquanto o efeito de teste pode reter ao longo de dias quantidade similar de informação que foi adquirida imediatamente após a exposição do texto.
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INTRODUCTION: Expert knowledge is critical to fight dementia in inequitable regions like Latin American and Caribbean countries (LACs). However, the opinions of aging experts on public policies' accessibility and transmission, stigma, diagnostic manuals, data-sharing platforms, and use of behavioral insights (BIs) are not well known. METHODS: We investigated opinions among health professionals working on aging in LACs (N = 3365) with regression models including expertise-related information (public policies, BI), individual differences (work, age, academic degree), and location. RESULTS: Experts specified low public policy knowledge (X2 = 41.27, P < .001), high levels of stigma (X2 = 2636.37, P < .001), almost absent BI knowledge (X2 = 56.58, P < .001), and needs for regional diagnostic manuals (X2 = 2893.63, df = 3, P < .001) and data-sharing platforms (X2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI-based treatment for a proposed prevention program improved perception across experts. DISCUSSION: Our findings help to prioritize future potential actions of governmental agencies and non-governmental organizations (NGOs) to improve LACs' dementia knowledge.
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PURPOSE: To develop a short educational program about aphasia (SEPA) for family caregivers of people with aphasia and verify its effect in their burden and quality of life. METHODS: This is a quantitative experimental study. The participants included in the study were family caregivers of people with aphasia. They completed the Zarit interview scale and WHOQOL-Bref instruments pre- and post-intervention. The intervention was a short educational program about aphasia, administered in a group setting and conducted in two didactic sessions. RESULTS: Four participants were included in the study. In the group analysis, there was no significant difference in any measure. However, looking into the individual performances, all participants presented a trend for improvement in most of the scores. CONCLUSION: Possibly, family caregivers of people with aphasia might benefit from the SEPA. It would be relevant for future studies to include larger samples and consider new strategies to improve inclusion of participants.
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Afasia/psicologia , Cuidadores/psicologia , Educação em Saúde/métodos , Qualidade de Vida , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Fatores SocioeconômicosRESUMO
Introduction Subthalamic nucleus deep brain stimulation (STN-DBS) improves motor function in individuals with Parkinson disease (PD). The evidence about the effects of STN-DBS on the voice is still inconclusive. Objective To verify the effect of STN-DBS on the voice of Brazilian individuals with PD. Methods Sixteen participants were evaluated on the Unified Parkinson Disease Rating Scale-Part III, and by the measurement of the acoustic modifications in on and off conditions of stimulation. Results The motor symptoms showed significant improvement with STN-DBS on. Regarding the acoustic measures of the voice, only the maximum fundamental frequency (fhi) showed a statistical difference between on- and off-conditions, with reduction in off-condition. Conclusion Changes in computerized acoustic measures are more valuable when interpreted in conjunction with changes in other measures. The single finding in fhi suggests that DBS-STN increases vocal instability. The interpretation of this result should be done carefully, since it may not be of great value if other measures that also indicate instability are not significantly different.
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OBJECTIVE: This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. METHOD: It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. RESULTS: The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. CONCLUSION: Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership.
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Doenças da Laringe/etiologia , Laringe/fisiopatologia , Música , Saúde Ocupacional , Ocupações , Qualidade de Vida , Distúrbios da Voz/etiologia , Qualidade da Voz , Adolescente , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Doenças da Laringe/diagnóstico , Doenças da Laringe/fisiopatologia , Doenças da Laringe/psicologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Fatores de Risco , Inquéritos e Questionários , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia , Adulto JovemRESUMO
ABSTRACT. COVID-19 is an infection, primarily respiratory, caused by the SARS-CoV-2, which can also affect the central nervous system, causing neuropsychological damage. There are studies describing post-COVID-19 cognitive deficits, but it is important to know this outcome in populations with different social, biological, and cultural characteristics. Objective: The aim of this study was to assess the self-perception of cognitive sequelae in post-COVID-19 individuals and identify whether there is a possible relationship between the outcome of the participants' self-perception and sociodemographic and clinical data. Methods: This is a cross-sectional study, carried out through an online questionnaire on the Google Forms platform, in which sociodemographic data, general health data, clinical manifestations of COVID-19, and post-COVID-19 self-perception of the cognitive domains of memory, attention, language, and executive functions were collected. Results: The final sample consisted of 137 participants, and it was possible to identify that memory and attention were the domains with the highest impression of worsening post-COVID-19, followed by executive functions and language. In addition, it was identified that being female may be related to a worse self-perception of all cognitive functions and that having depression or other psychiatric diseases and obesity can significantly affect at least half of the cognitive domains evaluated. Conclusions: This study pointed to a post-COVID-19 cognitive worsening of the participants.
RESUMO. A COVID-19 é uma infecção, primariamente respiratória, causada pelo vírus SARS-CoV-2, mas que também pode atingir o sistema nervoso central, ocasionando danos neuropsicológicos. Há estudos que descrevem os déficits cognitivos pós-COVID-19, mas é importante conhecer esse desfecho em populações com diferentes características sociais, biológicas e culturais. Objetivo: Avaliar a autopercepção de sequelas cognitivas em indivíduos pós-COVID-19 e identificar se há uma possível relação entre o desfecho da autopercepção dos participantes e dados sociodemográficos e clínicos. Métodos: Trata-se de um estudo transversal, realizado com o uso de um questionário online na plataforma Google Forms, no qual foram identificados dados sociodemográficos, dados de saúde geral, manifestações clínicas da COVID-19 e a autopercepção dos domínios cognitivos de memória, atenção, linguagem e funções executivas pós-COVID-19. Resultados: A amostra final foi composta de 137 participantes, e pôde-se observar que memória e atenção foram os domínios com maior impressão de piora pós-COVID-19, seguidos por funções executivas e linguagem. Além disso, constatou-se que ser do gênero feminino pode estar relacionado com uma pior autopercepção de todas as funções cognitivas pós-COVID-19 e que ter depressão ou outras doenças psiquiátricas e obesidade pode afetar significativamente pelo menos metade dos domínios cognitivos avaliados. Conclusões: Este trabalho apontou para a piora cognitiva pós-COVID-19 dos participantes.