Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations.

Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging.

Brain clocks capture diversity and disparity in aging and dementia.

Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of multimodal diversity (geographical, socioeconomic, sociodemographic, sex, neurodegeneration) on the brain age gap (BAG) is unknown. Here, we analyzed datasets from 5,306 participants across 15 countries (7 Latin American countries -LAC, 8 non-LAC). Based on higher-order interactions in brain signals, we developed a BAG deep learning architecture for functional magnetic resonance imaging (fMRI=2,953) and electroencephalography (EEG=2,353). The datasets comprised healthy controls, and individuals with mild cognitive impairment, Alzheimer's disease, and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (fMRI: MDE=5.60, RMSE=11.91; EEG: MDE=5.34, RMSE=9.82) compared to non-LAC, associated with frontoposterior networks. Structural socioeconomic inequality and other disparity-related factors (pollution, health disparities) were influential predictors of increased brain age gaps, especially in LAC (R2=0.37, F2=0.59, RMSE=6.9). A gradient of increasing BAG from controls to mild cognitive impairment to Alzheimer's disease was found. In LAC, we observed larger BAGs in females in control and Alzheimer's disease groups compared to respective males. Results were not explained by variations in signal quality, demographics, or acquisition methods. Findings provide a quantitative framework capturing the multimodal diversity of accelerated brain aging.

Brain health in diverse settings: How age, demographics and cognition shape brain function.

Diversity in brain health is influenced by individual differences in demographics and cognition. However, most studies on brain health and diseases have typically controlled for these factors rather than explored their potential to predict brain signals. Here, we assessed the role of individual differences in demographics (age, sex, and education; n = 1298) and cognition (n = 725) as predictors of different metrics usually used in case-control studies. These included power spectrum and aperiodic (1/f slope, knee, offset) metrics, as well as complexity (fractal dimension estimation, permutation entropy, Wiener entropy, spectral structure variability) and connectivity (graph-theoretic mutual information, conditional mutual information, organizational information) from the source space resting-state EEG activity in a diverse sample from the global south and north populations. Brain-phenotype models were computed using EEG metrics reflecting local activity (power spectrum and aperiodic components) and brain dynamics and interactions (complexity and graph-theoretic measures). Electrophysiological brain dynamics were modulated by individual differences despite the varied methods of data acquisition and assessments across multiple centers, indicating that results were unlikely to be accounted for by methodological discrepancies. Variations in brain signals were mainly influenced by age and cognition, while education and sex exhibited less importance. Power spectrum activity and graph-theoretic measures were the most sensitive in capturing individual differences. Older age, poorer cognition, and being male were associated with reduced alpha power, whereas older age and less education were associated with reduced network integration and segregation. Findings suggest that basic individual differences impact core metrics of brain function that are used in standard case-control studies. Considering individual variability and diversity in global settings would contribute to a more tailored understanding of brain function.

Evidence of validity and reliability of the Colombian version of Addenbroke's Cognitive Examination Revised (ACE-R).

OBJECTIVE: The purpose of this study is to provide evidence that supports the validity and reliability of the Colombian version of the Addenbrooke's Cognitive Examination Revised (ACE-R) in comparison to the MMSE at assessing and finding patients with Mild Cognitive Impairment (MCI). Additionally, the study aims to determine the optimal cut-off scores based on the age of a population with a low education level. METHOD: This study included 314 individuals (235 participants diagnosed with MCI and 79 cognitively healthy) who live in two different rural departments (states) in Colombia. The participants were recruited for this study through community clubs for the older adults. Most of the individuals were female (236), the average age was 65.95 years of age (SD= 7.8), and the average education level was of 3.78 years (SD = 1.79). It is important to note that the sample only included people with a maximum of 6 years of schooling. RESULTS: A ROC analysis indicated that the ACE-R is more effective than the MMSE at evaluating and finding MCI individuals within the three groups. The cut-off points for the Under 60 years of age group was 83.50 (sensitivity 0.880% and specificity 0.632%); 61-69 years of age 80.50 (sensitivity 0.714% and specificity 0.677%); and Over 70 years of age was 79.50 (sensitivity 0.750% and specificity 0.659%). The internal consistency analysis with MacDonald's Ω determined reliability indicators ≥70 in the ACE-R, except for the age range of 61 to 69 years. CONCLUSION: The Colombian version of the ACE-R demonstrates to be a valid and reliable global cognitive screening tool. It is effective at discerning MCI individuals from healthy within a group of participants with a low education level.

Parental Perception of Remote Education in Pandemic: An Analysis Based on Children's Cognitive Performance.

The COVID-19 pandemic significantly changed patterns of human interaction, including in the educational sector, which was forced to transform relationships among students, families, and the academic community. The present study sought to establish the interrelationships between performance on cognitive tests during the preschool stage and the perceptions of parents about remote education in school children during the pandemic. The study included 100 preschool children from socially vulnerable sectors who underwent remote and distance learning in 2020 and 2021. The reliability of the applied questionnaire was determined through a confirmatory factor analysis. A structural equation model was constructed to determine the perceptions of parents about remote education based on cognitive performance during the preschool stage. The model fit yielded favorable results for predictive variables (χ2 = 7.734, DF = 9 [p = 0.561], the comparative goodness-of-fit index [CFI] = 1.000, root mean square error of approximation [RMSEA] = 0.000, standardized mean square residual [SRMR] = 0.069), and executive function (χ2 = 3.711, DF = 5 [p > 0.592], CFI = 1.000, RMSEA = 0.000, SRMR = 0.039) as latent variables that affected parents' perceptions. These results indicate that parents' perceptions of remote education are mediated by predictive aspects of learning and executive function during the preschool stage.

Effect of Cognitive Training Programs Based on Computer Systems on Executive Functions in Children With ADHD: A Systematic Review.

BACKGROUND: The purpose of this systematic review is to synthesize the existing literature reporting the effects of computerized cognitive trainings on the executive functions of children with ADHD. METHOD: A systematic review was carried out following the PRISMA statement; the primary sources used were five electronic databases (Scopus, Science Direct, Pubmed, Springer, Taylor & Francis). RESULTS: 20 articles met the eligibility criteria, data on the training characteristics and the effects on executive functions were extracted, followed by an analysis of bias and the methodological quality of the studies. The results of the studies were widely heterogeneous, largely associated with the variety of training programs and the measurement instruments used. The most studied executive functions were working memory and inhibitory control. Some of the studies reported that the intervention led to significant effects on working memory and attention (N = 7), and improvements in inhibitory control (N = 5) and planning (N = 4) were also reported. At the same time, others did not report the effects of the intervention on these processes. The assessment of the quality of the evidence showed important risk biases among the reviewed studies. CONCLUSION: Some training based on computer systems showed positive effects on the executive functions of working memory, attention, and inhibitory control in children with ADHD. However, other training sessions did not show significant effects. In general, the evidence shows mixed results, a high diversity of measurement instruments, and high risks of bias between the studies. Therefore, the evidence has not been consistent about the general benefits of computerized training on the executive functions of children with ADHD.

Prevalence of Mild Cognitive Impairment in Southern Regions of Colombia.

Background: Recent reports suggest that by 2050 there will be an increase of around 310% of cases affected by dementia in Latin American countries. A previous study in a Southern region reported one of the highest prevalences of dementia in Latin America. Objective: To investigate the prevalence of mild cognitive impairment associated with low education, rurality, and demographic characteristics. Methods: A cross-sectional study recruited a community-dwelling sample of 823 adults from rural and urban areas of two Southern provinces of Colombia from 2020-2022. Participants were assessed with a neuropsychological protocol validated in Colombia. To obtain general and region-specific prevalence rates, age, sex, schooling, and socioeconomic level were considered and controlled for. Results: Most of the participants reported low education and socioeconomic level, the participation of women was higher. It was determined that the prevalence of mild cognitive impairment (MCI) was 53.6%, with 56.6% in the province of Caquetá followed by 51.9% in the province of Huila. The amnestic MCI represented 42.6%, the amnestic multi-domain was 39%, the non-amnestic 16.55%, and the non-amnestic multi-domain 1.81%. Our participants reported comorbidities such as diabetes and hypertension. We also observed a relationship between exposure to pesticides and MCI. Conclusions: We observed one of the highest prevalences of MCI in Latin America reported to date. Variables such as age, gender, and education proved risk factors for MCI in the explored regions. Our findings are very much in line with recent studies that highlight the influence of non-canonical risk factors of dementia in underrepresented countries from Latin America.

COVID-19 surge readiness: use cases demonstrating how hospitals leveraged digital identity access management for infection control and pandemic response.

BACKGROUND: Surging volumes of patients with COVID-19 and the high infectiousness of SARS-CoV-2 challenged hospital infection control/safety, staffing, care delivery and operations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats and accurately identify/authenticate patients and staff were undiminished, which fostered creative use cases where hospitals leveraged identity access and management (IAM) technologies to improve infection control and minimise disruption of clinical and administrative workflows. METHODS: Working with a leading IAM solution provider, implementation personnel in the USA and UK identified all hospitals/health systems where an innovative use of IAM technology improved facility infection control and pandemic response management. Interviews/communications with hospital clinical informatics leaders collected information describing the use case deployed. RESULTS: Eight innovative/valuable hospital use cases are described: symptom-free attestation by clinicians at shift start; detection of clinician exposure/contact tracing; reporting of clinician temperature checks; inpatient telehealth consults in isolation units; virtual visits between isolated patients and families; touchless single sign-on authentication; secure access enabled for rapid expansion of personnel working remotely; and monitoring of temporary worker attendance. DISCUSSION: No systematic, comprehensive survey of all implemented IAM client sites was conducted, and other use cases may be undetected. A standardised reporting/information sharing vehicle is needed whereby IAM use cases aiding facility pandemic response and infection control can be disseminated. CONCLUSIONS: Clinical care, infection control and facility operations were improved using IAM solutions during COVID-19. Facility end-user innovation in how IAM solutions are deployed can improve infection control/patient safety, care delivery and clinical workflows during surges of epidemic infectious diseases.

Healthy Lifestyles Associated With Socioeconomic Determinants in the Older Adult Population.

INTRODUCTION/OBJECTIVE: The evaluation of lifestyle in older adults and the study of socioeconomic determinants becomes an essential indicator of the health conditions of older adults. The purpose of this study was to establish the relationship between socioeconomic factors and healthy lifestyles in older adults. METHODS: Study with a quantitative approach, descriptive type, non-experimental design, cross-sectional in a sample of 407 elderlies who have applied a self-designed instrument for socioeconomic characterization and the FANTASTIC test to assess lifestyle. For data analysis, a bivariate analysis was applied using chi2 and multivariate analysis using ordinal logistic regression. RESULTS: 53% of elderlies aged between 60 and 70 years reported their lifestyle as excellent and very good. Age, average household income, and perceived health status are associated with healthy lifestyles in older adults. CONCLUSIONS: This study found that in addition to socioeconomic determinants, self-perceived health is a factor that influences the lifestyles of this population.

Emotional processing in bullying: an event-related potential study.

Bullying is a subtype of violence that leads to maladaptive behaviors and emotional responses, with implications for social competence, emotions, and empathy. The present study compared the time course of emotional processing in children who were involved in the dynamics of bullying (i.e., as victims, bullies, and observers) by evaluating event-related potentials [early posterior negativity and late positive potential (LPP)] in different brain regions during a passive visualization task that involved positive, neutral, and negative social pictures. High-density electroencephalograms were recorded in 45 children, 8-12 years old (M = 9.5 years, SD = 1.3), while they observed emotional and neutral social pictures that we selected from the International Affective Picture System. Late positive potential had higher amplitudes in the victim group, especially in posterior and anterior regions. In the central region, LPP was greater toward neutral social pictures in bullying victims. The greater amplitude of LPP in victims was observed during and after the stimulus. The results showed a consistent response with a higher intensity in response to emotional stimuli in the victim group, suggesting a tendency toward hypervigilance that could interfere with emotional regulation.

An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials

Introduction: Psychological morbidities are common in breast cancer patients. Clinical conditions like depression, cognitive alterations, anxiety, distress, fear of cancer, sleep disorders, and fatigue may persist in cancer survivors. Therefore, psychological interventions are an essential treatment for breast cancer. Objective: To identify psychological interventions and psychological outcomes for women with breast cancer. Methods: Five databases were searched: EMBASE, ScienceDirect, MEDLINE (Ovid), CENTRAL (Ovid) y PsycINFO (APA PsyNET), from Jan 2014 to Jun 4th, 2018. Two authors reviewed all title articles and abstracts in databases and selected potentially eligible studies. A narrative synthesis of results was used due to the heterogeneity in randomized controlled trials, population characteristics, psychotherapies applied, outcomes, and timing of assessments. Results: This overview included 14 randomized controlled trials which comprise 1914 participants (included non-metastatic and metastatic), across 21 articles. The most common psychological interventions were cognitive-behavioral based. The principal psychological outcomes assessed were depression, quality of life, fatigue, and anxiety. Conclusion: Results from this review are useful to clarify an overview of intervention in psychological morbidities in breast cancer. Comorbidities vary, contribute costs to patients, and there is insufficient empirical evidence about psychotherapies to resolve all psychological morbidities in breast cancer patients.

Introducción: Las morbilidades psicológicas son comunes en pacientes con cáncer de mama. Condiciones clínicas como depresión, alteraciones cognitivas, ansiedad, angustia, miedo al cáncer, trastornos del sueño y fatiga pueden persistir en sobrevivientes de cáncer. Por ello, las intervenciones psicológicas son relevantes durante el tratamiento en el cáncer de mama. Objetivo: Identificar intervenciones y resultados psicológicos para mujeres con cáncer de mama. Métodos: Se buscaron en cinco bases de datos: EMBASE, ScienceDirect, MEDLINE (Ovid), CENTRAL (Ovid) y PsycINFO (APA PsyNET), de enero de 2014 al 4 de junio de 2018. Dos autores revisaron todos los artículos en bases de datos y seleccionaron estudios potencialmente elegibles. Se utilizó una síntesis narrativa de los resultados debido a la heterogeneidad en ensayos controlados aleatorios, características de la población, psicoterapias aplicadas, resultados y tiempo de las evaluaciones. Resultados: Este resumen incluyó 14 ensayos controlados aleatorios que comprometen a 1914 participantes (incluidos no metastásicos y metastásicos) en 21 artículos. Las intervenciones psicológicas más comunes fueron basadas en el comportamiento cognitivo. Los principales resultados psicológicos evaluados fueron la depresión, la calidad de vida, la fatiga y la ansiedad. Conclusión: Los resultados de esta revisión son útiles para aclarar una visión general de la intervención en morbilidades psicológicas en el cáncer de mama. Las comorbilidades varían, contribuyen con costos a los pacientes y no hay suficiente evidencia empírica sobre psicoterapias para resolver todas las morbilidades psicológicas en la mujer con cáncer de mama.

La depresión y su relación con el deterioro cognitivo leve y la enfermedad de Alzheimer. Un estudio de revisión sistemática / Depression and its relationship with mild cognitive impairment and Alzheimer disease: A review study

El objetivo del presente estudio fue determinar si la depresión antecede al deterioro cognitivo leve (DCL) como factor de riesgo o como predictor en la enfermedad de Alzheimer (EA). Se realizó una revisión sistemática de estudios observacionales (transversales y de cohorte o seguimiento) mediante el algoritmo de búsqueda PRISMA, de los marcadores clínicos en DCL y EA, en las bases de datos Science Direct, Springer, Scopus y Proquest. Los criterios de elegibilidad del estudio incluyeron como criterios inclusión: tipos de documentos, artículos de estudios primarios; tipo de fuente, revistas científicas, en idioma inglés, desde enero de 2010 hasta abril de 2020, en pacientes con DCL y EA y en el grupo de edad comprendido en personas con un rango de edad mínimo de 45años. Los criterios de exclusión fueron: las publicaciones de más de 10años (el objetivo del artículo era explorar estudios recientes), estudios de investigación secundaria, tipo de documento de informe, otros idiomas diferentes al inglés. Se identificaron 3.385 artículos, de los que finalmente se seleccionaron 30 artículos. Se encontró que existe una asociación entre la depresión y la EA, pero propiamente como un factor de riesgo, mas no como un predictor o marcador clínico del desarrollo de la EA. El grado de asociación es mayor cuando presentan sintomatología depresiva y simultáneamente reportan quejas de memoria subjetiva o la presencia de DCL. (AU)

The objective of the present study was to determine whether depression precedes Mild cognitive impairment (MCI) as a risk factor or as a predictor in Alzheimer's disease (AD). A systematic review of observational studies (cross-sectional and cohort or follow-up) was carried out using the PRISMA search algorithm, for clinical markers in MCI and AD, in the Science Direct, Springer, Scopus and Proquest databases. The study eligibility criteria included inclusion criteria: of types of documents, articles of primary studies, type of source scientific journals, published in the English language, from January 2010 to April 2020, in patients with MCI and AD and in the group of age included in people with a minimum age range of 45years. Exclusion criteria were: publications older than 10years because the aim of the article was to explore recent studies, secondary research studies, type of report document, languages other than English. 3385 articles were identified, of which 30 articles were finally selected. It was found that there is an association between depression and AD, but properly as a risk factor but not, as a predictor or clinical marker of the development of AD. The degree of association is greater when they present depressive symptoms and simultaneously report subjective memory complaints or the presence of MCI. (AU)

[Depression and its relationship with mild cognitive impairment and Alzheimer disease: A review study]. / La depresión y su relación con el deterioro cognitivo leve y la enfermedad de Alzheimer. Un estudio de revisión sistemática.

The objective of the present study was to determine whether depression precedes Mild cognitive impairment (MCI) as a risk factor or as a predictor in Alzheimer's disease (AD). A systematic review of observational studies (cross-sectional and cohort or follow-up) was carried out using the PRISMA search algorithm, for clinical markers in MCI and AD, in the Science Direct, Springer, Scopus and Proquest databases. The study eligibility criteria included inclusion criteria: of types of documents, articles of primary studies, type of source scientific journals, published in the English language, from January 2010 to April 2020, in patients with MCI and AD and in the group of age included in people with a minimum age range of 45years. Exclusion criteria were: publications older than 10years because the aim of the article was to explore recent studies, secondary research studies, type of report document, languages other than English. 3385 articles were identified, of which 30 articles were finally selected. It was found that there is an association between depression and AD, but properly as a risk factor but not, as a predictor or clinical marker of the development of AD. The degree of association is greater when they present depressive symptoms and simultaneously report subjective memory complaints or the presence of MCI.

[Influence of the caregiver on the cognitive and functional decline of people with dementia: A systematic review]. / Influencia del cuidador en el declive cognitivo y funcional de personas con demencia: revisión sistemática.

Dementia is a neurodegenerative disease that requires the accompaniment of a caregiver who is in charge of assisting and supervising basic and psychosocial needs. The objective of this article was to determine the influence of the caregiver on the cognitive and functional decline of patients with dementia. The method was a systematic review by searching the Scopus, Pubmed and Science Direct databases between the years 2010-2020. In conclusion, the informal caregiver condition was the most reported by the investigations, generally assumed by wives and children; Caregiver characteristics such as personality, subjective interpretations of the functional status of adults with dementia, and caregivers' coping strategies were associated with a decrease in the rate of cognitive and functional impairment of people with dementia.

Procesos cognitivos en trombosis de seno longitudinal superior: reporte de caso / Cognitive processes in superior longitudinal sinus thrombosis: case report

INTRODUCCIÓN: la trombosis de seno longitudinal superior es una enfermedad de difícil detección a causa de sus diferentes causas y debido al polimorfismo de sus manifestaciones neurológicas; además es común en el sexo femenino relacionado a los estímulos estrogénicos y otros factores hormonales, pero poco probable en menor de 40 años. PACIENTE: paciente menor de 40 años posterior a presentar dos episodios de accidentes cerebrovasculares isquémicos, se evalúa un año después de la lesión el estado cognitivo y funcional mediante la batería Neuropsi Atención y Memoria y el Inventario de Adaptabilidad Mayo-Portland; los procesos cognitivos afectados en un nivel de clasificación leve fueron la atención y concentración, el funcionamiento ejecutivo; en el estado funcional reportado por el cónyuge sugiere afectación de síntomas clínicos como irritabilidad, ira agresividad, dolores de cabeza, cansancio y reacciones a síntomas menores e interacción inadecuada, estos síntomas no fueron reportados por la paciente sugiriendo posible anosognosia en su proceso de adaptabilidad CONCLUSIÓN: Tras un proceso de lesión cerebral por afectación trombótica, las secuelas cognitivos y funcionales permanecen posterior a la recuperación espontanea, llevando a emplear procesos de rehabilitación.

INTRODUCTION: the superior longitudinal sinus thrombosis is a disease difficult to detect because of its different causes and because of the polymorphism of its neurological manifestations; It is also common in females related to estrogen stimuli and other hormonal factors, but unlikely in younger than 40 years. PATIENT: a patient younger than 40 years after having two episodes of ischemic strokes, cognitive and functional status is assessed one year after the injury using the neuropsi battery attention and memory and the mayo-portland adaptability inventory; Cognitive processes affected at a slight level of classification were attention and concentration, executive functioning; In the functional status reported by the spouse suggests involvement of clinical symptoms such as irritability, anger, aggression, headaches, fatigue and reactions to minor symptoms and inadequate interaction, these symptoms were not reported by the patient suggesting possible anosognosia in her process of adaptability CONCLUSIÓN: After a process of brain injury due to thrombotic involvement, the cognitive and functional sequelae remain after spontaneous recovery, suggesting the import of rehabilitation processes.

Desempeño de la cognición social en niños y niñas inmersos en la dinámica del acoso escolar en la ciudad de Neiva, Colombia / Performance of social cognition in boys and girls immersed in the dynamics of bullying in the city of Neiva, Huila (Colombia)

Resumen La presente investigación tuvo como objetivo comparar el desempeño en ejecución de las pruebas de cognición social en los perfiles de niños y niñas vinculados al acoso escolar en una institución educativa pública de la ciudad de Neiva. Con un diseño de tipo transversal y a través de un muestreo no probabilístico de tipo intencional, se evaluaron 103 estudiantes de básica primaria, seleccionados de acuerdo con los criterios de elegibilidad. Los resultados mostraron una mayor frecuencia de niños que se identificaron como observadores-víctimas y un desempeño inferior en las pruebas de faux pas (metida de pata), historias extrañas de Happé y test de miradas en la comparación por perfiles de acoso escolar y la edad. Los resultados sugieren profundizar en estudios que relacionen la convivencia escolar y el desarrollo de la cognición social con las características sociodemográficas y culturales en la población estudiada.

Abstract The objective of this research was to compare the performance of social cognition tests in the profiles of boys and girls linked to bullying in a public educational institution in the city of Neiva. With a cross-type design and through a non-probabilistic sampling of intentional type, 103 primary school students selected according to the eligibility criteria were evaluated. The results showed a higher frequency of children who identified themselves as observers-victims and a lower performance in faux pas-boobs, strange stories by Happé and a comparison test by profiles of bullying and age. The results suggest deepening studies that relate school life and the development of social cognition with sociodemographic and cultural characteristics in the population studied.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de San Antonio Masahuat, La Paz; El Coyolito, Chalatenango y Guacotécti, Cabañas / Effectiveness at 3 and 6 months of a comprehensive intervention for dental caries in schoolchildren from San Antonio Masahuat, La Paz; El Coyolito, Chalatenango and Guacotécti, Cabañas

Objetivo: Determinar la efectividad a 3 y 6 meses de una intervención integral para caries en dientes permanentes, en los escolares de 9 a 11 años, en el año 2017 en las Unidades Comunitarias de Salud Familiar de San Antonio Masahuat, la Paz; el Coyolito, Chalatenango y Guacotécti, Cabañas. Metodología: estudio de tipo intervención comunitaria, cuasi experimental con grupo control pre-post desarrollado en usuarios de las Unidades Comunitarias de Salud Familiar (UCSF) San Antonio Masahuat, el Coyolito, y Guacotécti, en donde se realizó una intervención en dientes permanentes en una muestra de 72 pacientes en edades de 9 a 11 años. Fue medida la efectividad de los tratamientos a través de la reducción de placa dentobacteriana (PDB), prevención y limitación del daño por caries y supervivencia de sellantes de fosas y fisuras (SFF) y obturaciones. Los datos fueron analizados en el programa SPSS. Resultados: El CPO-D inicial fue de 24.49% pero a los 6 meses se redujo a 11.4%. La supervivencia de los SFF a los 6 meses fue de 62.68%. El porcentaje de las obturaciones a los 6 meses fue de 58.09%. Conclusiones: se determinó que la intervención integral fue efectiva debido a que hubo una reducción en el nivel de PDB, y de caries dental, remineralización de lesiones cariosas por flúor barniz, y supervivencia de SFF.

Objective: To determine the effectiveness at 3 and 6 months of a comprehensive intervention for permanent tooth decay, in schoolchildren aged 9 to 11 years, in 2017 in the Community Family Health Units of San Antonio Masahuat, La Paz; El Coyolito, Chalatenango and Guacotécti, Cabañas. Methodology: community intervention, quasi-experimental study with a pre-post control group developed in users of the Community Family Health Units (UCSF) San Antonio Masahuat, Coyolito, and Guacotécti, where an intervention was performed on permanent teeth in a Sample of 72 patients aged 9 to 11 years. The effectiveness of the treatments was measured through the reduction of dentobacterial plaque (PDB), prevention and limitation of caries damage and survival of pit and fissure sealants (SFF) and seals. The data were analyzed in the SPSS program. Results: The initial CPO-D was 24.49% but at 6 months it was reduced to 11.4%. The survival of the SFF at 6 months was 62.68%. The percentage of seals at 6 months was 58.09%. Conclusions: it was determined that the integral intervention was effective because there was a reduction in the level of PDB, and dental caries, remineralization of carious lesions by varnish fluoride, and survival of SFF.

Característica Neuroendocrinas del trauma temprano y su relación con el bullying / Neuroendocrine characteristics of early trauma and its relation to bullying

Resumen El objetivo del presente artículo es revisar el sustento teórico de los mecanismos neurobiológicos y neuroendocrinos que se desarrollan con el trauma temprano, los cuales pueden ser generadores de vulnerabilidad cognitiva y emocional en los sujetos expuestos a ambientes con características de maltrato infantil; por otro lado, se pretende identificar la relación existente entre la vulnerabilidad temprana expresada cognitiva y afectivamente con las relaciones concernientes a perfiles de niños víctimas de acoso escolar en la primera infancia y proponer un esquema explicativo para el desarrollo de perfiles de vulnerabilidad o resiliencia a partir del rol que cumple la escuela como factor protector para la modificación de la expresión de los genes en los niños, niñas y adolescentes en condiciones de vulnerabilidad.

Abstract The aim of this article is to review the theoretical basis of neurobiological and neuroendocrine mechanisms that develop early trauma, which can be generators cognitive and emotional vulnerability in subjects exposed to environments with characteristics of child abuse; furthermore, it seeks to identify the relationship between early vulnerability cognitive expressed and affectively with relationships concerning profiles of child victims of bullying in early childhood and propose an explanatory framework for the development of profiles of vulnerability or resilience from the role that school as a protective factor for modifying the expression of genes in children and adolescents in vulnerable conditions.

Toma de decisiones en menores con factores de riesgo para el Trastorno Disocial de la Conducta / Decision making in minors with risk factor of dissocial behavior disorder

Introducción. Existe la hipótesis de que las emociones participan del proceso cognitivo de la toma de decisiones guiando la conducta y dotando a la experiencia de una cualidad positiva o negativa que permite la adaptación del individuo al medio social. Método: La muestra estuvo conformada por 81 menores de edad (48 que cumplían con uno o dos criterios del DSM-IV y 33 sin alteraciones de comportamiento). Se utilizó la Escala Muldimensional de la Conducta, el SNAP IV y el Check list para TDC como instrumentos de tamizaje para su selección, posteriormente se realizó la evaluación con la versión computarizada de la IGT (Iowa Gambling Task). Resultados: Se dan diferencias estadísticamente significativas entre el grupo estudio y de comparación para la selección de las barajas desventajosas B durante la ejecución de la tarea. Los menores en riesgo presentaron un desempeño menor para la prueba general de toma de decisiones. Discusión: Los resultados indican la presencia de alteraciones en los procesos de toma de decisiones de los menores que presentan uno o dos criterios clínicos para desarrollar el TDC.

Introduction: There is a hypothesis that proposes that emotions take part in the cognitive process related to decision-making behavior; such processes provide experience of a positive or negative quality that allows the adaptation of a human being to a social background. Methods: There were 81 minors participants (48 qualified with one or two standards of DSM-IV and 33 without conduct disorders). We used Multidimensional Scale of Conduct, SNAP IV, and checklist for CD as screening instruments for its selection, and later we performed the assessment with the online version of IGT (Iowa Gambling Task). Results: A statistically significant difference was present between study and control groups in the selection of unfavorable decks of cards. Those children affected by behavioral disorders presented lower results in the general decision-making test. Conclusions: Results suggest the presence of disorders in decision-making in minors that present one or two clinical criteria to develop CD. This could be due to difficulties in contingency processing for unfavorable decisions, which prevented them from generating somatic states based on the possible future consequences.