Designing, development and validation of an app to reduce the response time of the emergency medical services.

INTRODUCTION: Delays in prehospital care attributable to the call-taking process can often be traced back to miscommunication, including uncertainty around the call location. Geolocation applications have the potential to streamline the call-taking process by accurately identifying the caller's location. OBJECTIVE: To develop and validate an application to geolocate emergency calls and compare the response time of calls made via the application with those of conventional calls made to the Brazilian Medical Emergency System (Serviço de Atendimento Médico de Urgência-SAMU). METHODS: This study was conducted in two stages. First, a geolocating application for SAMU emergency calls (CHAMU192) was developed using a mixed methods approach based on design thinking and subsequently validated using the System Usability Scale (SUS). In the second stage, sending time of the geolocation information of the app was compared with the time taken to process information through conventional calls. For this, a hypothetical case control study was conducted with SAMU in the Maringá, Paraná, Brazil. A control group of 350 audio recordings of emergency calls from 2019 was compared to a set of test calls made through the CHAMU192 app. The CHAMU192 group consisted of 201 test calls in Maringá. In test calls, the location was obtained by GPS and sent to the SAMU communication system. Comparative analysis between groups was performed using the Mann-Whitney test. RESULTS: CHAMU192 had a SUS score of 90, corresponding to a "best imaginable" usability rating. The control group had a median response time of 35.67 seconds (26.00-48.12). The response time of the CHAMU192 group was 0.20 (0.15-0.24). CONCLUSION: The use of the CHAMU192 app by emergency medical services could significantly reduce response time. The results demonstrate the potential of app improving the quality and patient outcomes related to the prehospital emergency care services.

AI-based approach for transcribing and classifying unstructured emergency call data: A methodological proposal.

Emergency care-sensitive conditions (ECSCs) require rapid identification and treatment and are responsible for over half of all deaths worldwide. Prehospital emergency care (PEC) can provide rapid treatment and access to definitive care for many ECSCs and can reduce mortality in several different settings. The objective of this study is to propose a method for using artificial intelligence (AI) and machine learning (ML) to transcribe audio, extract, and classify unstructured emergency call data in the Serviço de Atendimento Móvel de Urgência (SAMU) system in southern Brazil. The study used all "1-9-2" calls received in 2019 by the SAMU Novo Norte Emergency Regulation Center (ERC) call center in Maringá, in the Brazilian state of Paraná. The calls were processed through a pipeline using machine learning algorithms, including Automatic Speech Recognition (ASR) models for transcription of audio calls in Portuguese, and a Natural Language Understanding (NLU) classification model. The pipeline was trained and validated using a dataset of labeled calls, which were manually classified by medical students using LabelStudio. The results showed that the AI model was able to accurately transcribe the audio with a Word Error Rate of 42.12% using Wav2Vec 2.0 for ASR transcription of audio calls in Portuguese. Additionally, the NLU classification model had an accuracy of 73.9% in classifying the calls into different categories in a validation subset. The study found that using AI to categorize emergency calls in low- and middle-income countries is largely unexplored, and the applicability of conventional open-source ML models trained on English language datasets is unclear for non-English speaking countries. The study concludes that AI can be used to transcribe audio and extract and classify unstructured emergency call data in an emergency system in southern Brazil as an initial step towards developing a decision-making support tool.

Validation of the Pediatric Resuscitation and Trauma Outcome (PRESTO) model in injury patients in Tanzania.

INTRODUCTION: Sub-Saharan Africa has the highest rate of unintentional paediatric injury deaths. The Pediatric Resuscitation and Trauma Outcome (PRESTO) model predicts mortality using patient variables available in low-resource settings: age, systolic blood pressure (SBP), heart rate (HR), oxygen saturation, need for supplemental oxygen (SO) and neurologic status (Alert Verbal Painful Unresponsive (AVPU)). We sought to validate and assess the prognostic performance of PRESTO for paediatric injury patients at a tertiary referral hospital in Northern Tanzania. METHODS: This is a cross-sectional study from a prospective trauma registry from November 2020 to April 2022. We performed exploratory analysis of sociodemographic variables and developed a logistic regression model to predict mortality using R (V.4.1). The logistic regression model was evaluated using area under the receiver operating curve (AUC). RESULTS: 499 patients were enrolled with a median age of 7 years (IQR 3.41-11.18). 65% were boys, and in-hospital mortality was 7.1%. Most were classified as alert on AVPU Scale (n=326, 86%) and had normal SBP (n=351, 98%). Median HR was 107 (IQR 88.5-124). The logistic regression model based on the original PRESTO model revealed that AVPU, HR and SO were statistically significant to predict in-hospital mortality. The model fit to our population revealed AUC=0.81, sensitivity=0.71 and specificity=0.79. CONCLUSION: This is the first validation of a model to predict mortality for paediatric injury patients in Tanzania. Despite the low number of participants, our results show good predictive potential. Further research with a larger injury population should be done to improve the model for our population, such as through calibration.

Intervenção em orientação profissional para adolescentes com e sem superdotação¹ / Professional guidance intervention for adolescents with and without giftedness / Intervención de orientación profesional para adolescentes con y sin talento

A orientação profissional aos adolescentes com altas habilidades/superdotação é importante para a compreensão de suas habilidades e competências que irão facilitar a inserção no mercado de trabalho. O estudo teve como objetivo comparar os efeitos da intervenção em orientação profissional para adolescentes com e sem superdotação em relação à maturidade para escolha profissional, indecisão vocacional, autoeficácia e sintomas de depressão, ansiedade e estresse. Utilizou-se um questionário de dados sociodemográficos, critério de Classificação Brasil, Escala de Maturidade para Escolha Profissional, Escala de Indecisão Vocacional, Depression, Anxiety and Stress Scale e a Escala de Autoeficácia Geral Percebida. Participaram 31 adolescentes. Observou-se que a intervenção em orientação profissional reduziu a indecisão vocacional e sintomas de estresse. Os superdotados apresentaram aumento de determinação, autoconhecimento e maturidade para escolha profissional.

The professional guidance for adolescents with high abilities/giftedness is important for understanding their skills and competences that will facilitate their entry into the labor market. Objective to compare the effects of intervention in professional guidance for adolescents with and without giftedness in relation to the maturity for professional choice, vocational indecision, self-efficacy and symptoms of depression, anxiety and stress. We used a questionnaire of sociodemographic data, Brazil Classification criteria, Maturity Scale for Professional Choice, Vocational Indecision Scale, Depression, Anxiety and Stress Scale and the Perceived General Self-efficacy Scale. 31 adolescents participated. It was observed that the intervention in professional guidance reduced vocational indecision and symptoms of stress. The gifted showed an increase in determination, self-knowledge and maturity for professional choice.

La orientación profesional para adolescentes con altas capacidades / superdotación es importante para la comprensión de sus habilidades y competencias que facilitarán su inserción en el mercado laboral. Objetivo de comparar los efectos de la intervención en la orientación profesional para adolescentes con y sin superdotación en relación con la madurez para la elección profesional, la indecisión vocacional, la autoeficacia y los síntomas de depresión, ansiedad y estrés. Utilizamos un cuestionario de datos sociodemográficos, criterios de clasificación de Brasil, escala de madurez para la elección profesional, escala de indecisión vocacional, escala de depresión, ansiedad y estrés y la escala de autoeficacia general percibida. Participaron 31 adolescentes. Se observó que la intervención en orientación profesional redujo la indecisión vocacional y los síntomas de estrés. Los superdotados mostraron un aumento en la determinación, el autoconocimiento y la madurez para la elección profesional.

National Institute of Mental Health Life Chart Method - Self/Prospective (NIMH-LCM-S/P™): translation and adaptation to Brazilian Portuguese.

OBJECTIVE: The objective of this study was to translate and adapt the National Institute of Mental Health Life Chart Method - Self/Prospective (NIMH-LCM-S/P™) instrument for self-monitoring of mood into Brazilian Portuguese and provide evidence of content validity. Additionally, a user guide was prepared for the instrument and evaluated by mental health professionals. METHODS: The study was divided into two stages - Stage 1: Translation and cross-cultural adaptation and Stage 2: Determination of content validity index (CVI) scores. The translation and cross-cultural adaptation process involved 37 participants between translators, experts, target population, and evaluators. RESULTS: The CVI was evaluated by 15 mental health professionals. 11 (78.57%) of the items evaluated attained the maximum CVI score of 1.00, which constitutes the highest level of content validity, and no changes were suggested by participants. Only one of the items evaluated had a CVI score lower than 0.80. CONCLUSION: The final translated and adapted version of the NIMH-LCM-S/P™ and its user guide were evaluated by the target population and the mental health professionals. Both groups displayed satisfactory comprehension levels, suggesting there is potential for using this instrument in clinical practice to assess therapeutic interventions in Brazilian settings.

Depression, somatization, and sleep disorders as risk factors for temporomandibular disorders development: a population-based case-control study / Depressão, somatização e distúrbios do sono como fatores de risco para o desenvolvimento de disfunções temporomandibulares: um estudo de controle de casos baseado na população / Depresión, somatización y trastornos del sueño como factores de riesgo para el desarrollo de trastornos temporomandibulares: un estudio de casos y controles de base poblacional

The objective of this study was to determine the association between temporomandibular disorders (TMD) with depression, somatization and sleep disorders in the city of Maringá, Brazil. A total of 1,643 participants were selected from the Brazilian Unified Health System (SUS). Of these, the test group consisted of 84 participants who had moderate or severe limitations due to TMD pain and the control group consisted of 1,048 participants with no pain. There was a highly statistically significant difference (p<0.001) between cases and controls regarding depression (82.1 versus 37.4%), somatization (84.5 versus 31.4%), and sleep disorders (84.6 versus 36.4%), in moderate to severe levels. The levels of moderate to severe depression, somatization and sleep disorders were significantly higher in TMD subjects with high TMD pain disability. The risk of developing TMD increased 4 to 5 times when the individual has moderate to severe levels of depression, somatization, and sleep disorders.

O objetivo deste estudo foi determinar a associação entre disfunções temporomandibulares (DTM) com depressão, somatização e distúrbios do sono na cidade de Maringá, Brasil. Foram selecionados 1.643 participantes atendidos no Sistema Único de Saúde (SUS). Desses, o grupo caso foi formado por 84 participantes que apresentaram limitações moderada ou grave devido à dor na DTM e o grupo controle foi formado por 1.048 participantes com ausência de dor. Verificou-se diferença estatisticamente significativa (p<0,001) entre casos e controles em relação à depressão (82,1 versus 37,4%), somatização (84,5 versus 31,4%) e distúrbios do sono (84,6 versus 36,4%), em níveis moderados a graves. Os níveis de depressão moderada a grave, somatização e distúrbios do sono foram significativamente mais altos em indivíduos com DTM com alta incapacidade devido à dor por DTM. O risco de desenvolver DTM aumentou quatro a cinco vezes quando o indivíduo apresenta níveis moderados a graves de depressão, somatização e distúrbios do sono.

El objetivo de este estudio fue determinar la asociación entre los trastornos temporomandibulares (TMD) con la depresión, la somatización y los trastornos del sueño en la ciudad de Maringá, Brasil. Un total de 1.643 participantes fueron seleccionados del Sistema Único de Salud (SUS) de Brasil. (SUS). De estos, el grupo de casos fue formado por 84 participantes que presentaban limitaciones moderadas o graves debido al dolor TMD y el grupo de control estaba formado por 1.048 participantes sin dolor. Hubo una diferencia estadísticamente significativa (p <0,001) entre casos y controles con respecto a depresión (82,1 frente a 37,4%), somatización (84,5 frente a 31,4%) y trastornos del sueño (84,6 frente a 36,4%), en niveles moderados a severos. Los niveles de depresión moderada a grave, somatización y trastornos del sueño fueron significativamente más altos en personas con TMD con alta discapacidad por dolor en TMD. El riesgo de desarrollar TMD aumenta de 4 a 5 veces cuando el individuo tiene niveles moderados a severos de depresión, somatización y trastornos del sueño.

National Institute of Mental Health Life Chart Method - Self/Prospective (NIMH-LCM-S/P™): translation and adaptation to Brazilian Portuguese

Abstract Objective The objective of this study was to translate and adapt the National Institute of Mental Health Life Chart Method - Self/Prospective (NIMH-LCM-S/P™) instrument for self-monitoring of mood into Brazilian Portuguese and provide evidence of content validity. Additionally, a user guide was prepared for the instrument and evaluated by mental health professionals. Methods The study was divided into two stages - Stage 1: Translation and cross-cultural adaptation and Stage 2: Determination of content validity index (CVI) scores. The translation and cross-cultural adaptation process involved 37 participants between translators, experts, target population, and evaluators. Results The CVI was evaluated by 15 mental health professionals. 11 (78.57%) of the items evaluated attained the maximum CVI score of 1.00, which constitutes the highest level of content validity, and no changes were suggested by participants. Only one of the items evaluated had a CVI score lower than 0.80. Conclusion The final translated and adapted version of the NIMH-LCM-S/P™ and its user guide were evaluated by the target population and the mental health professionals. Both groups displayed satisfactory comprehension levels, suggesting there is potential for using this instrument in clinical practice to assess therapeutic interventions in Brazilian settings.

Smart Check - COVID-19 triage system: Evaluation of the impact on the screening time and identification of clinical manifestations of SARS-CoV-2 infection in a public health service.

INTRODUCTION: Most patients with COVID-19 have mild or moderate manifestations; however, there is a wide spectrum of clinical presentations and even more severe repercussions that require high diagnostic suspicion. Vital sign acquisition and monitoring are crucial for detecting and responding to patients with COVID-19. OBJECTIVE: Thus, we conducted this study to demonstrate the impact of using a tool called Smart Check on the triage time of patients with suspected COVID-19 and to identify the main initial clinical manifestations in these patients. METHODOLOGY: We assessed triage times before and after the use of Smart Check in 11 466 patients at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil, from 1 June to 31 July 2020. In this group, we identified 220 patients for the identification of COVID-19 clinical manifestations in a case-control analysis. RESULTS: Smart Check was able to decrease the triage time by 33 seconds on average (P < .001), with 75% of the exams being performed within 5 minutes, whereas with the usual protocol these steps were performed within 6 minutes. A range of clinical presentations made up the COVID-19 initial manifestations. Those with the highest frequency were dry cough (46.4%), fever (41.3%), dyspnoea (35.8%), and headache (31.8%). Loss of appetite was the manifestation that had a statistically significant association with the SARS-CoV-2 presence (univariate analysis). When analysed together, loss of appetite associated with dyspnoea and/or ageusia and/or fever was related to the diagnosis of COVID-19. CONCLUSIONS: Smart Check, a simple clinical evaluation tool, along with the targeted use of rapid PCR testing, can optimise triage time for patients with and without COVID-19. In triage centres, a number of initial signs and symptoms should be cause for SARS-CoV-2 infection suspicion, in particular the association of respiratory, neurological, and gastrointestinal manifestations.

Emergency Care Sensitive Conditions in Brazil: A Geographic Information System Approach to Timely Hospital Access.

Background: The benefits of treatment for many conditions are time dependent. The burden of these emergency care sensitive conditions (ECSCs) is especially high in low- and middle-income countries. Our objective was to analyze geospatial trends in ECSCs and characterize regional disparities in access to emergency care in Brazil. Methods: From publicly available datasets, we extracted data on patients assigned an ECSC-related ICD-10 code and on the country's emergency facilities from 2015-2019. Using ArcGIS, OpenStreetMap, and WorldPop, we created catchment areas corresponding to 180 minutes of driving distance from each hospital. We then used ArcGIS to characterize space-time trends in ECSC admissions and to complete an Origin-Destination analysis to determine the path from household to closest hospital. Findings: There were 1362 municipalities flagged as "hot spots," areas with a high volume of ECSCs. Of those, 69.7% were more than 180 minutes (171 km) from the closest emergency facility. These municipalities were primarily located in the states of Minas Gerais, Bahia, Espiríto Santo, Tocantins, and Amapá. In the North region, only 69.1% of the population resided within 180 minutes of an emergency hospital. Interpretations: Significant geographical barriers to accessing emergency care exist in certain areas of Brazil, especially in peri-urban areas and the North region. One limitation of this approach is that geolocation was not possible in some areas and thus we are likely underestimating the burden of inadequate access. Subsequent work should evaluate ECSC mortality data. Funding: This study was funded by the Duke Global Health Institute Artificial Intelligence Pilot Project.

Data-driven risk stratification for preterm birth in Brazil: a population-based study to develop of a machine learning risk assessment approach.

Background: Preterm birth (PTB) is a growing health issue worldwide, currently considered the leading cause of newborn deaths. To address this challenge, the present work aims to develop an algorithm capable of accurately predicting the week of delivery supporting the identification of a PTB in Brazil. Methods: This a population-based study analyzing data from 3,876,666 mothers with live births distributed across the 3,929 Brazilian municipalities. Using indicators comprising delivery characteristics, primary care work processes, and physical infrastructure, and sociodemographic data we applied a machine learning-based approach to estimate the week of delivery at the point of care level. We tested six algorithms: eXtreme Gradient Boosting, Elastic Net, Quantile Ordinal Regression - LASSO, Linear Regression, Ridge Regression and Decision Tree. We used the root-mean-square error (RMSE) as a precision. Findings: All models obtained RMSE indexes close to each other. The lower levels of RMSE were obtained using the eXtreme Gradient Boosting approach which was able to estimate the week of delivery within a 2.09 window 95%IC (2.090-2.097). The five most important variables to predict the week of delivery were: number of previous deliveries through Cesarean-Section, number of prenatal consultations, age of the mother, existence of ultrasound exam available in the care network, and proportion of primary care teams in the municipality registering the oral care consultation. Interpretation: Using simple data describing the prenatal care offered, as well as minimal characteristics of the pregnant, our approach was capable of achieving a relevant predictive performance regarding the week of delivery. Funding: Bill and Melinda Gates Foundation, and National Council for Scientific and Technological Development - Brazil, (Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPQ acronym in portuguese) Support of the research project named: Data-Driven Risk Stratification for Preterm Birth in Brazil: Development of a Machine Learning-Based Innovation for Health Care- Grant: OPP1202186.

Indecisão e maturidade vocacional, autoeficácia e personalidade em adolescentes com e sem superdotação / Vocational and maturity indecision, self-efficacy, and personality in gifted and non-gifted adolescents / Indecisión y madurez vocacional, autoeficacia y personalidad en adolescentes superdotados y no superdotados

O objetivo deste estudo foi comparar as características sociodemográficas, nível de indecisão vocacional (EIV), autoeficácia geral percebida (EAGP), personalidade (BFP) e maturidade para a escolha profissional (EMEP) de adolescentes com e sem superdotação. A amostra foi composta por 31 adolescentes com idade média de 16,29 anos (DP = 1,21), 12 com superdotação e 19 sem superdotação. Os superdotados foram recrutados em um Núcleo Estadual de Altas Habilidades/Superdotação e os sem superdotação em uma escola particular. Os dois grupos de adolescentes responderam os mesmos instrumentos: ficha de dados sociodemográficos, EMEP, EIV, BFP e EAGP. Os sem superdotação apresentaram menores níveis de autoeficácia (EAGP) e maiores níveis de neuroticismo (BFP) e responsabilidade (EMEP). Já os adolescentes com superdotação obtiveram maiores níveis de realização (BFP), autoeficácia (EAGP), determinação (EMEP), extroversão e abertura (BFP) e autoconhecimento (EMEP). Os resultados contribuem para que orientadores profissionais e de carreira desenhem intervenções mais assertivas para adolescentes superdotados. (AU)

The aim of the study was to compare the sociodemographic characteristics, level of vocational indecision (EIV), perceived general self-efficacy (EAGP), personality (BFP) and maturity for professional choice (EMEP), of adolescents with and without giftedness. The sample consisted of 31 adolescents with a mean age of 16.29 years (SD = 1.21), 12 with giftedness and 19 without. The gifted students were recruited from a State Center for High Skills/Giftedness and the non-gifted students from a private school. The two groups of adolescents answered the same instruments, including a sociodemographic data form, the EMEP, EIV, BFP and EAGP. The non-gifted students presented lower levels of self-efficacy (EAGP) and higher levels of neuroticism (BFP) and responsibility (EMEP). The gifted adolescents presented higher levels of achievement (BFP), self-efficacy (EAGP), determination (EMEP), extraversion and openness (BFP), and self-knowledge (EMEP). The results can help professional and career counselors to design more assertive actions for gifted adolescents. (AU)

El objetivo del estudio fue comparar las características sociodemográficas, nivel de indecisión vocacional (EIV), autoeficacia general percibida (EAGP), personalidad (BFP) y madurez para la elección profesional (EMEP), de adolescentes con y sin superdotación. La muestra se compuso por 31 adolescentes con una edad media de 16,29 años (DS = 1,21), 12 con superdotación y 19 sin superdotación. Los superdotados fueron reclutados de un Centro Estatal de Altas Habilidades/Superdotación y aquellos sin superdotación de una escuela privada. Los dos grupos de adolescentes respondieron los mismos instrumentos: ficha sociodemográfica, EMEP, EIV, BFP y EAGP. Los niveles más bajos de autoeficacia (EAGP) y niveles más altos de neuroticismo (BFP) y responsabilidad (EMEP). Los adolescentes superdotados, por su parte, tenían niveles más altos de logro (BFP), autoeficacia (EAGP), determinación (EMEP), extraversión y apertura (BFP) y autoconocimiento (EMEP). Los resultados ayudan a los consejeros profesionales y de carrera a diseñar acciones más asertivas para los adolescentes superdotados. (AU)

Fatores de personalidade, depressão, ansiedade e estresse em proprietários de animais / Personality factors, depression, anxiety, and stress in pet owners / Personalidad, depresión, ansiedad y factores de estrés en propietarios de animales

O presente estudo compara fatores de personalidade, sintomas de depressão, ansiedade e estresse entre proprietários e indivíduos que não possuem animais de estimação. Participaram 145 adultos, entre 18 e 78 anos (M = 30,96, DP = 12,10). Os participantes foram divididos de acordo com a espécie do animal de estimação: (a) cães, (b) gatos, (c) cães e gatos. Os resultados sugerem que pessoas sem animais de estimação apresentaram mais sintomas de ansiedade do que aquelas que possuem. Proprietários de cães e gatos apontaram maiores escores no fator de personalidade conscienciosidade do que os participantes que não possuíam nenhum animal de estimação. Desta forma, há diferenças em possuir um animal. Contudo, novos estudos na área, utilizando análises de variáveis mediadoras, bem como pesquisas longitudinais que possam explorar a possível relação causal entre diferentes características de pessoas que possuem animais de estimação e bem-estar, fazem-se necessárias.

The study compares personality factors, symptoms of depression, anxiety and stress between owners and non-pet owners. A total of 145 adults participated, between 18 and 78 years (M = 30.96, SD = 12.10). Participants were divided according to the type of pet they had: 1) dogs, 2) cats, 3) dogs and cats. The results suggest that people who do not have pets showed more anxiety symptoms than those who have pets. Dogs and cats owners showed higher scores of conscientiousness personality factor than participants who did not have any pets. The results reveal differences between animals owners and non-owners. There is a need for studies using mediating variables analyzes, as well as longitudinal research that can explore the feasible causal relationship between different characteristics of people who own pets and well-being.

El estudio compara factores de personalidad, síntomas de depresión, ansiedad y estrés entre propietarios y no propietarios de animales. Participaron 145 adultos de 18 a 78 años (M = 30,96, SD = 12,10). Los participantes se dividieron según el tipo de mascota: 1) perros, 2) gatos, 3) perros y gatos. Los resultados sugieren que las personas que no tienen mascotas mostraron más síntomas de ansiedad que las que tienen mascotas. Los dueños de perros y gatos presentaron puntuaciones más altas del factor de conciencia de la conciencia que los participantes que no tenían ninguna mascota. Los resultados revelan diferencias entre propietarios de animales y no propietarios. Hay una necesidad de estudios que utilicen análisis de variables mediadoras, así como encuestas longitudinales que puedan explorar la posible relación causal entre las diferentes características de las personas que tienen mascotas y el bienestar.

Psychopathological Comorbid Symptoms in Animal Hoarding Disorder.

The main goal of this research is to describe the psychopathological symptoms comorbid to animal hoarding disorder. This is a cross-sectional study with a sample of a 33 individuals sample diagnosed with animal hoarding disorder. For data collection, a Sociodemographic Data questionnaire and a Semi-Structured Clinical Interview were used, based on the DSM-5 Level 1 Cross-Cutting Symptom Measure. The sample consisted of 24 women (72.7%) and 9 men (27.30%), with a prevalence of 64% of the elderly. The mean number of self-reported animals per residence was 41.12 (DP = 24.41), totaling 1357 animals: 915 (68%) dogs, 382 (28%) cats, and 50 (4%) ducks. The results indicated animal hoarding disorder the comorbid psychopathological symptoms of depression (36%), anxiety (36%), memory deficits (27%), mania (21%) and obsessive-compulsive disorder (18%). The analyses revealed a higher occurrence of these symptoms among participants who had hoarded animals for over 20 years.

Cognitive performance of individuals with animal hoarding.

BACKGROUND: The purpose of this study was to characterize the cognitive performance of individuals with animal hoarding. METHODS: This is a cross-sectional study, in which 33 individuals between the ages of 29 to 84 (M = 61.39; SD = 12.69) with animal hoarding have been assessed. The participants completed a neurocognitive battery including measures of general cognitive functioning, visual memory and organization, verbal fluency, and verbal reasoning. RESULTS: Data suggest that individuals with animal hoarding have high rates of cognitive deficits related to visual memory and verbal reasoning. CONCLUSIONS: Based on the performance tests used, we can suggest the existence of cognitive difficulties related especially to the executive functions of individuals with animal hoarding in this sample.

The Association Between Eating-Compensatory Behaviors and Affective Temperament in a Brazilian Population.

Eating-compensatory behaviors are associated with biological and psychological complications, with high rates of morbidity and mortality. Different elements may contribute to the development of eating-compensatory behaviors, such as genetic, physiological, environmental, and temperamental factors. Therefore, the aim of this study was to examine the association between affective temperaments and eating-compensatory behaviors. A sample of 27,501 volunteers, between 18 and 55 years old, mean age 28.9 ± 8.7 years (69.6% women), were assessed by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). The results showed that eating-compensatory behaviors were associated with distinctive affective temperaments. Cyclothymic types were more associated with eating-compensatory behaviors. The avoidant and irritable types presented lower percentages of eating-compensatory behaviors in women and men, respectively. In conclusion, this study highlighted that participants who adopted frequent eating-compensatory behaviors are more likely to have dysfunctional affective traits. Consequently, the affective temperaments should be considered as a strategy to build capacity for prevention, treatment, and care of eating-compensatory behaviors.

Personality factors and cognitive functioning in elderly with Parkinson's disease.

Parkinson's disease (PD) is a chronic and progressive neurological disease, resulting from cell degeneration in the substantia nigra, responsible for the production of dopamine. OBJECTIVE: This study aimed to characterize the cognitive functioning, personality factors and prevalence of depressive and anxiety symptoms in individuals with Parkinson's disease (PD). Furthermore, this study sought to analyze whether personality factors were predictors of cognitive functioning. METHODS: The sample consisted of 30 elderly with PD. Participants completed a sociodemographic data sheet, the NEO-FFI-R (Five Factor Inventory NEO Revised), the Montreal Cognitive Assessment, the Beta-III, the phonemic verbal fluency test and semantics (Animals), the digits span subtest of the Wechsler Intelligence Scale for Adults and the Boston Naming Test and the word list of the CERAD battery, the Geriatric Depression Scale and the Beck Anxiety Inventory. RESULTS: The elderly with PD presented impairment in verbal episodic memory and executive functions. Most of the participants demonstrated low levels of neuroticism. The extraversion factor was positively correlated with executive functions and the openness to experience factor was positively correlated with verbal episodic memory. It was concluded that the elderly with PD presented memory and executive function impairments. The factor that most contributed to performance of the elderly with PD on memory and executive function tasks was the extraversion factor.

A doença de Parkinson (PD) é uma doença neurológica crônica e progressiva, resultante da degeneração celular na substância negra, responsável pela produção de dopamina. OBJETIVO: Este estudo teve como objetivo caracterizar o funcionamento cognitivo, fatores de personalidade e prevalência de sintomas de depressão e ansiedade em indivíduos com doença de Parkinson (DP). Além disso, este estudo procurou analisar se os fatores de personalidade eram preditores de funcionamento cognitivo. MÉTODOS: A amostra foi constituída por 30 idosos com DP. Os participantes responderam a uma ficha de dados sociodemográficos, o NEO-FFI-R (Inventário de Cinco Fatores NEO Revisado), o Montreal Cognitive Assessment (MoCA), o Beta III, o Teste de Fluência Verbal Semântica (Categoria Animais), o Subteste Dígitos da Escala de Inteligência Wechsler para adultos, o teste de nomeação de Boston da bateria CERAD, a Escala de Depressão Geriátrica e o Inventário de Ansiedade de Beck. RESULTADOS: Os idosos com DP apresentaram comprometimento nas funções de memória episódica verbal e funções executivas. A maioria dos participantes demonstrou baixos níveis de neuroticismo. O fator de extroversão foi positivamente correlacionado com as funções executivas e o fator de abertura à experiência foi positivamente correlacionado com a memória episódica verbal. CONCLUSÃO: Conclui-se que idosos com DP apresentam comprometimento na memória e nas funções executivas. O fator que mais contribuiu para o desempenho dos idosos com DP em tarefas de memória e funções executivas foi o fator extroversão.

Personality factors and cognitive functioning in elderly with Parkinson's disease / Fatores de personalidade e funcionamento cognitivo em idosos com doença de parkinson

ABSTRACT Parkinson's disease (PD) is a chronic and progressive neurological disease, resulting from cell degeneration in the substantia nigra, responsible for the production of dopamine. Objective: This study aimed to characterize the cognitive functioning, personality factors and prevalence of depressive and anxiety symptoms in individuals with Parkinson's disease (PD). Furthermore, this study sought to analyze whether personality factors were predictors of cognitive functioning. Methods: The sample consisted of 30 elderly with PD. Participants completed a sociodemographic data sheet, the NEO-FFI-R (Five Factor Inventory NEO Revised), the Montreal Cognitive Assessment, the Beta-III, the phonemic verbal fluency test and semantics (Animals), the digits span subtest of the Wechsler Intelligence Scale for Adults and the Boston Naming Test and the word list of the CERAD battery, the Geriatric Depression Scale and the Beck Anxiety Inventory. Results: The elderly with PD presented impairment in verbal episodic memory and executive functions. Most of the participants demonstrated low levels of neuroticism. The extraversion factor was positively correlated with executive functions and the openness to experience factor was positively correlated with verbal episodic memory. It was concluded that the elderly with PD presented memory and executive function impairments. The factor that most contributed to performance of the elderly with PD on memory and executive function tasks was the extraversion factor.

RESUMO A doença de Parkinson (PD) é uma doença neurológica crônica e progressiva, resultante da degeneração celular na substância negra, responsável pela produção de dopamina. Objetivo: Este estudo teve como objetivo caracterizar o funcionamento cognitivo, fatores de personalidade e prevalência de sintomas de depressão e ansiedade em indivíduos com doença de Parkinson (DP). Além disso, este estudo procurou analisar se os fatores de personalidade eram preditores de funcionamento cognitivo. Métodos: A amostra foi constituída por 30 idosos com DP. Os participantes responderam a uma ficha de dados sociodemográficos, o NEO-FFI-R (Inventário de Cinco Fatores NEO Revisado), o Montreal Cognitive Assessment (MoCA), o Beta III, o Teste de Fluência Verbal Semântica (Categoria Animais), o Subteste Dígitos da Escala de Inteligência Wechsler para adultos, o teste de nomeação de Boston da bateria CERAD, a Escala de Depressão Geriátrica e o Inventário de Ansiedade de Beck. Resultados: Os idosos com DP apresentaram comprometimento nas funções de memória episódica verbal e funções executivas. A maioria dos participantes demonstrou baixos níveis de neuroticismo. O fator de extroversão foi positivamente correlacionado com as funções executivas e o fator de abertura à experiência foi positivamente correlacionado com a memória episódica verbal. Conclusão: Conclui-se que idosos com DP apresentam comprometimento na memória e nas funções executivas. O fator que mais contribuiu para o desempenho dos idosos com DP em tarefas de memória e funções executivas foi o fator extroversão.

Animal Hoarding Disorder: A new psychopathology?

This study aimed to characterize the sociodemographic profile of animal hoarders in a southern city of Brazil. In addition, it aimed to propose Animal Hoarding Disorder as a new nosological category, distinct from Hoarding Disorder. Thirty-three individuals with Animal Hoarding Disorder, 73% female and 60% elderly, composed the sample. The average age of the sample was 61.39 years (SD = 12.69) and the average period that individuals hoarded or lived with a large number of animals was 23.09 years (SD = 15.98.) It was observed that 56.7% of the sample hoarded other inanimate objects, besides the animals. The total number of hoarded animals was 1.357 and the average number of animals per hoarder was approximately 41 (SD = 24.41). Significant differences between hoarding disorder and animal hoarding are discussed. Unlike hoarded objects, hoarded animals generally do not obstruct domicile environments. The processes of disengaging from or donating animals also differ from those of object hoarding, since there is an affectional bond with lives and not with unanimated objects. In this sense, the characterization of Animal Hoarding Disorder as a new mental disorder may arouse great interest from both clinical professionals and researchers.

Animal hoarding disorder: a systematic review / Transtorno de acumulação de animais: uma revisão sistemática / Trastorno de acumulación de animales: una revisión sistemática

The main objective of this systematic review was to identify studies that investigated Animal Hoarding Disorder. In addition, it aimed to verify the sociodemographic characteristics about individuals with this disorder, conditions of the environment and the animals, quantity and species of hoarded animals, the diagnostic criteria and the therapeutic interventions applied. Empirical or documental articles written in English, Spanish or Portuguese were analyzed, with no use of time restrictors. Among 75 articles found 9 were analyzed. It was observed that hoarders were females and approximately hoarded more than 30 animals. The environments were found under unhealthy conditions and cats and dogs were the most hoarded animals. This disorder produces great suffering for the individual, their families and also their animals. It is concluded that due to the lack of empirical studies on the subject, researches need to be made in order to fill this gap and, consequently, to construct intervention strategies.

O objetivo principal deste artigo foi identificar estudos que investigaram o transtorno de acumulação de animais. Além disso, buscou verificar as características sociodemográficas dos indivíduos com esse transtorno, as condições do ambiente e dos animais, quantidade e espécies de animais acumulados, critérios diagnósticos e as intervenções terapêuticas utilizadas. Analisou-se artigos empíricos ou documentais, redigidos na língua inglesa, espanhola ou portuguesa, sem restritor de tempo. Dentre os 75 artigos encontrados, analisou-se nove artigos. Observou-se que os acumuladores, são do sexo feminino e acumulam em média, mais de 30 animais. As condições das habitações eram insalubres, e os animais mais acumulados são cães e gatos. O transtorno produz grande sofrimento para o indivíduo, para sua família e também para os animais. Conclui-se que devido à carência estudos empíricos sobre a temática, pesquisas necessitam ser realizadas para sanar essa lacuna e, consequentemente, construir estratégias de intervenções.

El objetivo principal de este artículo fue identificar estudios que investigaran el trastorno de acumulación de animales. Además, se buscó verificar características sociodemográficas de los individuos con este trastorno, las condiciones del ambiente e de los animales, cantidad y especies de animales acumulados, los criterios diagnósticos y las intervenciones terapéuticas utilizadas. Se analizaron artículos empíricos o documentales, escritos en lengua inglesa, española o portuguesa, sin restricción de tiempo. De los 75 artículos encontrados, nueve fueron analizados. Se observó que los acumuladores, normalmente, eran de sexo femenino y acumulaban en media más de 30 animales. Las condiciones de las viviendas eran insalubres y los animales más acumulados eran canes y gatos. El trastorno produce gran sufrimiento para el individuo, su familia y también para los animales. Se concluye que debido a la falta de estudios empíricos sobre el tema, necesitan ser realizadas investigaciones para llenar este vacío y, consecuentemente, construir estrategias de intervención.