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.

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.

The Perioperative Quality Improvement Programme (PQIP patient study): protocol for a UK multicentre, prospective cohort study to measure quality of care and outcomes after major surgery.

INTRODUCTION: Major surgery accounts for a substantial proportion of health service activity, due not only to the primary procedure, but the longer-term health implications of poor short-term outcome. Data from small studies or from outside the UK indicate that rates of complications and failure to rescue vary between hospitals, as does compliance with best practice processes. Within the UK, there is currently no system for monitoring postoperative complications (other than short-term mortality) in major non-cardiac surgery. Further, there is variation between national audit programmes, in the emphasis placed on quality assurance versus quality improvement, and therefore the principles of measurement and reporting which are used to design such programmes. METHODS AND ANALYSIS: The PQIP patient study is a multi-centre prospective cohort study which recruits patients undergoing major surgery. Patient provide informed consent and contribute baseline and outcome data from their perspective using a suite of patient-reported outcome tools. Research and clinical staff complete data on patient risk factors and outcomes in-hospital, including two measures of complications. Longer-term outcome data are collected through patient feedback and linkage to national administrative datasets (mortality and readmissions). As well as providing a uniquely granular dataset for research, PQIP provides feedback to participating sites on their compliance with evidence-based processes and their patients' outcomes, with the aim of supporting local quality improvement. ETHICS AND DISSEMINATION: Ethical approval has been granted by the Health Research Authority in the UK. Dissemination of interim findings (non-inferential) will form a part of the improvement methodology and will be provided to participating centres at regular intervals, including near-real time feedback of key process measures. Inferential analyses will be published in the peer-reviewed literature, supported by a comprehensive multi-modal communications strategy including to patients, policy makers and academic audiences as well as clinicians.

Influence of COVID-19 quarantine on the health of adults with mild cognitive impairment.

COVID-19 is an infectious disease declared by the World Health Organization as a public health emergency of international concern. Objective: The objective of this article was to determine the physical, psychological, and social health conditions and mood of COVID-19 quarantine in adults with mild cognitive impairment. Methods: The sample consisted of 129 participants, most of them were healthy, but some have mild cognitive impairment. The data were collected with a questionnaire and the Yesavage Geriatric Depression Scale applied through phone calls from April to June 2020. Results: Statistically significant differences were found in the changes in sleep habits of the healthy participants (p=0.018). Intragroup comparisons of the Yesavage Geriatric Depression Scale in healthy participants were significant (p=0.010) and at the intergroup level before and after quarantine showed significant differences in pretest scores (p=0.003). Conclusions: Social isolation had a negative psychological effect on sleep habits, depressed mood, and physical health, mainly in healthy participants.

COVID-19 é uma doença infecciosa declarada pela Organização Mundial da Saúde como emergência de saúde pública de interesse internacional. Objetivo: O objetivo deste artigo é determinar as condições de saúde física, psicológica, social e de humor na quarentena de COVID-19 em adultos com comprometimento cognitivo leve. Métodos: A amostra foi composta de 129 participantes, a maioria saudável, mas alguns com comprometimento cognitivo leve. Os dados foram coletados por meio de questionário e da escala de depressão geriátrica de Yesavage, aplicada por meio de ligações telefônicas no período de abril a junho de 2020. Resultados: Diferenças estatisticamente significantes foram encontradas nas mudanças nos hábitos de sono dos participantes saudáveis (p=0,018). As comparações intragrupo da escala de depressão geriátrica de Yesavage em participantes saudáveis foram significativas (p=0,010) e, no nível intergrupo, antes e depois da quarentena mostraram diferenças significativas nos escores do pré-teste (p=0,003). Conclusões: O isolamento social teve efeito psicológico negativo sobre os hábitos de sono, humor deprimido e saúde física, principalmente em participantes saudáveis.

OASI2: a cluster randomised hybrid evaluation of strategies for sustainable implementation of the Obstetric Anal Sphincter Injury Care Bundle in maternity units in Great Britain.

BACKGROUND: The Obstetric Anal Sphincter Injury (OASI) Care Bundle comprises four primary and secondary prevention practices that target the rising rates of severe perineal tearing during childbirth, which can have severe debilitating consequences for women. The OASI Care Bundle was implemented in 16 maternity units in Britain in the OASI1 project (2017-2018), which demonstrated the care bundle's effectiveness in reducing OASI rates. In OASI2, the care bundle will be scaled up to 20 additional National Health Service (NHS) maternity units in a hybrid effectiveness-implementation study that will examine the effectiveness of strategies used to introduce, implement and sustain the care bundle. METHODS: OASI2 is a two-arm cluster-randomised control trial (C-RCT) of maternity units in England, Scotland and Wales, with an additional non-randomised study arm. C-RCT arm 1 (peer support, n = 10 units) will be supported by 'buddy' units to implement the OASI Care Bundle. C-RCT arm 2 (lean implementation, n = 10 units) will implement without external support. The additional study arm (sustainability, n = 10 units) will include some original OASI1 units to evaluate the care bundle's sustainability and OASI rates over time, from before OASI1 and through the end of OASI2. Units in all three study arms will receive an Implementation Toolkit with training resources and implementation support. The C-RCT arms will be compared in terms of OASI rate reduction (primary effectiveness outcome) and clinicians' adoption of the care bundle (primary implementation outcome). Clinical data will be collated from maternity information systems; implementation data will be collected through validated surveys with women and clinicians, supplemented by qualitative methods. Descriptive statistics and regression modelling will be used for analysis. Emergent themes from the qualitative data will be assessed using framework analysis. DISCUSSION: OASI2 will study the impact of various implementation strategies used to introduce and sustain the OASI Care Bundle, and how these strategies affect the bundle's clinical effectiveness. The study will generate insights into how to effectively scale-up and sustain uptake and coverage of similar interventions in maternity units. A locally adaptable 'implementation blueprint' will be produced to inform development of future guidelines to prevent perineal trauma. TRIAL REGISTRATION: ISRCTN26523605.

Relación Del Estado Nutricional Con El Desarrollo Cognitivo Y Psicomotor De Los Niños En La Primera Infancia / Relationship Between Nutritional Status And Cognitive And Psychomotor Development Of Children In Early Childhood

RESUMEN La gestación, los primeros años de vida y el estado nutricional juegan un papel importante en el desarrollo físico, psicosocial, emocional y cognitivo en la infancia y adolescencia. Diferentes investigaciones han encontrado una relación entre el estado nutricional con un mejor desempeño cognitivo, por el contrario, la malnutrición en estas etapas puede ocasionar desequilibrios entre las necesidades nutricionales que podrían llevar a que se presente obesidad o desnutrición e influir sobre el desarrollo cognitivo. El objetivo de este artículo fue revisar la relación del estado nutricional con el desarrollo cognitivo y psicomotor de los niños en la primera infancia. El método fue revisión sistemática en las bases de datos ProQuest, Redalyc, Science Direct y Scopus en los años 2013-2018. Este artículo concluye que tanto la capacidad intelectual como el desarrollo de la motricidad fina y gruesa, dependen del estado nutricional de los infantes y por tanto se sugiere una relación entre la nutrición y el desarrollo psicomotor y cognitivo.

ABSTRACT Gestation, the first years of life and nutritional status are important role in physical, psychosocial, emotional and cognitive development in childhood and adolescence. Different investigations have found a relationship between nutritional status with better cognitive performance, although conversely, malnutrition in these stages can cause imbalances between nutritional needs that could lead to obesity or malnutrition and influence cognitive development. The aim of this article was to review the relationship between nutritional status and cognitive and psychomotor development of children in early childhood. The method was systematic review in the databases ProQuest, Redalyc, Science Direct and Scopus in the years 2013-2018. This article concludes that both the intellectual capacity and the development of fine and gross motor skills depend on the nutritional status of infants and therefore a relationship between nutrition and psychomotor and cognitive development is suggested.