The NeuroBel: A Screening Test for Verbal Language Impairment in Spanish-Speaking Elderly People With Cognitive Decline.

PURPOSE: The NeuroBel is a short test that can detect cognitive decline using language tasks. This study replicated previous research using larger clinical samples from three Spanish-speaking countries. METHOD: Eight tasks were used to analyze verbal language functioning using a psycholinguistic approach. A total of 232 elderly, monolingual Spanish speakers from Spain, Cuba, and Colombia participated in this study. Of these, 76 had Alzheimer's disease (AD) in the initial phase, 75 had mild cognitive impairment (MCI), and 81 did not exhibit cognitive impairment (healthy controls). RESULTS: Significant differences were observed among the three clinical groups. The participants with AD and the participants with MCI had significantly lower NeuroBel scores than the control group on most of the tasks. However, repetition (in AD vs. MCI) and auditory lexical decision (in MCI vs. control) tasks were not significant in Tukey's post hoc tests. Discriminant analysis showed that 80.6% of the participants were correctly classified into the original groups and revealed the tasks that were the best and worst for differentiating among groups. The receiver-operating characteristic curves showed high sensitivity for AD and MCI. The area under the curve was .97 in the contrast of AD versus MCI + controls, .96 in the determination of overall cognitive decline (AD + MCI vs. controls), and .93 in the contrast of MCI and control groups. CONCLUSION: This study confirmed that the NeuroBel is a suitable test for detecting cognitive decline based on language impairment in Spanish-speaking elderly people.

Factores tecnológicos-educativos asociados a problemas fisioergonómicos en estudiantes de medicina

Introducción: Existe evidencia sobre el efecto negativo del uso de tecnologías de información y comunicación en estudiantes, sin embargo, poco se conoce sobre problemas fisioergonómicos secundarios a su uso. Objetivo: Identificar los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina. Métodos: Estudio transversal en estudiantes de medicina de 11 países de Latinoamérica y el Caribe. Se utilizó un cuestionario cuyas variables fueron las características socio-educativas y tecnológicas, así como los problemas fisioergonómicos (dolor de cuello, dolor de espalda, ojo seco/rojo y dolor de cabeza). Resultados: De 11 587 estudiantes, 14,5 % reportó presentar 4 problemas fisioergonómicos. La mayoría reportó dolor de cuello (50 %), dolor de espalda (50,5 %) y dolor de cabeza (53,7 %). Tuvieron mayor frecuencia de presentar estos problemas fisioergonómicos las mujeres (RP= 1,06), quienes estudiaron una carrera previa (RP= 1,19), pertenecer a todos los años de estudios (RP= 1,12-1,20), quienes tenían mayor uso de Internet en horas (RP= 1,01) y aquellos que accedían a Twitter en horas de clases (RP= 1,30). La frecuencia de presentar estos problemas disminuyó en quienes tenían menor edad en años (RP= 0,99), procedían de una universidad privada (RP= 0,81), y quienes pertenecían a cualquier grupo extracurricular (RP= 0,67-0,93). Conclusiones: Los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina son ser mujer, tener carrera previa, pertenecer a todos los años de estudios, horas de uso de internet y el acceso a Twitter durante clases.

Introduction: There is evidence on the negative effect of the use of information and communication technologies on students, however, little is known about physio-ergonomic problems secondary to their use. Objective: To identify the technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students. Methods: Cross-sectional study in medical students from 11 countries in Latin America and the Caribbean. A questionnaire was used whose variables were socio-educational and technological characteristics, as well as physio-ergonomic problems (neck pain, back pain, dry/red eye and headache). Results: Of 11 587 students, 14.5% reported presenting 4 physio-ergonomic problems. Most reported neck pain (50%), back pain (50.5%), and headache (53.7%). Women (PR= 1.06), who studied a previous degree (PR= 1.19), who belonged to all years of studies (PR= 1.12-1.20), who had greater use of the Internet, had a higher frequency (in hours) of presenting these physio-ergonomic problems (PR= 1.01) and those who accessed Twitter during school hours (PR= 1.30). They decreased the frequency of presenting these problems, being younger in years (PR= 0.99), coming from a private university (PR= 0.81), and who belonged to any extracurricular group (PR= 0.67-0.93). Conclusions: The technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students were being a woman, having a previous degree, belonging to all the years of study, hours of Internet use and access to Twitter during classes.

Voice feminization in male-to-female transgendered clients after Wendler's glottoplasty with vs. without voice therapy support.

The objective of this study was to evaluate the medium-term results of Wendler's glottoplasty surgery (WG) and the effects of post-operative voice therapy in a group of male-to-female transsexuals. This is a retrospective study of 18 transsexuals who voluntarily underwent WG between 2010 and 2014 at a single hospital. Ten of the subjects underwent an additional voice therapy training. The group was assessed pre- vs. post-treatments with a limited battery of measures consisting of fundamental frequency (Fo), maximum phonation time, the TSEQ transgender self-assessment questionnaire, and perceptual assessment of the voice (Visual Analog Scale and a simplified version of the classical Hirano-GRBAS scale) by inter-rater agreement. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured, and the surface of both vocal folds was vaporized with a laser diode. The results showed a significant increase in vocal tone and feminization of voice in all participants, including a significant increase in Fo 12 months after treatment. Significant improvements were also shown in other evaluated measures, such as self-reported satisfaction and the degree of feminization of the voice. However, no improvements in maximum phonation time were observed. The use of voice therapy appears decisive for optimal improvement of this class of patients. WG applied appropriately by well-trained hands is thus a very effective and less traumatic procedure than other techniques that aim for an acceptable feminization of the voice in MtoF transgendered clients.

Specific Language Impairment: Evaluation and detection of differential psycholinguistic markers in phonology and morphosyntax in Spanish-speaking children.

BACKGROUND: The diagnosis of Specific Language Impairment (SLI) is very complex, given the variety of clinical pictures described in this disorder. Knowledge about the linguistic markers of SLI can facilitate its differentiation from the normal profile of language development. These markers can also be used as tools that may improve diagnostic. AIMS: To determine which psycholinguistic markers best discriminate Spanish-speaking children with SLI from children with typical language development. METHOD AND PROCEDURE: The performance of 31 Spanish-speaking children with SLI was analysed using a battery of 13 psycholinguistic tasks organized into two areas: phonology and morphosyntax. The performance of the SLI group was compared to that of two subgroups of controls: aged matched (CA) and linguistically matched (CL). OUTCOMES AND RESULTS: The data show that the SLI group performed worse than the CA subgroup on all 13 verbal tasks. However, the performance of the SLI group did not significantly differ from that of the CL subgroup on most (11/13) of the tasks. Stepwise discriminant analysis established the canonical function of three tasks (morphologic integration, sentence understanding and diadochokinesis) which significantly discriminated SLI from CA, with sensitivity 84% and specificity 90%. CONCLUSIONS AND IMPLICATIONS: These results contribute to determining the psycholinguistic and clinical characteristics of SLI in Spanish-speaking children and provide some methods for screening assessment.

Trastorno específico del lenguaje: subtipos de una patología compleja / Specific language impairment: subtypes of a complex disorder

Existen distintas propuestas sobre marcadores psicolingüísticos y sobre taxonomías del trastorno específico del lenguaje (TEL). Este trabajo presenta los resultados obtenidos en 8 tareas psicolingüísticas por 2 grupos de niños: 31 niños con TEL (GTEL) y 31 niños igualados en edad cronológica (GC). Las tareas han sido elaboradas ad hoc para valorar los marcadores psicolingüísticos en las 4 áreas clásicas: fonología, morfosintaxis, semántica y pragmática. En primer lugar, se comprueba que los niños del GTEL rinden significativamente peor que los niños del GC en las 8 tareas. En segundo lugar, un análisis de conglomerados K-medias clasifica a los 31 sujetos del grupo TEL en 4 conglomerados. En tercer lugar, un análisis discriminante comprueba si la clasificación clínica hecha a priori se mantiene tras los resultados del estudio. Se presenta el perfil de los conglomerados y se discuten sus características respecto a los subtipos de la taxonomía clínica de Rapin y Allen. Finalmente, se analizan las similitudes y diferencias entre ambas tipologías. Los resultados obtenidos ayudan a esclarecer los marcadores psicolingüísticos del TEL en niños de habla española y refuerzan la utilidad clínica de su clasificación en subtipos y la vigencia de la taxonomía de Rapin y Allen (AU)

There are various proposals for psycholinguistic markers and for taxonomies of specific language impairment (SLI). This study presents the results obtained in eight psycholinguistic tasks by two groups of Spanish-speaking children: 31 children with SLI (SLI) and 31 children matched for chronological age (CA). The tasks were developed ad hoc to assess psycholinguistic markers in the four traditional areas: phonology, morphosyntax, semantics and pragmatics. Firstly, we found that SLI group scored significantly worse than CA group in the eight tasks. Secondly, a K-Means cluster analysis distinguished five clusters within the 31 subject of SLI group. Thirdly, a discriminant analysis checks whether an a priori clinical classification is maintained after the study results. We present the profile of these clusters and discuss their features regarding Rapin & Allen taxonomy clinical subtypes. Finally, the similarities and differences between the two classifications are analyzed. The results obtained in this work help shed light on the psycholinguistic markers of the Spanish-SLI and reinforce the clinical utility of its classification into subtypes and the validity of the Rapin & Allen taxonomy (AU)

Trastorno Específico del Lenguaje: Marcadores psicolingüísticos en semántica y pragmática en niños españoles / Specific Language Impairment: Markers into semantic and pragmatic areas in Spanish-speaking children

El objetivo del estudio fue determinar qué marcadores semánticos y pragmáticos sirven para discriminar mejor a niños con Trastorno Específico del Lenguaje (TEL) de niños con desarrollo normal del lenguaje. El estudio analiza los resultados de 31 niños hispanohablantes con TEL en una batería de 9 tareas psicolingüísticas. Sus resultados se compararon con el de dos subgrupos control: uno de niños emparejados en edad cronológica (CE) y otro de niños emparejados en edad lingüística (CL). Los datos mostraron que el grupo TEL realizó peor que el grupo CE la mayoría de las tareas (8/9). Sin embargo, el grupo TEL sólo fue significativamente peor que el CL en una de las tareas. Un primer Análisis Discriminante TEL vs CA estableció una función canónica con una Sensibilidad de 93,5% y una Especificidad de 87.1%. Un segundo Análisis Discriminante TEL vs CL estableció una función canónica con Sensibilidad de 77,4% y Especificidad de sólo 54.8%. Una tarea semántica (Definición de palabras) y una tarea pragmática (Lenguaje contextual) parecen ser las mejores tareas para establecer un perfil del TEL en estas áreas. Estos resultados se discuten a la luz de las implicaciones que pueden tener para el diagnóstico clínico y la psicopatología del lenguaje

The aim of this study is to determine which semantics and pragmatics markers best discriminate Spanish-speaking children with Specific Language Impairment (SLI) from children with typical language development. This study analyzes the performance of 31 Spanish-speaking children with SLI on a battery of 9 psycholinguistic tasks. The performance of the SLI children was compared with that of two subgroups of controls: aged-matched (CA) and linguistically matched (CL). The data show that the SLI group performed more poorly than the CA subgroup on most of the tasks (8/9). However, the SLI group performance only was significantly worse that of the CL subgroup on one of the tasks. A first Discriminant Analysis SLI vs CA established canonical function with Sensitivity 93,5% and Specificity 87,1%. A second Discriminant Analysis SLI vs CL identified a canonical function with Sensitivity 77,4% and Specificity only 54,8%. One semantic task (Definition of words) and another pragmatic task (Scene language) appear to be the best variables for establishing an SLI profile in this psycholinguistics areas. Discuss the implications of these findings for the clinical diagnosis and speech-language pathology

Evaluación del tratamiento logopédico en la rehabilitación de la disfonía en adultos: seguimiento de los efectos grupales y de las variaciones individuales / Evaluation of voice therapy for dysphonia in adults: follow-up of group effects and individual variability

Este estudio analiza las diferencias grupales e individuales en los resultados obtenidos tras la reeducación vocal de un grupo de pacientes disfónicos con diferentes diagnósticos, utilizando un protocolo multidimensional breve de evaluación. Las voces de 21 participantes con disfonía y 21 controles se evalúan y comparan en pretratamiento vs. postratamiento logopédico. El funcionamiento de la voz fue valorado antes y después del tratamiento mediante un conjunto de pruebas que incluían la videolaringostroboscopia, la valoración aerodinámica y tests de autoevaluación mediante cuestionarios de autoinforme. El grupo de tratamiento logopédico (TL) recibió 2 sesiones de terapia de la voz a la semana durante 3 meses. Tres reevaluaciones de seguimiento se llevaron también a cabo después de terminado el tratamiento para valorar la eficacia y la latencia del mismo. Un MANOVA con la prueba de la traza de Pillai mostró un efecto significativo de grupo del tratamiento logopédico en todas las variables evaluadas. Un T-test pretratamiento vs. postratamiento de los cambios individuales resultó también significativo en la mayoría de los participantes con disfonía, a pesar del amplio rango de puntuaciones mostrado (alta varianza) por las diferentes medidas utilizadas para valorar el programa de tratamiento logopédico aplicado. Los resultados corroboran la eficacia de la reeducación vocal con logopedia tanto en los análisis grupales como individuales en al menos algunos tipos de patologías de la voz. Sin embargo, ciertas características y antecedentes de los participantes se destacan como las más favorables para beneficiarse del tratamiento logopédico de la voz (AU)

This study analyzed group and individual differences in the results of vocal rehabilitation in a group of dysphonic patients with different diagnoses, using a brief multidimensional assessment protocol. The voices of 21 participants with dysphonia and 21 controls were evaluated and compared in a pre- vs. post-speech therapy treatment. Voice performance was assessed before and after treatment by a set of tests that included videolaryngostroboscopy, aerodynamic tasks, and self-rating questionnaires. The speech-therapy treatment group received two sessions of speech therapy a week for 3 months. Three follow-up reevaluations of group effects and individual variability were also carried out to assess the latency period after the end of treatment. MANOVA with Pillai's trace test showed a significant group effect of the vocal treatment on all of the variables assessed. A pre- vs. post- treatment T-test of individual changes was also significant in most of the dysphonic participants, despite the wide range of scores (high variance) in the different measures used after the voice therapy program. The results of both group and individual analyses support the effectiveness of vocal rehabilitation with speech therapy in at least some types of voice disorders. However, voice therapy was more effective in participants with certain characteristics and antecedents (AU)

Comparing voice-therapy and vocal-hygiene treatments in dysphonia using a limited multidimensional evaluation protocol.

PURPOSE: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. METHOD: Forty-two participants with voice disorders were randomly assigned to one of two groups. Participants in group 1 received voice-therapy and participants in group 2 received a vocal-hygiene program. Vocal function was assessed before and after treatment. RESULTS: MANOVA analysis Pillai's trace test shows significant pre-post immediate differences between treatments in favor of direct-intervention. Repeated-measures ANOVAs display significant within subjects main effect for follow-up period in the 8 measures considered. Interaction effects of group×time are also found in five out of the eight continuous variables analyzed (3 aerodynamics-acoustic and 2 self-rating), indicating differences between both treatments. Qualitative dimensions (perceptual, laryngoscopic and spectrographic assessments) also support voice-therapy superiority. CONCLUSIONS: Results of this study suggest superiority of a voice-therapy (direct treatment) approach over a vocal-hygiene program (indirect treatment). This advantage is on the majority of the 8 continuous variables analyzed (aerodynamics, acoustic, and self-rating), including qualitative perceptual, laryngoscopic and spectrographic voice-dimensions. The stability of changes is extended during a post-treatment follow-up period. LEARNING OUTCOMES: (1) The reader should distinguish the advantage using one type of treatment or another in clinical contexts. (2) The reader must know the most important direct techniques used in clinical treatment of voice disorders.