Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges.

Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.

Assessment of welfare indicators in grazing dairy cows in Northeast Brazil / Avaliação de indicadores de bem-estar em vacas leiteiras a pasto no Nordeste do Brasil

The welfare of dairy cows is a major global concern, due to its impact on cow health and productivity, as well as public health. The aim of this study was to identify the main problems related to welfare in dairy herds managed on pasture in the state of Paraíba, Brazil. For this investigation, a cross-sectional study was conducted in 12 dairy farms in the municipalities of Areia, Alagoa Grande, Serraria, and Pilões, Paraíba, Brazil. Each farm was visited only once, recording the number of cows in the herd, type and number of milkings per day, daily milk yield, and access time to the pasture. Body conditionscore, cleanliness score, bodily injuries, and qualitative behavioral assessment (QBA) were measured. A total of 335 dairy cows were evaluated; herds ranged from 14 to 43 lactating cows, with an average milk yield of 8.4 ± 3.25 kg day-¹. Of the 335 cows observed, 26% had a low body condition score, 82% had bodily injuries, and 20% had dirt on their legs. For the QBA, a principal component analysis (PCA) indicated that PC1 had a high correlation mainly with positive body expressions (e.g., sociable, active, and happy), and PC2 was associated with negative terms of body expression (e.g., apathetic, frustrated, and fearful). In conclusion, evaluating indicators of cows' body condition, bodily injury, and cleanliness highlighted the importance of promoting improvements in pasture, management, and housing conditions to enable better performance, health, and welfare of the animals.

O bem-estar de vacas leiteiras é uma preocupação global, devido ao seu impacto na saúde e produtividade das vacas, bem como na saúde pública. O objetivo deste estudo foi identificar os principais problemas relacionados ao bem-estar em rebanhos leiteiros manejados a pasto no estado da Paraíba, Brasil. Para esta investigação, foi realizado um estudo transversal em 12 fazendas leiteiras nos municípios de Areia, Alagoa Grande, Serraria e Pilões, Paraíba, Brasil. Cada fazenda foi visitada apenas uma vez, registrando se o número de vacas do rebanho, tipo e número de ordenhas por dia, produção diária de leite e tempo de acesso à pastagem. Escore de condição corporal, escore de limpeza, injúrias corporais e avaliação qualitativa do comportamento (AQC) foram medidos. Um total de 335 vacas leiteiras foram avaliadas; os rebanhos variaram de 14 a 43 vacas em lactação, com produção média de leite de 8,4 ± 3,25 kg dia-1.Das 335 vacas observadas, 26% apresentaram baixo escore de condição corporal, 82% sofreram injúrias corporais e 20% apresentaram sujeira nas pernas. Para o AQC, uma análise de componentes principais(ACP) indicou que o CP1 teve alta correlação com expressões corporais positivas (por exemplo, sociável, ativo e contente), e CP2 foi associado a termos negativos de expressão corporal (por exemplo, apático, frustrado e com medo). Em conclusão, a avaliação de indicadores da condição corporal das vacas, injúrias corporais e limpeza destacou a importância de promover melhorias nas pastagens, manejo e condições de alojamento para permitir melhor desempenho, saúde e bem-estar dos animais.

Assessment of welfare indicators in grazing dairy cows in Northeast Brazil / Avaliação de indicadores de bem-estar em vacas leiteiras a pasto no Nordeste do Brasil

The welfare of dairy cows is a major global concern, due to its impact on cow health and productivity, as well as public health. The aim of this study was to identify the main problems related to welfare in dairy herds managed on pasture in the state of Paraíba, Brazil. For this investigation, a cross-sectional study was conducted in 12 dairy farms in the municipalities of Areia, Alagoa Grande, Serraria, and Pilões, Paraíba, Brazil. Each farm was visited only once, recording the number of cows in the herd, type and number of milkings per day, daily milk yield, and access time to the pasture. Body conditionscore, cleanliness score, bodily injuries, and qualitative behavioral assessment (QBA) were measured. A total of 335 dairy cows were evaluated; herds ranged from 14 to 43 lactating cows, with an average milk yield of 8.4 ± 3.25 kg day-¹. Of the 335 cows observed, 26% had a low body condition score, 82% had bodily injuries, and 20% had dirt on their legs. For the QBA, a principal component analysis (PCA) indicated that PC1 had a high correlation mainly with positive body expressions (e.g., sociable, active, and happy), and PC2 was associated with negative terms of body expression (e.g., apathetic, frustrated, and fearful). In conclusion, evaluating indicators of cows' body condition, bodily injury, and cleanliness highlighted the importance of promoting improvements in pasture, management, and housing conditions to enable better performance, health, and welfare of the animals.(AU)

O bem-estar de vacas leiteiras é uma preocupação global, devido ao seu impacto na saúde e produtividade das vacas, bem como na saúde pública. O objetivo deste estudo foi identificar os principais problemas relacionados ao bem-estar em rebanhos leiteiros manejados a pasto no estado da Paraíba, Brasil. Para esta investigação, foi realizado um estudo transversal em 12 fazendas leiteiras nos municípios de Areia, Alagoa Grande, Serraria e Pilões, Paraíba, Brasil. Cada fazenda foi visitada apenas uma vez, registrando se o número de vacas do rebanho, tipo e número de ordenhas por dia, produção diária de leite e tempo de acesso à pastagem. Escore de condição corporal, escore de limpeza, injúrias corporais e avaliação qualitativa do comportamento (AQC) foram medidos. Um total de 335 vacas leiteiras foram avaliadas; os rebanhos variaram de 14 a 43 vacas em lactação, com produção média de leite de 8,4 ± 3,25 kg dia-1.Das 335 vacas observadas, 26% apresentaram baixo escore de condição corporal, 82% sofreram injúrias corporais e 20% apresentaram sujeira nas pernas. Para o AQC, uma análise de componentes principais(ACP) indicou que o CP1 teve alta correlação com expressões corporais positivas (por exemplo, sociável, ativo e contente), e CP2 foi associado a termos negativos de expressão corporal (por exemplo, apático, frustrado e com medo). Em conclusão, a avaliação de indicadores da condição corporal das vacas, injúrias corporais e limpeza destacou a importância de promover melhorias nas pastagens, manejo e condições de alojamento para permitir melhor desempenho, saúde e bem-estar dos animais.(AU)

Methodological strategies for functional analysis and evaluation of obsessive-compulsive behavior / Estratégias metodológicas para avaliação e análise funcional do comportamento obsessivo-compulsivo / Estrategias metodológicas para evaluación y análisis funcional de la conducta obsesiva-compulsiva

The study aimed to identify the controlling variables of obsessive-compulsive behaviors of an adult participant, based on three evaluation strategies. For the first one, Indirect Functional Assessment, the researchers recovered records of therapy sessions attended by the participant, in which conditions favorable to obsessive-compulsive behaviors were described. For the second one, Descriptive Functional Assessment, the researchers observed the participant's behavior during sessions in which they presented tasks previously mentioned as triggering of the problem behavior. For the third one, Brief Functional Analysis - Single Function Test, the researchers manipulated a demand condition and a control condition, aiming to examine the functional hypothesis that the problem behavior would be maintained by escape/avoidance of tasks. Although dissonant, the results allowed the researchers to discard the negative reinforcement hypothesis. The pertinence of the adoption of different evaluation strategies for clinical practice and the frailties of interventions guided only by verbal reports are discussed.

O estudo teve por objetivo identificar variáveis controladoras de comportamentos obsessivo-compulsivos de um participante adulto, com base em três estratégias de avaliação. Na primeira, Avaliação Funcional Indireta, recuperaram-se registros de sessões de terapia frequentadas pelo participante, em que foram descritas condições favorecedoras dos comportamentos obsessivo-compulsivos. Na segunda, Avaliação Funcional Descritiva, observou-se o comportamento do participante em sessões nas quais se dispunham tarefas antes indicadas como desencadeantes do comportamento-problema. Na terceira, Análise Funcional Breve - Teste de Função Única, foram manipuladas condições de demanda e controle, a fim de examinar a hipótese funcional de que o comportamento-problema seria mantido por fuga/ esquiva de tarefas. Embora divergentes, os resultados das avalições permitiram descartar a hipótese de que o comportamento-alvo seria mantido pela retirada da tarefa. Discutem-se a pertinência da adoção de diferentes estratégias de avaliação no trabalho clínico e a fragilidade de intervenções unicamente orientadas por relatos verbais.

El estudio objetivó identificar variables controladoras de la conducta obsesiva-compulsiva de un participante adulto, basando-se en tres estrategias de evaluación. Por la primera, Evaluación Funcional Indirecta, fueran recuperados registros de sesiones de terapia frecuentadas por el participante, en que se describieron condiciones favorecedoras de los comportamientos obsesivo-compulsivos. Por la segunda, Evaluación Funcional Descriptiva, fue observada la conducta del participante en sesiones en las cuales se disponían tareas indicadas como desencadenantes de la conducta-problema. Por la tercera, Análisis Funcional - Prueba de Función Única, fueran manipuladas condiciones de demanda e control, objetivando examinar la hipótesis funcional de que la conducta problema sería mantenida por fuga/evasión de tareas. Aunque divergentes, los resultados permitirán descartar a la hipótesis de que la conducta objetivo sería mantenida por reforzamiento negativo. Se discute la pertinencia de la adopción de diferentes estrategias de evaluación del trabajo clínico, y debilidades de intervenciones únicamente orientadas por relatos verbales.

Attention deficit hyperactivity disorder: From parents to children. / Trastorno por déficit de atención e hiperactividad: de padres a hijos.

INTRODUCTION: Multiple studies of attention deficit hyperactivity disorder (ADHD) have recognised a heritability factor in that a higher frequency of the disorder is observed in children with an affected relative. Our aim was to determine the association between ADHD symptoms in young children enrolled in five schools in Bogota and a history of ADHD symptoms in their parents using the Wender-Utah Rating Scale. METHODOLOGY: Case-control study of participants selected according to DSM-IV criteria for ADHD and the Behavioral Assessment System for Children (BASC) completed by parents and teachers; the WISC-IV scale was used to exclude children with cognitive deficit. Parents completed the Wender-Utah Rating Scale to retrospectively identify any ADHD symptoms in childhood. A score of 36 was used as a cutoff point. RESULTS: The study included 202 children: 117 cases and 85 controls. A positive history of ADHD symptoms in childhood was identified for 16% of 175 mothers and 20.6% of 141 fathers. The presence of symptoms in either parent, especially the mother, constitutes a significant risk factor for ADHD in children and this relationship persists after controlling for different variables. If both parents have the disorder, the risk tends to increase. CONCLUSION: Although ADHD has been linked to a genetic component, other environmental factors may be involved in the disorder.

Trastorno por Déficit de Atención e Hiperactividad (TDAH): prevalencia y características sociodemográficas en población reclusa / Attention Deficit Hyperactivity Disorder (ADHD): prevalence and sociodemographic features in imprisoned population

ResumenDiversos estudios coinciden en señalar que la prevalencia de enfermedades mentales en internos penitenciarios es significativamente mayor que en la población general. En este contexto, la literatura muestra que existe una importante presencia de síntomas del Trastorno por Déficit de Atención con Hiperactividad (TDAH) en esta población. Sin embargo, la investigación al respecto es escasa. En este estudio se estimó la prevalencia con cribado positivo para TDAH en la población penitenciaria, y se establecieron las características sociodemográficas asociadas al trastorno. Se administraron dos escalas de evaluación del TDAH ampliamente empleadas y validadas en población adulta - ASRS y WURS. Los participantes fueron 143 presos del Establecimiento Penitenciario de Villabona (Asturias, España), con un rango de edad entre 18 y 69 años. Los resultados obtenidos indican una prevalencia aparente del TDAH en torno al 25% utilizando ambas escalas y con resultados coincidentes entre ellas. Además se encontraron diferencias significativas por sexo, por nivel de escolaridad y situación laboral, con diferentes perfiles según la presencia de los síntomas del TDAH. Estos resultados evidencian la necesidad de estudiar las consecuencias de este trastorno en la población penitenciaria, con el objeto de mejorar el manejo terapéutico en este contexto, atendiendo a sus características. (AU)

AbstractThere is a good deal of evidence suggesting that the prevalence of mental disorders among imprisoned people is significantly higher that in general population. In this context, literature shows that there is an important presence of Attention Deficit Hyperactivity Disorder (ADHD) within this population. However, research on this topic is lacking. This study estimated the prevalence of ADHD in a penitentiary population by means of positive screening and established the sociodemographic characteristics related to the presence of the disorder. Two different scales of ADHD, widely applied and validated for adult population, were used for this purpose - ASRS and WURS. One-hundred and forty three prisoners between 18 and 69 years old from Villabona's Penitentiary Establishment (Asturias, Spain) took part in this study. Results showed 25% of apparent prevalence of ADHD, using both scales. Statistically significant differences were found in sex, educational level and employment situation, showing different profiles as a function of the presence of ADHD symptoms. These results highlight the need to study the consequences of this disorder within imprisoned populations in order to improve therapeutic management, paying attention to their characteristics. (AU)

Estratégias e instrumentos para a identificação de bullying em estudos nacionais / Strategies and instruments for the identification of bullying in national studies / Estrategias y herramientas para la identificación de bullying en estudios nacionales

No Brasil, estudos sobre bullying são recentes e não há consenso sobre os métodos mais eficazes para a identificação do fenômeno. Este estudo teve como objetivos descrever as estratégias utilizadas para identificar situações de bullying no país e discutir o alcance e limitações destas medidas de avaliação. Foram selecionados estudos publicados entre 2000 e 2012, indexados na LILACS, Pepsic ou SciELO, utilizando-se “bullying” como palavra-chave. Foram encontrados 178 artigos e incluídos 25. Situações de bullying foram identificadas, principalmente por meio de escalas e de questionários padronizados em outros países, sem evidências de validade para a realidade brasileira, e por meio de instrumentos criados pelos próprios pesquisadores. Esses não foram disponibilizados nem descritos na seção de método. Verificou-se fragilidade metodológica na produção sobre rastreamento de bullying no Brasil. Espera-se que este estudo possa contribuir para a elaboração e utilização de medidas mais eficazes de identificação de bullying...

In Brazil, studies about bullying are recent and there is no consensus on the most effective methods to identify the phenomenon. This study aimed to describe the strategies used to identify bullying situations in the country. It also discusses the reach and limitations of the assessment measures. A search was conducted of studies published between 2000 and 2012, indexed in LILACS, Pepsic or SciELO, and using "bullying" as a keyword. From 178 articles, 25 have been included. bullying situations were mainly identified through scales and standardized questionnaires from other countries, without validity evidence for the Brazilian population, and using instruments created by the researchers, which have not been provided or described in the method section. There was methodological weakness in the literature about screening for bullying in Brazil. It is anticipated that this study could contribute to the elaboration and use of more effective screening measures for the identification of bullying...

En Brasil, estudios sobre bullying son recientes y no hay consenso sobre los métodos más eficaces para la identificación del fenómeno. El estudio tuvo como objetivo describir las estrategias utilizadas para identificar situaciones de bullying en el país y discutir los alcances y limitaciones de estas medidas de evaluación. Los estudios publicados entre 2000 y 2012, indexados en LILACS , SciELO o Pepsic, utilizando “bullying” como palabra clave fueron seleccionados. Se encontraron 178 artículos, y 25 fueron incluidos. Situaciones de bullying fueron identificadas principalmente por escalas y cuestionarios estandarizadas en otros países, sin evidencia de validez para la realidad brasileña, y por instrumentos creados por los propios investigadores, sin ellos disponibles o descritos en la sección de método. Hubo debilidad metodológica en la literatura sobre el rastreo de bullying en Brasil. Se espera que este estudio pueda contribuir al desarrollo y la aplicación de medidas más eficaces para identificar bullying...

Estratégias e instrumentos para a identificação de bullying em estudos nacionais / Strategies and instruments for the identification of bullying in national studies / Estrategias y herramientas para la identificación de bullying en estudios nacionales

No Brasil, estudos sobre bullying são recentes e não há consenso sobre os métodos mais eficazes para a identificação do fenômeno. Este estudo teve como objetivos descrever as estratégias utilizadas para identificar situações de bullying no país e discutir o alcance e limitações destas medidas de avaliação. Foram selecionados estudos publicados entre 2000 e 2012, indexados na LILACS, Pepsic ou SciELO, utilizando-se “bullying” como palavra-chave. Foram encontrados 178 artigos e incluídos 25. Situações de bullying foram identificadas, principalmente por meio de escalas e de questionários padronizados em outros países, sem evidências de validade para a realidade brasileira, e por meio de instrumentos criados pelos próprios pesquisadores. Esses não foram disponibilizados nem descritos na seção de método. Verificou-se fragilidade metodológica na produção sobre rastreamento de bullying no Brasil. Espera-se que este estudo possa contribuir para a elaboração e utilização de medidas mais eficazes de identificação de bullying.(AU)

In Brazil, studies about bullying are recent and there is no consensus on the most effective methods to identify the phenomenon. This study aimed to describe the strategies used to identify bullying situations in the country. It also discusses the reach and limitations of the assessment measures. A search was conducted of studies published between 2000 and 2012, indexed in LILACS, Pepsic or SciELO, and using "bullying" as a keyword. From 178 articles, 25 have been included. bullying situations were mainly identified through scales and standardized questionnaires from other countries, without validity evidence for the Brazilian population, and using instruments created by the researchers, which have not been provided or described in the method section. There was methodological weakness in the literature about screening for bullying in Brazil. It is anticipated that this study could contribute to the elaboration and use of more effective screening measures for the identification of bullying.(AU)

En Brasil, estudios sobre bullying son recientes y no hay consenso sobre los métodos más eficaces para la identificación del fenómeno. El estudio tuvo como objetivo describir las estrategias utilizadas para identificar situaciones de bullying en el país y discutir los alcances y limitaciones de estas medidas de evaluación. Los estudios publicados entre 2000 y 2012, indexados en LILACS , SciELO o Pepsic, utilizando “bullying” como palabra clave fueron seleccionados. Se encontraron 178 artículos, y 25 fueron incluidos. Situaciones de bullying fueron identificadas principalmente por escalas y cuestionarios estandarizadas en otros países, sin evidencia de validez para la realidad brasileña, y por instrumentos creados por los propios investigadores, sin ellos disponibles o descritos en la sección de método. Hubo debilidad metodológica en la literatura sobre el rastreo de bullying en Brasil. Se espera que este estudio pueda contribuir al desarrollo y la aplicación de medidas más eficaces para identificar bullying.(AU)

Cognitive features that distinguish preschool-age children with neurofibromatosis type 1 from their peers: a matched case-control study.

OBJECTIVE: To examine the cognitive functioning of 40-month-old children with neurofibromatosis type 1 (NF1). STUDY DESIGN: In this case-control study, 43 children with NF1 and 43 comparison children (matched by age, sex, and maternal years of education) were assessed using the Wechsler Preschool and Primary Scale of Intelligence, Third Edition. Language, visual perception, preliteracy, and executive functioning were also examined. Parents completed questionnaires about their child's behavior. Group differences were examined using the paired-samples t test or the related Wilcoxon signed rank test. Conditional logistic regression was conducted to identify which cognitive variables predicted group membership (ie, NF1 or control). RESULTS: The NF1 group had significantly poorer general intelligence than matched comparisons. Preschool-age children with NF1 had significantly poorer language, visual perception, response inhibition, and preliteracy skills than comparison children. The Wechsler Preschool and Primary Scale of Intelligence, Third Edition, Object Assembly and Information subtests were significant predictors of group membership. Parent ratings indicated no group differences in behavior. CONCLUSIONS: After accounting for potentially confounding variables of age, sex, and maternal years of education, young children with NF1 have significantly poorer intellectual functioning, expressive language, and visual perception. These cognitive features that distinguish young children with NF1 from healthy peers can be detected in the preschool age group and are likely to impact on learning and performance during early school years. These areas should be targeted for intervention to maximize the developmental outcomes of young children with NF1.

Confiabilidad y validación de un modelo de formulación clínica conductual / Reliability and validation of a behavioral model of clinical behavioral formulation

El objetivo de la presente investigación fue determinar la confiabilidad y la validez de contenido y predictiva de un modelo de formulación desarrollado desde una perspectiva conductual. Para ello se utilizó un diseño de investigación mixto que integró niveles de análisis descriptivos y experimentales de caso único A-B-con seguimiento. Se analizó la fiabilidad de las siguientes categorías descriptivas y explicativas: (a) problemas, (b) predisponentes, (c) precipitantes, (d) adquisición y (e) mecanismos inferidos, en formulaciones hechas por terapeutas entre el años 2005 al 2008 y por otros psicólogos con el modelo derivado del presente estudio. Con respecto a la validez, jueces expertos determinaron que el modelo tenía validez de contenido y a través del uso de éste en tres estudios de caso se determinó que tenía validez predictiva. Se discute la importancia de ampliar la investigación con otras poblaciones y establecer la validez concurrente y clínica del modelo.

The aim of this investigation was determined the reliability and content and predictive validity of a clinical case formulation, developed from a behavioral perspective. It was used a mixed design that integrated levels of descriptive analysis and unique case study, A-B with follow. In this study was established the reliability of follow descriptive and explanatory categories: (a) problem description, (b) predisposing, (c) precipitating, (d) acquisition and (e) inferred mechanism (maintenance), the analysis was did with cases attended between 2005 and 2008 and persons that was formulated with the model derived of the current investigation. Regard to validity, expert judges considered that the model had content validity. The predictive validity was established across application of model to three case studies. Discussion shows the importance to extend the investigation with the model in other population and determinate the interformulator and clinical validity of these.