Capacity to Consent to Research Among Adolescent-Parent Dyads in Rakai, Uganda.

OBJECTIVES: To assess the cognitive capacity of early, middle, and late adolescents and their parents or guardians to provide informed consent to a population-based cohort study. STUDY DESIGN: Adolescent-parent/guardian dyads including 40 early (n = 80; 10-14 years), 20 middle (15-17 years), and 20 late (18-19 years) adolescents were recruited from the Rakai Community Cohort Study, an open demographic cohort in Uganda. Participants were administered the MacArthur Competence Assessment Tool for Clinical Research, a structured open-ended assessment; interviews were recorded and transcribed. Twenty transcripts were scored independently by two coders; the intraclass correlation coefficient was 0.89. The remaining interviews were scored individually. We compared mean scores for early and middle/late adolescents using a one-sided t test and score differences between parent/guardian and adolescent dyads using two-sided paired t tests. RESULTS: Early adolescents (mean score, 28.8; 95% CI, 27.1-30.5) scored significantly lower (P < .01) than middle/late adolescents (32.4; 31.6-33.1). In paired dyad comparisons, we observed no statistically significant difference in scores between parents/guardians and middle/late adolescents (difference, -0.2; 95% CI, -1.0-0.6). We found a statistically significant difference in scores between parents/guardians and early adolescents (difference, 3.0; 95% CI, 1.2-4.8). CONCLUSIONS: The capacity of adolescents-of different ages and in diverse settings-to comprehend risks, benefits, and other elements of informed consent is a critical but understudied area in research ethics. Our findings support the practice of having middle and late adolescents provide independent informed consent for sexual and reproductive health studies. Early adolescents may benefit from supported decision-making approaches.

Fish oil and probiotics supplementation through milk chocolate improves spatial learning and memory in male Wistar rats.

Background: Cognition and brain function is critical through childhood and should be improved with balanced diets. Incorporating bioactive ingredients such as omega-3 polyunsaturated fatty acids (ω3 PUFAs) and probiotics into food formulations could be used as an approach to improve cognitive function. This study evaluated the effects on cognitive capacity of complementing rodent diets with chocolate, by itself and in combination with ω3 PUFAs from fish oil and probiotics. Methods: Spatial learning and memory in the rats were determined by the Barnes maze test in short- and long-term memory. Samples from the cecum were obtained to assess microbial counts (Lactobacillus, Bifidobacterium, Enterobacteriaceae, and total bacteria), and brains were recovered to analyze the neural morphology of the tissues. Also, glucose, brain weights, and epididymal tissue were analyzed. Results: The combination of chocolate with fish oil and probiotics improved the memory of rats compared to the result of each bioactive compound when evaluated separately. Treatments did not affect sugar level, epididymal adipose tissue, or brain weight. On the other hand, consuming probiotics alone or in combination with chocolate decreased Enterobacteria counts, while Lactobacillus and Bifidobacteria counts were not affected. Neural morphological analysis showed that combining chocolate with probiotics and ω3 PUFAs increased the number of neurons in the hippocampal CA1 and CA3 regions. Conclusion: Chocolate added with probiotics and ω3 PUFAs improved spatial memory and learning in the studied model.

Influence of Two Different Exercise Programs on Physical Fitness and Cognitive Performance in Active Older Adults: Functional Resistance-Band Exercises vs. Recreational Oriented Exercises.

This study examines the impact of a resistance-band functional exercise program, compared with a recreational exercise program, on physical fitness and reaction times in persons older than 60 years. Fifty-four community-dwelling volunteers (71.76 ± 6.02 years) were assigned to a specific exercise program: Functional activity program (focused on resistance-band multi-joint activities; experimental group, EG), or recreational physical activity program (with gross motor activities of ludic content; control group, CG). Before and after the intervention, we determined cognitive capacity in terms of simple reaction time (S-RT), choice reaction time (C-RT) and fitness. In both groups physical performance improved, though this improvement was more marked in the EG for grip strength, arm strength and gross motor abilities (p < 0.05). Reaction times were better only in EG (S-RT = 10.70%, C-RT = 14.34%; p < 0.05) after the corresponding physical training intervention. The training period showed no effect on the moderate relationship between both RT and gross motor abilities in the CG, whereas the EG displayed an enhanced relationship between S-RT and grip-strength as well as the C-RT with arm strength and aerobic capacity (r ~ 0.457; p < 0.05). Our findings indicate that a functional exercise program using a resistance band improves fitness and cognitive performance in healthy older adults. Key pointsBetter cognitive processes can be achieved as physical condition improvesExercise sessions of a more recreational type do not seem to constitute a stimulus able to improve both physical and cognitive performance in healthy active older adultsThe improvement of cognitive function, as assessed through reaction times, seems more linked to the workload and strength component of the training program.

Associação do estado nutricional com capacidade cognitiva, sexo e idade em idosos residentes na cidade de Maringá/PR / Association of nutritional status with cognitive ability, gender and age in elderly residents in the city of Maringá / PR

Estudos de avaliação do estado nutricional mostram que indivíduos idosos apresentam risco nutricional, que pode estar associado à capacidade cognitiva, sexo e idade. Objetivo - Verificar a associação do estado nutricional com capacidade cognitiva, sexo e idade em idosos residentes na cidade de Maringá/PR. Métodos - O estudo foi de associação, transversal, de base domiciliar, com coleta de dados primários, desenvolvido com idosos ( 60 anos ou mais) da Pastoral da Pessoa Idosa (PPI) da paróquia Santo Antônio de Pádua da cidade de Maringá/PR. As variáveis analisadas foram: capacidade cognitiva, estado nutricional, sexo e idade. A capacidade cognitiva foi avaliada por meio do miniexame do estado mental (MEEM) e o estado nutricional, segundo o indicador nutricional área muscular do braço (AMB). Para verificar a associação entre os agrupamentos foi utilizado o teste qui-quadrado (2) e o teste exato de Fisher. A diferença entre as variáveis e os agrupamentos foi verificada por meio dos testes de Wilcoxon-Mann-Whitney e Kruskal-Wallis. Resultados - Participaram da pesquisa 214 idosos (69,2 por cento mulheres). Quanto ao estado nutricional, 48,6 por cento apresentaram estado nutricional adequado. As mulheres e o grupo etário dos idosos 80 anos apresentaram maior proporção de idosos com estado nutricional adequado (52,7 por cento e 53,7 por cento, respectivamente). Associação estatisticamente significativa foi observada somente entre estado nutricional e sexo. Em relação à capacidade cognitiva, 65,4 por cento dos idosos apresentaram distúrbio cognitivo (DC) (72,9 por cento do sexo feminino). Os idosos sem DC apresentaram maior proporção de idosos com estado nutricional adequado (52,7 por cento), quando comparados aos idosos com DC (46,4 por cento). As mulheres sem DC apresentaram maior proporção de idosos com estado nutricional adequado (56,5 por cento) em relação às mulheres com DC (51,0 por cento), e aos homens com (34,2 por cento) e sem...

Association of nutritional status with cognitive ability, gender and age in elderly residents in the city of Maringá / PR. [thesis]. São Paulo (BR): Faculdade de Saúde Pública da Universidade de São Paulo; 2009. Introduction Studies evaluating the nutritional state show that elderly individuals present nutritional risk that can be associated to cognitive capacity, sex and age. Objective Verify the association of the nutritional state with the cognitive capacity, sex and age in elderly people living in the city of Maringa/PR. Methods It was an associating, transversal and domicile based study, with primary data collection, developed with elderly people ( 60 years old or more) from Pastoral da Pessoa Idosa (PPI) at the parish Santo Antonio de Padua in the city of Maringa/PR. The variables analyzed were: cognitive capacity, nutritional state, sex and age. The cognitive capacity was evaluated through the Mini-Mental State Exam (MMSE) and the nutritional state according to the nutritional indicator arm muscle area (AMA). To verify the association between the groupings, a Chisquare (2) and the Exact Text of Fisher were used. The difference between the variables and the groupings were verified by the tests Wilcoxon-Mann- Whitney and Kruskal-Wallis. Results 214 elderly people participated in the research (69.2 per cent women). Considering the nutritional state, 48.6 per cent presented adequate nutritional state. The women and the 80 years old group presented more proportion of elderly people with adequate nutritional state (52.7 per cent and 53.7 per cent, respectively). Association statistically meaningful was observed only between the nutritional state and sex. In relation to the cognitive...