Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic.

OBJECTIVE/BACKGROUND: Unmet needs in perinatal mental healthcare are an important public health issue particularly in the context of a stressful life event such as the COVID-19 pandemic but data on the extent of this problem are needed. AIM: The aim of this study is to determine the (1) proportion of women with clinically significant symptoms of perinatal depression, anxiety or comorbid symptoms of depression and anxiety, receiving mental healthcare overall and by country and (2) factors associated with receiving mental healthcare. METHOD: Women in the perinatal period (pregnancy or up to 6 months postpartum) participating in the Riseup-PPD-COVID-19 cross-sectional study, reported on sociodemographic, social support health-related factors, and COVID-19 related factors, and on symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (Generalised Anxiety Disorder [GAD-7]) using self-report questionnaires. Clinically significant symptoms were defined as EPDS ≥ 13 for depression and GAD-7 ≥ 10 for anxiety. Mental healthcare was defined as self-reported current mental health treatment. RESULTS: Of the 11 809 participants from 12 countries included in the analysis, 4 379 (37.1%) reported clinically significant symptoms of depression (n = 1 228; 10.4%; EPDS ≥ 13 and GAD-7 ⟨ 10), anxiety (n = 848; 7.2%; GAD-7 ≥ 10 and EPDS ⟨ 13) or comorbid symptoms of depression and anxiety (n = 2 303; 19.5%; EPDS ≥ 13 and GAD-7 ≥ 10). Most women with clinically significant symptoms of depression, anxiety, or comorbid symptoms of depression and anxiety were not receiving mental healthcare (89.0%). Variation in the proportion of women with clinically significant symptoms of depression and/or anxiety reporting mental healthcare was high (4.7% in Turkey to 21.6% in Brazil). Women in the postpartum (vs. pregnancy) were less likely (OR 0.72; 95% CI 0.59-0.88), whereas women with previous mental health problems (vs. no previous mental health problems) (OR 5.56; 95% CI 4.41-7.01), were more likely to receive mental healthcare. CONCLUSION: There are high unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety across countries during the COVID-19 pandemic. Studies beyond the COVID-19 pandemic and covering the whole range of mental health problems in the perinatal period are warranted to understand the gaps in perinatal mental healthcare.

Is lower fetal heart rate variability a susceptibility marker to the impact of negative coparenting on infant regulatory capacity?

Lower fetal heart rate variability (FHRV) may be a prenatal endophenotypic susceptibility marker and increase the impact of both positive and negative coparenting on infant regulatory capacity. This study analyzed the moderator role of FHRV in the association between positive and negative coparenting and infant regulatory capacity at 3 months. The sample comprised 86 first-born infants and their mothers and fathers recruited at a public Health Service in Northern Portugal. FHRV was recorded during routine cardiotocography examination at the third trimester of gestation. Mothers and fathers reported on coparenting and infant regulatory capacity at 2 weeks and 3 months postpartum. FHRV moderated the association between mother's and father's negative coparenting at 2 weeks postpartum and infant regulatory capacity at three months. Infants with low FHRV presented higher regulatory capacity when mothers or fathers reported less negative coparenting, while lower regulatory capacity when mothers or fathers reported more negative coparenting, than infants with high FHRV. Findings suggested lower FHRV as a prenatal endophenotypic susceptibility marker that increases the impact of negative coparenting on infant regulatory capacity.

La más baja variabilidad del pulso cardíaco fetal (FHRV) pudiera ser un marcador determinante de la susceptibilidad endofenotípica prenatal y aumentar el impacto de la crianza compartida tanto positiva como negativa sobre la capacidad regulatoria del infante. Este estudio analizó el papel moderador de FHRV en la asociación entre la positiva y negativa crianza compartida y la capacidad regulatoria del infante a los tres meses. El grupo muestra estaba compuesto de 86 infantes primerizos y sus mamás y papás. Se grabó la FHRV durante una examinación de cardiotocografía de rutina en el tercer trimestre de la gestación. Las mamás y los papás reportaron acerca de la crianza compartida y la capacidad regulatoria del infante a las dos semanas y a los tres meses después del parto. La FHRV moderó la asociación entre la crianza compartida negativa de la mamá y del papá a las dos semanas después del parto y la capacidad regulatoria del infante a los tres meses. Los infantes con baja FHRV presentaron una capacidad regulatoria más alta cuando las mamás o los papás reportaron una crianza compartida menos negativa, mientras que la capacidad regulatoria más baja se dio cuando las mamás o los papás reportaron una crianza compartida más negativa, que los infantes con una FHRV alta. Los resultados señalan la más baja FHRV como un marcador determinante de la susceptibilidad endofenotípica prenatal que aumenta el impacto de la crianza compartida negativa sobre la capacidad regulatoria del infante. Los infantes con baja FHRV pueden ser aquellos que mejor desarrollan mecanismos de autorregulación en la presencia de una crianza compartida menos negativa, mientras que están bajo alto riesgo de problemas regulatorios en la presencia de una crianza compartida más negativa.

Une variabilité de la fréquence cardiaque fœtale (VFCF) plus basse pourrait être un marqueur de sensibilité endophénotypique prénatale et augmenter l'impact du coparentage positif et négatif sur la capacité régulatoire du nourrisson. Cette étude a analysé le rôle modérateur de la VFCF dans le lien entre le coparentage positif et négatif et la capacité régulatoire du nourrisson à trois mois. Cet échantillon a inlu 86 nourrisson premiers nés et leurs mères et pères. La VFCF a été enregistrée penfdant un examen de cardiotocographie de routine au troisième trimestre de la grossesse. Les mères et les pères ont fait état de leur coparentage et de la capacité régulatoire du nourrisson à deux semaines et à trois mois postpartum. La VFCF a modéré le lien entre le coparentage négatif de la mère et du père à deux mois postpartum et la capacité régulatoire du nourrisson à trois mois. Les nourrissons avec une VFCF basse ont présenté une capacité régulatoire plus élevée lorsque les mères ou les pères ont signalé moins de coparentage négatif, alors qu'ils ont présenté une capacité régulatoire plus basse lorsque les mères ou les pères ont signalé un coparentage plus négatif, que les nourrissons avec une VFCF élevée. Les résultats ont suggéré une VFCF plus basse comme un marqueur de sensibilité endophénotypique prénatale qui augmente l'impact de coparentage négatif sur la capacité régulatoire du nourrisson. Les enfants avec une VFCF basse peuvent être ceux qui développent mieux leurs mécanismes auto-régulatoires en présence de moins de coparentage négatif, tout en étant à haut risque de problèmes régulatoires en présence de plus de coparentage négatif.

Python-Microscope - a new open-source Python library for the control of microscopes.

Custom-built microscopes often require control of multiple hardware devices and precise hardware coordination. It is also desirable to have a solution that is scalable to complex systems and that is translatable between components from different manufacturers. Here we report Python-Microscope, a free and open-source Python library for high-performance control of arbitrarily complex and scalable custom microscope systems. Python-Microscope offers simple to use Python-based tools, abstracting differences between physical devices by providing a defined interface for different device types. Concrete implementations are provided for a range of specific hardware, and a framework exists for further expansion. Python-Microscope supports the distribution of devices over multiple computers while maintaining synchronisation via highly precise hardware triggers. We discuss the architectural features of Python-Microscope that overcome the performance problems often raised against Python and demonstrate the different use cases that drove its design: integration with user-facing projects, namely the Microscope-Cockpit project; control of complex microscopes at high speed while using the Python programming language; and use as a microscope simulation tool for software development.

The "airgap" and "swirling bubbles" signs in a patient with esophageal carcinoma.

INTRODUCTION: Pneumopericardium is a dreaded complication in esophageal carcinoma. CASE DESCRIPTION: We report a case of a 62 year old patient with past history of esophageal cancer with pneumopericardium, without hemodynamic compromise. Admission echocardiogram that revealed a pneumopericadium with the presence of the "swirling bubbles" and the "air gap" sign. A small esophagopericardial fistula was postulated as the cause of the pneumopericardium. He underwent esophageal stent placement with almost complete resolution of the pneumopericardium. DISCUSSION: Pneumopericardium is usually a sign of marked clinical deterioration in neoplasia and leads to patients' death few weeks. Here we presented a case, in which a more fortunate and unusual outcome happened. CASE DESCRIPTION: We present a case of a 62 year old patient, with a past history of esophageal cancer with pulmonary metastases undergoing palliative chemotherapy treatment and with two palliative esophageal stents. Other past medical history included active hepatitis B, arterial hypertension and dyslipidaemia. He was an ex smoker of 80 pack-year units.

Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex.

OBJECTIVES: We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS: The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS: While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS: Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.

The effect of parenting behaviours on adolescents' rumination: a systematic review of longitudinal studies.

Rumination is an emotional regulation mechanism strongly associated with the development and maintenance of internalising psychopathology in adolescence and adulthood. Parenting behaviours (PBs) play a pivotal role in the development of rumination in children and adolescents. Nonetheless, the specific PBs that can either protect against or increase the risk of rumination development remain poorly understood. This systematic review aimed to explore the (1) temporal associations between PBs and adolescents' rumination and (2) potential moderators influencing these associations. We conducted a comprehensive search across Web of Science, Scopus, PubMed, Academic Search Complete and Eric databases, adhering to PRISMA reporting guidelines. Out of 1,868 abstracts screened, 182 articles underwent full-text examination, with nine meeting the inclusion criteria for the systematic review. Overall, the studies indicated that PBs characterised by criticism, rejection and control were positively associated with the development of rumination in adolescents, whilst PBs marked by authoritative practises exhibited a negative association with rumination. Gender, temperament, environmental sensitivity and pubertal timing emerged as significant moderators in the effects of PBs on rumination. However, conclusions were limited due to the studies' methodological heterogeneity. Future studies on PBs and rumination should address various dimensions of PBs and different moderators to identify factors that can modify the development of rumination across adolescence. Findings may inform family-based prevention programmes to promote emotion regulation in adolescents as a protective factor against internalising psychopathology across adulthood.

Positive coparenting previous to the COVID-19 pandemic can buffer regulatory problems in infants facing the COVID-19 pandemic.

Coparenting can be a development-enhancing or risk-promoting environment for infant regulatory capacity, mainly in the presence of adversity. This study aimed to analyze the association between positive and negative coparenting previous to the COVID-19 pandemic and infant regulatory capacity in the presence of the COVID-19 pandemic, an adverse condition. A sample of 71 first-born infants and their mothers and fathers from a longitudinal cohort in Portugal were assessed at 2 weeks postpartum before the COVID-19 pandemic and again at 6 months postpartum, before (n = 35) or during the COVID-19 pandemic (n = 36). Parents completed measures of positive and negative coparenting and infant regulatory capacity in both assessment waves. Results revealed that the presence of the COVID-19 pandemic moderates the association between mothers' and fathers' positive coparenting previous to the COVID-19 pandemic and infant regulatory capacity at 6 months. The association between positive coparenting and regulatory capacity was stronger in infants facing the COVID-19 pandemic, than in infants who did not face the COVID-19 pandemic. Positive coparenting previous to the COVID-19 pandemic may be a development-enhancing environment for infant regulatory capacity in the presence of the COVID-19 pandemic. Positive coparenting may buffer regulatory problems in infants facing adverse conditions.

Fetal heart rate variability and infant self-regulation: the impact of mother's prenatal depressive symptoms.

BACKGROUND: Foetal heart rate (FHR) variability is considered a marker of foetal neurobehavioral development associated with infant self-regulation and thus may be an early precursor of the adverse impact of mother's prenatal depressive symptoms on infant self-regulation. OBJECTIVE: This study analysed the mediator role of FHR variability in the association between mother's prenatal depressive symptoms and infant self-regulation at three months. METHODS: The sample comprised 86 first-born infants and their mothers. Mothers reported on depressive symptoms at the first trimester of pregnancy and on depressive symptoms and infant self-regulation at three months postpartum. FHR variability was recorded during routine cardiotocography at the third trimester of pregnancy. A mediation model was tested, adjusting for mother's postnatal depressive symptoms. RESULTS: Higher levels of mother's prenatal depressive symptoms were associated with both lower FHR variability and lower infant self-regulation at three months. FHR variability was associated with infant self-regulation and mediated the association between mother's prenatal depressive symptoms and infant self-regulation at three months. CONCLUSION: Findings suggested FHR variability as an early precursor of infant self-regulation that underlies the association between mother's prenatal depressive symptoms and infant self-regulation. Infants of mothers with higher levels of prenatal depressive symptoms could be at risk of self-regulation problems, partially due to their lower FHR variability.

Karitane Parenting Confidence Scale: measuring parenting self-efficacy in Portuguese mothers during the first year postpartum.

BACKGROUND: The Karitane Parenting Confidence Scale (KPCS) was designed to assess parenting self-efficacy in parents of infants during the first year. OBJECTIVE: The aim of this study was to analyse the psychometric characteristics of the KPCS in Portuguese mothers during the first-year postpartum. METHODS: A sample of 383 mothers were recruited at two public outpatient units in Northern Portugal. Mothers completed the KPCS, a sociodemographic questionnaire, and measures of depressive and anxiety symptoms at least one time between two weeks, three, six and 12 months postpartum. RESULTS: Good fit was found for a factor model with three subscales: parenting, support and child development. The KPCS presented good internal consistency. Regarding the criterion validity of the KPCS, significant effects of mother's age were found on the development subscale and significant associations were found between mother's depressive and anxiety symptoms and the KPCS total scale and subscales. Optimal clinical cut-offs were suggested. CONCLUSION: Findings provided evidence on the psychometric characteristics of the KPCS which can be used to assess parenting self-efficacy in Portuguese mothers during the first-year postpartum, possibly identifying mothers with low parenting self-efficacy.

Binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery.

PURPOSE: The aim of the present study was to determine possible associations between binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. METHODS: A cross-sectional study was conducted with 254 obese patients recruited from the general surgery service for bariatric procedures at the hospital affiliated with the Federal University of Pernambuco, Brazil. Evaluations were performed using the Binge Eating Scale (BES), Beck Depression Inventory, Beck Scale for Suicidal Ideation (BSSI) and a questionnaire addressing sociodemographic characteristics. RESULTS: Most patients were women (82%), 48% had a moderate binge eating disorder, 42% a severe binge eating disorder, 32% had symptoms suggestive of mild, moderate or severe depression and 6% had suicidal ideation. Severe binge eating was positively associated with depressive symptoms (p < 0.001) and suicidal ideation (p < 0.05). Cases of severe binge eating were more frequent in young adults, but not necessarily associated with symptoms of depression or suicidal ideation in this portion of the sample. CONCLUSIONS: The present findings underscore the need for psychological and psychiatric follow-up of obese candidates for bariatric surgery using appropriate assessment scales to guide therapeutic approaches. LEVEL III: Evidence obtained from cross-sectional study.

Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents.

PURPOSE: The imposition of the thin body as an ideal of beauty and the changes that occur in adolescence lead to a constant concern with adolescents' body weight, putting them at risk for eating disorders. Thus, the study sought to investigate associations between eating disorders and salivary cortisol concentrations, nutritional status and depressive symptoms in female adolescents with bulimia. METHODS: A cross-sectional study was carried out with 1435 adolescents aged 10-19 years. The Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ) questionnaires were used. A follow-up study was conducted from a random selection of female adolescents diagnosed with Bulimia Development and Well-Being Assessment-(DAWBA) to assess associations with salivary cortisol concentrations and nutritional status. RESULTS: The prevalence of body dissatisfaction among adolescents with symptoms of bulimia was 37%. There was a significant difference between salivary cortisol and bulimia (Risk Group = 0.33 ± 0.20 µg/100 ml, Diagnostic Group = 0.44 ± 0.21 µg/100 ml p = 0.040), and correlation positive between the risk of bulimia with symptoms of depression (0.355 p = 0.002) and with Body Mass Index (0.259 p = 0.028). High concentrations of salivary cortisol in bulimic adolescents may be associated with hyperactivity of the hypothalamic-pituitary-adrenal axis and depressive symptoms. CONCLUSIONS: Nutritional status indicators cannot be used alone for the diagnosis of bulimia, since cortisol levels seem to be a reliable parameter in the identification of bulimia, provided they are used with other diagnostic criteria. LEVEL III: Evidence obtained from cross-sectional study.

Intermittent Hypobaric Hypoxic Preconditioning Provides Neuroprotection by Increasing Antioxidant Activity, Erythropoietin Expression and Preventing Apoptosis and Astrogliosis in the Brain of Adult Rats Exposed to Acute Severe Hypoxia.

BACKGROUND: Exposure to intermittent hypoxia has been demonstrated to be an efficient tool for hypoxic preconditioning, preventing damage to cells and demonstrating therapeutic benefits. We aimed to evaluate the effects of respiratory intermittent hypobaric hypoxia (IHH) to avoid brain injury caused by exposure to acute severe hypoxia (ASH). METHODS: biomarkers of oxidative damage, mitochondrial apoptosis, and transcriptional factors in response to hypoxia were assessed by Western blot and immunohistochemistry in brain tissue. Four groups of rats were used: (1) normoxic (NOR), (2) exposed to ASH (FiO2 7% for 6 h), (3) exposed to IHH for 3 h per day over 8 days at 460 mmHg, and (4) ASH preconditioned after IHH. RESULTS: ASH animals underwent increased oxidative-stress-related parameters, an upregulation in apoptotic proteins and had astrocytes with phenotype forms compatible with severe diffuse reactive astrogliosis. These effects were attenuated and even prevented when the animals were preconditioned with IHH. These changes paralleled the inhibition of NF-κB expression and the increase of erythropoietin (EPO) levels in the brain. CONCLUSIONS: IHH exerted neuroprotection against ASH-induced oxidative injury by preventing oxidative stress and inhibiting the apoptotic cascade, which was associated with NF-κB downregulation and EPO upregulation.

Interaction between the Renin-Angiotensin System and Enteric Neurotransmission Contributes to Colonic Dysmotility in the TNBS-Induced Model of Colitis.

Angiotensin II (Ang II) regulates colon contraction, acting not only directly on smooth muscle but also indirectly, interfering with myenteric neuromodulation mediated by the activation of AT1 /AT2 receptors. In this article, we aimed to explore which mediators and cells were involved in Ang II-mediated colonic contraction in the TNBS-induced rat model of colitis. The contractile responses to Ang II were evaluated in distinct regions of the colon of control animals or animals with colitis in the absence and presence of different antagonists/inhibitors. Endogenous levels of Ang II in the colon were assessed by ELISA and the number of AT1/AT2 receptors by qPCR. Ang II caused AT1 receptor-mediated colonic contraction that was markedly decreased along the colons of TNBS-induced rats, consistent with reduced AT1 mRNA expression. However, the effect mediated by Ang II is much more intricate, involving (in addition to smooth muscle cells and nerve terminals) ICC and EGC, which communicate by releasing ACh and NO in a complex mechanism that changes colitis, unveiling new therapeutic targets.

Non-invasive ventilation in the elderly - never too late!

Dear Editor, Practising evidence-based medicine in an ageing population is challenging. Nevertheless, using age as a diagnostic or therapeutic procedure contraindication is less and less common. Domiciliary non-invasive ventilation (NIV) in chronic respiratory failure patients has been largely used; however, data from older people is scarce...

Depression and paternal adjustment and attitudes during the transition to parenthood.

BACKGROUND: Depression symptoms may negatively affect the achievement of developmental tasks within the transition to parenthood, increasing the risk of paternal adjustment problems and negative paternal attitudes. OBJECTIVE: This study analysed the effect of men's depression symptoms on paternal adjustment and paternal attitudes trajectories from the second trimester of pregnancy to six months postpartum. METHODS: A sample of 127 men completed measures of depression symptoms and paternal adjustment and paternal attitudes at the second trimester of pregnancy and at six months postpartum. RESULTS: From the second trimester of pregnancy to six months postpartum, men with more depression symptoms revealed a decrease on positive attitudes towards sex (while men with fewer depression symptoms revealed an increase), a steeper decrease in the satisfaction with marital relationship (than men with fewer depression symptoms), and a decrease in positive attitudes towards pregnancy and the baby (while men with fewer depression symptoms revealed an increase). CONCLUSION: Depression symptoms early in pregnancy may represent a risk factor to increased paternal adjustment problems and negative paternal attitudes during the transition to parenthood.

Optical parametric chirped pulse amplifier producing ultrashort 10.5 mJ pulses at 1.55 µm.

We present an optical parametric chirped pulse amplifier (OPCPA) delivering 10.5 mJ pulses with durations down to 220 fs, at 100 Hz repetition rate, centered at 1550 nm. The system is pumped by a picosecond Nd:YAG amplifier at 1064 nm based on quasi-continuous-wave diode pumping and seeded by a femtosecond mode-locked Er fiber laser at 1550 nm. This choice of wavelengths enables the use of well-established technology and optical components for both pump and signal beams, resulting in a straightforward and robust system design and the ability for further power scaling to be used in high-energy laser-produced plasma experiments.

Accuracy and Psychometric Properties of the Brazilian Version of the Montreal Cognitive Assessment as a Brief Screening Tool for Mild Cognitive Impairment and Alzheimer's Disease in the Initial Stages in the Elderly.

OBJECTIVE: To evaluate the applicability and the psychometric properties of Montreal Cognitive Assessment Brazilian Version (MoCA-BR) in the elderly, as well as comparing its accuracy as a tracking test for mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) with the accuracy of Mini-Mental State Examination (MMSE). METHOD: A transversal study was performed in 4 reference medical centers that care for the elderly. In all, 229 elderly participated in the study. To select the sample, the clinical history of the elderly, Pfeffer Functional Activities Questionnaire, and neuropsychological battery, apart from MMSE and MoCA-BR cognitive tests, were selected. The elderly were classified into control, MCI, and mild AD groups. RESULTS: There was a significant statistical difference between the MoCA-BR scores of the elderly and the control group, MCI, and mild AD (p < 0.001). The Cronbach alpha for MoCA-BR was 0.77, indicating a good internal consistency. The test-retest reliability was elevated, with intraclass correlation coefficient (ICC) 0.91. The inter-examiner reliability was excellent (ICC 0.96). The area under curve of the receiver operating characteristics curve was 0.95, when evaluating the ability of MoCA-BR to discriminate between the elderly with cognitive impairment and cognitively healthy elderly. CONCLUSIONS: The results of the study show that the Brazilian version of MoCA is a reliable cognitive tracking tool and is accurate for the detection of MCI and early stage AD, with good applicability on the elderly with education equal to or more than 4 years and adequate to discriminate between cognitively healthy elderly, and those with MCI and mild, proving to be superior to MMSE in tracking MCI and similar to this test when tracking mild AD.

Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) in the elderly?

ABSTRACTObjective:To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer's Disease (AD). METHOD: A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2). RESULT: More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p < 0.001]. CONCLUSION: The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.

Attachment and coparenting representations in men during the transition to parenthood.

Coparenting is based on parents' representations of themselves as coparents. Attachment theory can be a useful framework to understand the way that different coparenting representations are developed during the transition to parenthood. This study aimed to analyze the association between men's attachment and coparenting representations at the first trimester of pregnancy and from the first trimester of pregnancy to 6 months' postpartum. A sample of 86 men was recruited and completed self-report measures of attachment and coparenting representations at the first and third trimester of pregnancy and at 1 and 6 months' postpartum. At the first trimester of pregnancy, higher attachment avoidance was associated with higher lack of coparenting support. From the first trimester of pregnancy to 6 months' postpartum, higher attachment avoidance was associated with (a) a steeper increase on lack of coparenting support, (b) an increase on coparenting conflict (while low attachment avoidance was associated with a decrease), and (c) a lower decrease on coparenting disagreement. This study may contribute to coparenting research by showing new evidence on attachment theory as a useful framework to understand how different coparenting representations are developed in men during the transition to parenthood.

La crianza compartida se basa en las representaciones que cada progenitor tiene de sí como responsable en conjunto de la crianza. La teoría de la afectividad puede ser un marco útil para comprender la manera como diferentes representaciones de la crianza compartida se desarrollan durante la transición a ser padres. Este estudio se propuso como meta analizar la asociación entre la afectividad de los hombres y las representaciones de la crianza compartida durante el primer trimestre del embarazo y a partir del primer trimestre del embarazo a los seis meses después del parto. Se reclutó un grupo muestra de 86 hombres quienes completaron medidas de auto-reporte sobre la afectividad y las representaciones de la crianza compartida al primer y tercer trimestre del embarazo, y al mes y seis meses después del parto. Al primer trimestre del embarazo, un más alto sentido de evitar la afectividad se asoció con una mayor falta de apoyo a la crianza compartida. Del primer trimestre del embarazo a los seis meses posteriores al parto, el más alto sentido de evitar la afectividad se asoció con (1) un más profundo aumento en la falta de apoyo a la crianza compartida, (2) un aumento en el conflicto de crianza compartida (mientras que el bajo nivel del sentido de evitar la afectividad se asoció con una baja), y (3) una más baja disminución en el desacuerdo de la crianza compartida. Este estudio pudiera contribuir a la investigación sobre la crianza compartida al mostrar nueva evidencia sobre la teoría de la afectividad como un marco útil para comprender cuán diferentemente se desarrollan las representaciones de crianza compartida en los hombres durante la transición a la paternidad.

Le coparentage est basé sur les représentations des parents d'eux-mêmes en tant que coparents. La théorie de l'attachement peut être une structure utile pour comprendre la manière dont différentes représentations de coparentages se développent durant la transition au parentage. Cette étude s'est donné pour but d'analyser l'association entre l'attachement des hommes et les représentations de coparentage durant le premier trimestre de la grossesse et du premier trimestre de la grossesse à six mois après la naissance. Un échantillon de 86 hommes a été recruté et a rempli des mesures auto-rapportées d'attachement et des représentations de coparentage au premier et au troisième trimestre de la naissance, et à un an et six mois après la naissance. Au premier trimestre de la grossesse le fait d'éviter l'attachement était lié à un manque de soutien de coparentage plus élevé. Du premier trimestre de la grossesse à six mois postpartum, le fait d'éviter l'attachement était lié à (1) une plus forte augmentation du manque de soutien de coparentage, (2) une augmentation du conflit de coparentage (alors qu'un faible fait d'éviter l'attachement était lié à une décroissance), et (3) une baisse du désaccord de coparentage. Cette étude contribue aux recherches sur le coparentage en montrant de nouvelles preuve de la théorie de l'attachement en tant que structure utile pour comprendre comment des représentations différentes de coparentage se développent chez les hommes durant la transition au parentage.

Influence of Age and Education on the Performance of Elderly in the Brazilian Version of the Montreal Cognitive Assessment Battery.

AIMS: To provide normative data for the Brazilian version of the Montreal Cognitive Assessment (MoCA-BR) and to measure the effect of sociodemographic variables on the cognitive performance of cognitively healthy elderly people. METHODS: A sample of 110 cognitively healthy individuals, aged over 65 years, with at least 4 years of schooling were recruited from 3 health care centers for the elderly in Recife, Brazil. The cognitive performance was assessed using MoCA-BR. RESULTS: The average score of these elderly people in the MoCA-BR was 23.2 ± 2.7. Their schooling correlated positively with the cognitive performance, with a Spearman's coefficient of 0.33 (p < 0.001). There was a statistically significant negative correlation between age and the cognitive performance (Spearman's rho = -0.19). The multiple linear regression model with the highest adjusted coefficient of determination was the one that included schooling and age (adjusted R2 = 0.127). CONCLUSIONS: The cognitive performance of healthy elderly was evaluated and was strongly influenced by schooling and, to a lower degree, by age.