Introdução: O tipo de dieta ingerido pelo indivíduo apresenta relação com a ocorrência de doenças cardiovasculares (DCV), e também com o desempenho cognitivo. As dietas vegetarianas promovem proteção cardiovascular, e parecem estar relacionadas com o desempenho cognitivo. A população de membros da Igreja Adventista do Sétimo Dia (ASD) tem sido estudada por apresentar menor frequência de DCV e de alguns tipos de câncer, e maior longevidade, e um dos hábitos fortemente associados a essas características é a dieta dessa população, que compreende grande número de vegetarianos. No entanto, apesar de as dietas vegetarianas serem frequentes entre os ASD, pouquíssimos estudos têm avaliado o desempenho cognitivo dessa população. O estudo ADVENTO é um estudo longitudinal que buscou avaliar o perfil de saúde de ASD onívoros, ovolactovegetarianos e vegetarianos estritos, utilizando-se de dados sóciodemográficos, cognitivos, psicológicos, dietéticos e cardiometabólicos dessa população. O presente trabalho é um sub-estudo do estudo ADVENTO, e pretende analisar os aspectos cognitivos de sua amostra, associando-os aos marcadores cardiometabólicos e à dieta da mesma. Objetivo: Comparar o desempenho cognitivo dos participantes do estudo ADVENTO praticantes das dietas onívora, ovolactovegetariana e vegetariana estrita, e associá-lo aos marcadores cardiometabólicos e aos tipos e características da dieta da amostra do estudo. Método: Os dados do estudo ADVENTO foram coletados entre março de 2013 e agosto de 2016, no Hospital Universitário da USP, gerando uma amostra composta por 1404 indivíduos ASDs, entre 35 e 74 anos, residentes no estado de São Paulo, divididos em 3 grupos: 542 onívoros, 617 ovolactovegetarianos e 239 vegetarianos estritos. Foram coletados marcadores cardiometabólicos como: índice de massa corporal (IMC), pressão arterial, frequência cardíaca, glicemia de jejum e colesterol total. A avaliação neuropsicológica foi composta por três subtestes da bateria Consortium to Establish a Registry for Alzheimer\'s Disease (CERAD): Lista de Palavras, Fluência Verbal e Teste das Trilhas (Forma B). O padrão dietético foi classificado com base em um questionário de frequência alimentar validado para a dieta brasileira. Quanto à análise estatística, os testes Kruskal-Wallis e Quiquadrado foram utilizados para as análises descritivas e para comparação do desempenho cognitivo entre os grupos, bem como da frequência de ocorrência de baixo desempenho cognitivo, e a análise de regressão logística foi utilizada para verificar a associação entre os marcadores cardiometabólicos e o baixo desempenho cognitivo, e também entre a dieta, bem como o consumo dos grupos de alimentos, e o baixo desempenho cognitivo. Resultados: Quanto ao desempenho nos testes cognitivos, na amostra total, o grupo de onívoros apresentou desempenho independentemente inferior ao do grupo de ovolactovegetarianos na fluência verbal semântica e nas funções executivas. Na amostra de adultos, o grupo de onívoros apresentou desempenho independentemente inferior ao do grupo de ovolactovegetarianos e ao de vegetarianos estritos nas funções executivas, e o grupo de vegetarianos estritos apresentou desempenho independentemente inferior ao de ovolactovegetarianos nas funções executivas. Na amostra de idosos, não foram observadas diferenças. Quanto à prevalência de desempenho baixo, na amostra total, o grupo de onívoros apresentou maior prevalência que o grupo de ovolactovegetarianos de desempenho baixo nas funções executivas e na função global, e o grupo de ovolactovegetarianos apresentou menor prevalência que o grupo de vegetarianos estritos de desempenho baixo na função global. Na amostra de adultos, o grupo de onívoros apresentou maior prevalência que o grupo de ovolactovegetarianos de desempenho baixo nas funções executivas e na função global, e também que o grupo de vegetarianos estritos de desempenho baixo nas funções executivas. Na amostra de idosos, o grupo de vegetarianos estritos apresentou maior prevalência que os grupos de ovolactovegetarianos e de onívoros de desempenho baixo na função global. Quanto à relação entre as variáveis cardiometabólicas e a cognição, na amostra total, o aumento da glicemia de jejum apresentou relação independente com maior ocorrência de desempenho baixo nas funções executivas. Na amostra de adultos, o aumento do IMC apresentou relação independente com maior ocorrência de desempenho baixo na fluência e o aumento da glicemia de jejum apresentou relação independente com maior ocorrência de desempenho baixo nas funções executivas. Na amostra de idosos, o aumento do IMC apresentou relação independente com menor ocorrência de desempenho baixo na função global, o aumento da pressão arterial sistólica apresentou relação independente com menor ocorrência de desempenho baixo na memória e o aumento da pressão arterial diastólica apresentou relação independente com menor ocorrência de desempenho baixo na fluência, mas o aumento do colesterol total apresentou relação independente com maior ocorrência de desempenho baixo na função global. Quanto à relação entre a dieta e a cognição, na amostra total, pertencer ao grupo de ovolactovegetarianos apresentou relação independente com menor ocorrência de desempenho baixo nas funções executivas e na função global, quando comparado ao grupo de onívoros, e pertencer ao grupo que incluía todos os vegetarianos apresentou relação independente com menor ocorrência de desempenho baixo nas funções executivas, quando comparado ao grupo de onívoros. Na amostra de adultos, pertencer ao grupo de ovolactovegetarianos apresentou relação independente com menor ocorrência de desempenho baixo nas funções executivas e na função global, quando comparado ao grupo de onívoros, e pertencer ao grupo que incluía todos os vegetarianos apresentou relação independente com menor ocorrência de desempenho baixo nas funções executivas e na função global, quando comparado ao grupo de onívoros. Na amostra de idosos, pertencer ao grupo de vegetarianos estritos apresentou relação independente com maior ocorrência de desempenho baixo na memória, nas funções executivas e na função global, e o aumento do consumo de frutas apresentou associação independente com maior ocorrência de desempenho baixo na memória. Conclusão: No presente trabalho, tanto na amostra total quanto na amostra de adultos, a dieta onívora apresentou associação independente com pior perfil de desempenho cognitivo, quando comparada à dieta ovolactovegetariana, e também à dieta vegetariana estrita, e esta última apresentou associação independente com pior perfil de desempenho cognitivo, quando comparada à dieta ovolactovegetariana. Na amostra de idosos, a dieta vegetariana estrita apresentou associação independente com pior perfil de desempenho cognitivo, quando comparada à dieta onívora / Introduction: The type of diet consumed by the individual is related to the occurrence of cardiovascular diseases (CVD), and also to cognitive performance. Vegetarian diets promote cardiovascular protection, and seem to be related to cognitive performance. Members of the Seventh-day Adventist Church (SDA) have been studied because they present lower rates of CVD and some types of cancer, and higher rates of longevity, and one of the habits strongly associated with those characteristics is the SDA diet, which comprises large number of vegetarians. Although vegetarian diets are usual among SDAs, very few studies have evaluated the cognitive performance of this population. The ADVENTO study is a longitudinal study designed to evaluate the health profile of omnivorous, lacto-ovo-vegetarian and vegetarian SDAs, through the collection of socio-demographic, cognitive, psychological, dietary and cardiometabolic data. The present work is a sub-study of the ADVENTO study, and intends to analyze the cognitive aspects of its sample, associating them with cardiometabolic markers and dietary aspects. Objective: To compare the cognitive performance of the ADVENTO study participants consuming omnivorous, lacto-ovo-vegetarian and strict vegetarian diets, and to associate it with cardiometabolic markers and dietary patterns, as well as diet characteristics, of the study sample. Method: Data from the ADVENTO study were collected between March 2013 and August 2016 at the University Hospital of the University of São Paulo (USP), Brazil, generating a sample composed of 1404 SDA individuals aged 35-74y, living in São Paulo state, divided into 3 groups: omnivores (n=542), lactoovo-vegetarians (n=617) and strict vegetarians (239). We collected cardiometabolic markers such as: body-mass index (BMI), blood pressure, heart rate, fasting blood glucose and total cholesterol. The neuropsychological evaluation was composed of three subtests from the Consortium to Establish a Registry for Alzheimer\'s Disease (CERAD) battery: Word List Learning, Verbal Fluency and Trail Making Test (Form B). The dietary pattern was classified based on a food frequency questionnaire validated for the Brazilian diet. Regarding the statistical analysis, the Kruskal-Wallis and Chi-square tests were used for the descriptive analyzes and for comparing the cognitive performance between the groups, as well as the frequency in which low cognitive performance occurred, and the logistic regression analysis was used to verify the association between cardiometabolic markers and low cognitive performance, and also between diet, as well as the consumption of food groups, and low cognitive performance. Results: Regarding the performance on the cognitive tests, in the total sample, the omnivore group performed independently lower than the lacto-ovo-vegetarian group on verbal semantic fluency and on the executive functions. In the adult sample, the omnivore group performed independently lower than the lacto-ovo-vegetarian group and than the strict vegetarian group on the executive functions, and the strict vegetarian group performed independently lower than the lacto-ovo-vegetarian group on the executive functions. In the elderly sample, no differences were observed. Regarding the prevalence of low performance, in the total sample, the omnivore group presented a higher prevalence than the lacto-ovo-vegetarian group of low performance on the executive functions and on global function, and the lacto-ovo-vegetarian group presented a lower prevalence than the strict vegetarian group of low performance on global function. In the adult sample, the omnivore group presented a higher prevalence than the lactoovo-vegetarian group of low performance on the executive functions and on global function, and than the strict vegetarian group of low performance on the executive functions. In the elderly sample, the strict vegetarian group presented a higher prevalence than the lacto-ovo-vegetarian group and than the omnivore group of low performance on global function. Regarding the relationship between the cardiometabolic variables and cognition, in the total sample, the increase in fasting blood glucose presented an independent relationship with a higher occurrence of low performance on the executive functions. In the adult sample, the increase in BMI presented an independent relationship with a higher occurrence of low performance on fluency, and the increase in fasting blood glucose presented an independent relationship with a higher occurrence of low performance on the executive functions. In the elderly sample, the increase in BMI presented an independent relationship with a lower occurrence of low performance on global function, the increase in systolic blood pressure presented an independent relationship with a lower occurrence of low performance on memory, and the increase in diastolic blood pressure presented an independent relationship with a lower occurrence of low performance on fluency, but the increase in total cholesterol presented an independent relationship with a higher occurrence of low performance on global function. Regarding the relationship between diet and cognition, in the total sample, belonging to the lacto-ovo-vegetarian group represented an independent relationship with lower occurrence of low performance on the executive functions and on global function, compared to the omnivore group, and belonging to the group which included all vegetarians, represented an independent relationship with a lower occurrence of low performance on the executive functions, compared to the omnivore group. In the adult sample, belonging to the lacto-ovo-vegetarian group represented an independent relationship with lower occurrence of low performance on the executive functions and on global function, compared to the omnivore group, and belonging to the group that included all vegetarians represented an independent relationship with lower occurrence of low performance on the executive functions and on global function, compared to the omnivore group. In the elderly sample, belonging to the strict vegetarian group represented an independent relationship with a higher occurrence of low performance on memory, low performance on the executive functions and low performance on global function, and the increase in fruit consumption presented an independent relatioship with a higher occurrence of low performance on memory. Conclusion: In the present study, the omnivore diet presented an independent association with a worse cognitive performance profile, both in the total sample and in the adult sample, compared to the lacto-ovovegetarian diet, as well as to the strict vegetarian diet, and the latter presented an independent association with a worse cognitive performance profile, compared to the lacto-ovo-vegetarian diet. In the elderly sample, the strict vegetarian diet presented an independent association with a worse cognitive performance profile compared to the omnivore diet

Bakgrund: Sjuksköterskor som vårdar patienter med demenssjukdom uttrycker att det behövs nya idéer för hur man kan stödja patienternas närstående för att öka den upplevda livskvalitén i situationen. Närstående uttrycker ofta en upplevd hopplöshet och vänder sig främst till sjuksköterskor när de är i behov av stöd för att själva inte drabbas av ångest eller depressioner. Sjuksköterskor uttrycker samtidigt att de inte alltid har möjlighet att se till närståendes behov fullt ut, eftersom det ofta kräver ett stort engagemang och arbete som inte ryms i deras begränsade arbetspass. Syfte: Att beskriva sjuksköterskors upplevelser av att stödja närstående till patienter med demenssjukdom. Metod: En kvalitativ litteraturstudie med beskrivande syntes. Resultat: Två teman formulerades: Att hantera komplexiteten och Att vara varandras resurser. Utifrån temana formulerades fyra subteman: Att försöka förstå närståendes situation, Att begränsas av organisatoriska resurser, Att lindra närståendes lidande och Att kommunicera med närstående. Tillsammans beskriver temana och subtemana sjuksköterskors upplevelser av att stödja närstående till patienter med demenssjukdom. Slutsats: Sjuksköterskorna upplever att det är svårt att stödja närstående i tillräckligt stor utsträckning, eftersom det begränsas av tid, möjlighet och kunskap. / Background: Nurses who care for patients with dementia express that new ideas are needed for how to support the patients' next of kin in order to increase the perceived quality of life in the situation. Patients’ next of kin often express a perceived hopelessness and primarily turn to nurses when they are in need of support for themselves not suffering from anxiety or depression. Nurses at the same time express that they do not always have the opportunity to fully attend the needs of their next of kin, as it often requires a great deal of commitment and work that does not fit into their limited workload. Purpose: To describe nurses' experiences of supporting patients with dementia next of kin. Method: Qualitative study with descriptive synthesis. Result: Two themes were formulated: Managing complexity and Being each other's resources. Based on themes, four sub-themes were formulated: Trying to understand patients next of kin’s current situation, To be limited by organizational resources, To ease the suffering of patients next of kin and To communicate with patients next of kin. Together, themes and sub-themes describe nurses' experiences of supporting patients with dementia next of kin. Conclusions: Nurses find it difficult to be able to support the patients’ next of kin on the level that they wanted to, as it is limited by time, opportunity and knowledge.

This study gives a platform to three old retired people who are constructed to be enjoying well-being and life satisfaction or going through life dissatisfaction after retirement. The epistemological framework was social constructionism. In-depth interviews with these three individuals were carried out. The premises of qualitative research were followed. The ‘case study approach’ was chosen as the most suitable method to gather information. Thematic content analysis was employed as a method of analysis of life stories of old retired people, which were reconstructed in terms of themes. Recurring themes in the life stories were then discussed and linked with the broader literature. The research allowed rich and informative information about life stories of three old retired people to emerge. Among the identified themes were financial status relating to adequate and appropriate sustenance after retirement; social networks and their effects on life satisfaction and dissatisfaction after retirement; health status; and cognitive functions in late adulthood. Everyone wishing to understand life in old age after retirement is encouraged to read this story. It is necessary to be sufficiently equipped in the event of an extended lifespan. / Psychology / M.A.(Psychology)

Die Ergebnisse von Studien, die den Einfluss neuroleptischer Medikation auf kognitive Funktionen schizophrener Patienten untersuchten, waren bisher widersprüchlich. Ziel dieser Arbeit war die Prüfung, ob Beeinträchtigungen kognitiver Funktionen sowohl bei unbehandelten als auch mit konventionellen bzw. atypischen Neuroleptika behandelten schizophrenen Patienten im Vergleich zu gesunden Probanden nachweisbar sind. Es wurden 44 stationäre schizophrene Patienten und 51 gesunde Kontrollprobanden mit einer modifizierten, neuropsychologischen Testbatterie untersucht. Nach 8-11 Wochen erfolgte eine Wiederholungsmessung. Bei den schizophrenen Patienten konnte eine generalisierte kognitive Störung festgestellt werden. Der Vergleich des Behandlungseffektes der Atypika mit der Veränderung der Testleistung bei den gesunden Kontrollen bei Wiederholungsmessung ergab, dass der "Behandlungserfolg" durch die Atypika kleiner als die Verbesserung der kognitiven Defizite bei den gesunden Kontrollen bei Wiederholungsmessung ist. Die günstigen Effekte der Atypika auf die kognitiven Fähigkeiten bei schizophrenen Patienten sind demnach zwar vorhanden, aber im Vergleich zu den "Lerneffekten" bei gesunden Probanden eher klein. Weiterhin wurde eine Dosisabhängigkeit bestimmter kognitiver Funktionen (Perseveration, motorische Fähigkeiten) bei Patienten, die mit konventionellen Neuroleptika behandelt wurden, gefunden. Bei Atypika konnte dieser Zusammenhang nicht beobachtet werden. Atypische Neuroleptika könnten für schizophrene Patienten, die eine hohe Neuroleptikadosis benötigen, bezüglich kognitiver Funktionen besser verträglich sein. / The findings of studies investigating the effects of neuroleptics on the cognitive function in patients with schizophrenia have been inconsistent. The aim of this study was to investigate the effects of conventional and atypical neuroleptics on cognitive function in schizophrenic patients compared to drug-free patients and healthy controls. 44 schizophrenic in-patients and 51 healthy subjects were assessed with a modified neuropsychological test battery. After 8-11 weeks a repeat assessment was done. Patients with schizophrenia had generalized cognitive deficits. Comparing the treatment effect of atypical neuroleptics in patients with schizophrenia with the improvement of the test performance in the repeat assessment in healthy controls, it was found that the "treatment success" is less pronounced than the improvement after repeat assessment in healthy controls. This shows that there are positive effects of atypical neuroleptics on cognitive function, but compared to the "learning effects" of healthy controls it is small. Furthermore, it could be shown that some effects of conventional neuroleptics on cognitive function and psychomotor performance were dose-dependent. This effect was not observed with atypical neuroleptics. The main conclusions were that atypical neuroleptics are more acceptable also in higher dosage. Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from atypical antipsychotic drugs.

The aim of this final thesis is to apply Feuerstein's instrumental enrichment program (FIE) to a person with traumatic brain injury (TBI). The theoretical part deals with the problematic of traumatic brain injury and Feuerstein's approach to the development of cognitive functions. The empirical part focuse on qualitative research to find out whether there has been an improvement in cognitive functions with three respondents with TBI after five months of intervention using the FIE program, or not. Respondents are young men aged between 23 and 32, about 10 years after the accident, who regularly rehabilitate and undergo reeducation at the Jedlička Institute and Schools (JÚŠ). The aim of the research is to compare whether the influence of the FIE program has improved cognitive functions. The comparison is achieved by objective assessment of cognitive functions using Klecanská opakovatelná neuropsychologická baterie (KONB; Klecany Repeatable Neuropsychological Battery). The results of the research are presented in structured case studies. These in addition to the results of the KONB examination and the description of several months of intervention, follows the respondents throughout their past from life before the accident, through the rehabilitation of the consequences of the accident to the present...

Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-10-20T16:34:20Z No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-20T17:09:31Z (GMT) No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-20T17:09:31Z (GMT). No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2010-06-08 / Neuropsychological assessment and differential diagnosis between infective and degenerative dementias.. There are no studies comparing the neuropsychological profile of patients with parasitic infectious dementia (DIP) and other forms of primarily degenerative dementia. The objectives were to compare the neuropsychological deficits present in three groups of patients with dementia and a normal control group in relation to the DIP group. For this purpose, we prospectively evaluated 130 individuals with dementia from Dementia Unit, Hospital das Clinicas, Federal University of Goias and from the Tropical Diseases Hospital, Goiânia, aged above 18 years, divided in the following groups: infectious dementia (DIP), Alzheimer's disease (AD) , frontotemporal lobar degeneration(DLFT) , parkinsonism plus (PP) and normal controls. All underwent extensive neuropsychological assessment, addressing all cognitive domains (verbal and visual memory, attention, executive functions, gnosis, praxis, visuospatial skills, language). The productions were transcribed into tables and quantified by specific tests (Stroop, Trail Making A / B, Cancelation Test, Maze, Digit Span, Rey Figure, RAVLT, Logical Memory, Verbal Fluency, Hooper and Proverbs from WAIS). The DIP group generally presented with severe neuropsychological deficits present in multiple cognitive domains, and possibly even higher than those presented by primarily degenerative dementia in the elderly. These cognitive deficits can signal that the functional and / or lesional disturbances in DIP group undertake extensive brain areas or even that are impaired basic neuropsychological functions (attention, executive functions) that support the other functions with which are interdependent (memory, visuospatial functions). The DIP group had a higher run time, and committed more errors in the bell cancellation test than the control group (p <0.001), indicating deficits in selectivity and planning suggestive of involvement of fronto-subcortical areas. Overall, the DIP group had a performance in memory tasks higher than the AD group, equal to the DLFT group and lower than the PP group, suggesting the presence of heterogeneous hippocampal pathology in DIP group. The results emphasize that the neuropsychological assessments aid in the differential diagnosis of dementia and the topographic location of lesions associated with the predominant profile of cognitive dysfunction. / A avaliação neuropsicológica constitui importante suporte no diagnóstico diferencial entre as diversas formas de demência. Ainda não existem estudos comparando o perfil neuropsicológico de pacientes com demência infecto-parasitária (DIP) e outras formas de demência primariamente degenerativa. Os objetivos desta pesquisa foram comparar as alterações neuropsicológicas presentes em quatro grupos de pacientes com demência em relação ao grupo de pacientes com DIP e comparar o perfil neuropsicológico do grupo DIP com um grupo controle constituído por sujeitos saudáveis, pontuando os elementos neuropsicológicos diferenciadores entre eles. Para tanto, foram avaliados prospectivamente 130 indivíduos portadores de demência do ambulatório de Demências do Hospital das Clínicas da Universidade Federal de Goiás e do Hospital de Doenças Tropicais, Goiânia, com idade acima de 18 anos divididos no seguintes grupos:demência infecto parasitária (DIP), doença de Alzheimer (DA), degeneração lobar frontotemporal (DLFT) , parkinsonismo plus (PP) e controles normais. Todos realizaram avaliação neuropsicológica extensa, contemplando todos os domínios cognitivos (memória verbal e visual, atenção, funções executivas, gnosias, praxias, habilidades vísuo-espaciais, linguagem). As produções foram transcritas em tabelas e quantificadas por meio de testes específicos (Stroop, Trail Making A/B, Sinos, Labirinto, Dígitos, Figura Rey, RAVLT, Memória Lógica, Fluência Verbal, Hooper e Provérbios do WAIS). O grupo DIP apresentou desempenho cognitivo prejudicado em praticamente todos os domínios, quando comparado ao grupo controle normal. O grupo DIP apresentou maior tempo de execução e cometeu muito mais erros no teste de cancelamento dos sinos que o grupo controle (p < 0,001), indicando déficits na seletividade e no planejamento sugestivos de comprometimento de áreas fronto-subcorticais. No geral, o grupo DIP apresentou desempenho em tarefas de memória superior ao grupo DA, igual ao grupo DLFT e inferior ao grupo PP e controle, sugerindo a presença heterogênea de patologia hipocampal no grupo DIP. Os resultados ressaltam que as avaliações neuropsicológicas auxiliam no diagnóstico diferencial das demências e na localização topográfica das lesões associadas ao perfil predominante de disfunções cognitivas.

No description available.

À tout âge, l’exercice physique peut être bénéfique au fonctionnement cognitif. Étant quotidiennement confrontés à des situations d’apprentissage, l’enfant et l’adolescent constituent une population particulièrement susceptible de profiter de ces bienfaits. Cependant, il importe de préciser et d’étudier les facteurs qui influencent la relation entre l’exercice physique et la cognition. L’objectif général de cette thèse était d’examiner, à l’aide de mesures électrophysiologiques, les effets aigus et chroniques de l’exercice physique sur les mécanismes neurophysiologiques du fonctionnement cognitif de l’enfant. Une première étude a apprécié la durée des effets aigus de l’exercice physique. Les résultats de ces travaux suggèrent qu’une séance ponctuelle d’exercice physique augmente la vigilance pendant au moins 30 min. Toujours dans un contexte d’effets aigus de l’exercice, l’impact de la demande cognitive de la tâche et de l’âge ont été examinés dans une seconde étude. Les résultats ne révèlent aucune interaction avec l’âge, cependant ils indiquent une spécificité pour les processus plus complexes du traitement de l’information. Enfin, une troisième étude a évalué l’effet de l’exercice physique chronique dans le cadre d’un programme d’activités physiques de 12 semaines. Aucun changement n’a été observé quant à l’aptitude cardiovasculaire ou la performance cognitive suite au programme. Une condition physique initialement élevée des participants pourrait expliquer ce résultat. En résumé, peu importe la condition physique de l’enfant, un exercice physique aigu d’intensité moyenne est bénéfique à la vigilance et à certains aspects du traitement cognitif de l’information. Les effets observés semblent suffisamment durables pour avoir un impact positif sur l’apprentissage en classe après une récréation ou un cours d’éducation physique. / Exercise can be beneficial for cognitive functioning throughout lifespan. Children and adolescents may particularly benefit from the effects of exercise on cognition as they continually face learning situations. However, it is important to identify and to study the factors that influence the relationship between exercise and cognition. The general objective of this thesis was to examine, with electrophysiological measures, the acute and chronic effects of exercise on electrophysiological mechanisms of cognitive functioning in children. A first study appreciated the duration of the acute effect of a single session of exercise. The results suggested that a single session of exercise increases vigilance for at least 30 min. Still in a context of acute exercise, the impact of the cognitive demand of the task and age were examined in a second study. Although the results did not reveal any significant interaction with age, they indicated specific benefits for the more complex cognitive processes compare to more automatic processes. Finally, a third study evaluated the effect of a 12-week program of physical activity. Following the 12-week program, no change was observed neither for the cardiovascular function nor the cognitive performance. The fact that participants already demonstrated a high level of fitness at baseline may explain this result. In conclusion, regardless of a child’s fitness level, it appears that an exercise of moderate intensity improves vigilance and some aspects of information processing. The observed effects appear to last long enough to have a positive impact on classroom learning after a recess or a physical education class.

Submitted by Oliveira Santos Dilzaná (dilznana@yahoo.com.br) on 2014-01-21T12:42:45Z No. of bitstreams: 1 Dissertação de Chrissie de Carvalho - Efeitos Neuropsicológicos da exposição ao manganês em crianças (dissertação de mestrado.pdf: 2969048 bytes, checksum: ba97ca375d35d6b397a49238b02b559d (MD5) / Approved for entry into archive by Ana Portela (anapoli@ufba.br) on 2014-02-03T15:10:24Z (GMT) No. of bitstreams: 1 Dissertação de Chrissie de Carvalho - Efeitos Neuropsicológicos da exposição ao manganês em crianças (dissertação de mestrado.pdf: 2969048 bytes, checksum: ba97ca375d35d6b397a49238b02b559d (MD5) / Made available in DSpace on 2014-02-03T15:10:24Z (GMT). No. of bitstreams: 1 Dissertação de Chrissie de Carvalho - Efeitos Neuropsicológicos da exposição ao manganês em crianças (dissertação de mestrado.pdf: 2969048 bytes, checksum: ba97ca375d35d6b397a49238b02b559d (MD5) / FAPESB - CAPES / O Manganês (Mn) é um elemento essencial ao corpo humano. O funcionando do Mn no organismo ocorre através de um mecanismo homeostático eficaz que mantem os níveis deste metal em concentrações ótimas. No entanto, altas concentrações de Mn no organismo podem acarretar prejuízos ao Sistema Nervoso Central, uma vez que, possui um potencial neurotóxico. O excesso de Mn no organismo tem sido associado a prejuízos neuropsicológicos em crianças e adultos. Os estudos com crianças expostas ao Mn retratam associações com a diminuição do desempenho em testes de Coeficiente Intelectual (QI), Desenvolvimento Psicomotor, Memória, Atenção e Função Motora. Objetivos: O presente trabalho tem por objetivo avaliar o desempenho neuropsicológico e comportamental de crianças em idade escolar e a associação com a exposição ao manganês. Materiais e Métodos: Participaram deste estudo 78 díades criança-mãe/responsável, crianças com idades entre 7 e 12 anos, e residentes em duas comunidades, Cotegipe e Santa Luzia, do município de Simões-Filho, situadas na região metropolitana de Salvador - Bahia, Brasil. Essas comunidades estão sob influência da poluição atmosférica gerada pelo processo de produção de ligas ferro-manganês de uma metalúrgica. Foi aplicada uma bateria neuropsicológica nas crianças compreendendo os domínios cognitivos: Inteligência, Memória, Atenção, Funções Executivas e Função Motora. Os pais ou responsáveis responderam a um questionário sociodemográfico e ao Child Behavior Checklist (CBCL), enquanto que os professores responderam à Escala Abreviada de Conners. Os níveis de Mn foram determinados por espectrometria de absorção atômica com forno de grafite e os resultados expressos em μg/g de Mn no cabelo (MnC). O desempenho neuropsicológico das crianças das duas comunidades foi comparado segundo testes estatísticos paramétricos e não paramétricos. Realizaram-se análises de correlação bivariada e análise de regressão múltipla para a investigação das associações entre o desempenho neuropsicológico e os níveis de Mn no cabelo. Resultados: Encontramos um desempenho inferior das crianças da comunidade de Santa Luzia, situada entre 2,5 a 3,5 km da fábrica, em relação à comunidade de Cotegipe situada até 2 km da Fábrica, nos seguintes testes: Fluência Fonológica (p=0,03), Cubos-WISC-III (p=0,04), Dígitos Ordem Indireta (OI) (p=0,002), Cubos de Corsi Ordem Direta (OD) (p=0,006), e maior quantidade de Erros em Nomeação (p=0,047). A análise do tamanho de efeito revelou que as diferenças entre as comunidades foi pequena, apenas a diferença entre o desempenho em Fluência Fonológica obteve uma magnitude de efeito moderada (d de 11 cohen= 0,56). Considerando os demais testes, o desempenho neuropsicológico das comunidades de Cotegipe e Santa Luzia foi semelhante. A análise do desempenho neuropsicológico geral das crianças das duas comunidades evidenciou escores abaixo da média que crianças com desenvolvimento típico em: Cubos (WISC-III), Tempo de Reação e Erros por Ação (TAVIS-III), Produzindo Palavras (Fluência Fonológica) e Soma dos Erros em Inibindo Respostas (NEPSY-II). A análise de rede das variáveis que estiveram correlacionadas significativamente (p<0,05) evidenciou uma rede coesa e com grau de nós interligados alto. As variáveis que apresentaram maior grau de correlações significativas com as demais foram: os escores em Dígitos OI, Cubos de Corsi OI, Fluência Fonológica, e o tempo total do Grooved Pegboard em ambas as mãos. O QI da criança correlacionou-se diretamente e moderadamente com o QI materno (r=0,47; p<0,001). Foram encontradas associações inversas entre log de MnC e os escores dos testes de QI, Dígitos OD e OI e recordação livre imediata em Memória para Lista (NEPSY-II). Observou-se a associação positiva entre log de MnC e velocidade motora, problemas de atenção, hiperatividade e comportamentos externalizantes. Conclusão: Os resultados confirmam que as crianças estão sob efeito da exposição crônica ao Mn advindo das emissões da planta metalúrgica. Concentrações elevadas de MnC foram associadas a um menor desempenho em medidas neuropsicológicas e comportamentais. Os resultados corroboram evidências crescentes que indicam aumento de comportamentos de impulsividade e externalizantes, assim como dificuldade de inibição de respostas, associados a exposição ao Mn e com possíveis efeitos sob o sistema dopaminérgico e de auto-regulação. Manganese (Mn) is an essential element to the human body. The functioning of Mn in the body occurs through a homeostatic mechanism that maintains effective levels of this metal in optimal concentrations. However, high concentrations of Mn in the body may cause damage to the central nervous system, assuming that Mn has a neurotoxic potential. Excess Mn in the body has been associated with neuropsychological impairments in children and adults. Studies with children exposed to Mn indicate associations with decreased performance on tests of intellectual coefficient (IQ), Psychomotor Development, Memory, Attention and Motor Function. Objectives: The aim of this study is to assess the behavioral and neuropsychological performance in school age children and the association with manganese exposure. Materials and Methods: The study included 78 dyads children-mother/caregiver, children aged between 7 and 12 years old, and residents in two communities, Cotegipe and Santa Luzia, in the district of Simões-Filho, located in the state of Bahia, Brazil. These communities are under the influence of pollution generated by the production process of a iron-manganese alloy plant. Was administered a neuropsychological battery for children including the cognitive domains: Intelligence, Memory, Attention, Executive Functions and Motor Function. Parents or caregivers answered a sociodemographic questionnaire and the Child Behavior Checklist (CBCL), while teachers answered to the Abbreviated Conners Scale. The levels of Mn were determined by atomic absorption spectrometry with graphite furnace and the results expressed in μg/g-Mn in the hair (MnH). The neuropsychological performances of children of both communities were compared according to parametric and non-parametric statistical tests. Bivariate correlations and multiple regression analysis were applied to investigate the associations between neuropsychological performance and manganese biomarkers’ levels. Results: We found a lower performance of children in the community of Santa Luzia, located between 2.5 to 3.5 km radius from the iron-manganese alloy plant, in relation to the community of Cotegipe located within 2 km radius of the plant, in the following tests: Phonologic Fluency (p = 0.03 ), Block Design -WISC-III (p = 0.04), Digit Span-Indirect Order (IO) (p = 0.002), Corsi Block - Direct Order (DO) (p = 0.006), and greater number of Naming Errors (p = 0.047). The effect size analysis revealed that the differences between communities was small, only the difference between the performance on Phonologic Fluency obtained a moderate effect size (Cohen d = 0.56). Considering the other tests, neuropsychological performance of both communities was similar. The analysis of general neuropsychological performance of 13 children of both communities showed below average scores than children with typical development in: Block Design (WISC-III), Reaction Time and Commission Errors (TAVIS-III), Word Generation (Phonologic Fluency) and Total Inhibition Errors (NEPSY-II). A network analysis of the variables that were significantly correlated (p <0.05) showed a cohesive network with a high degree of interconnected nodes. The variables that have higher degree of significant correlations with the others were: Digit Span IO, Corsi Block IO, Phonologic Fluency, and Grooved Pegboard total time on both hands. The child's IQ correlated directly and moderately with maternal IQ (r = 0.47, p <0.001). We found inverse associations between log MnH and scores on IQ, Digit Span DO and IO and immediate free recall in Memory List (NEPSY-II). We observed a positive association between log MnH and motor speed, attention problems, hyperactivity and externalizing behaviors. Conclusion: The results showed that the children of these communities are under the effect of chronic exposure to Mn emissions arising from the iron-manganese alloy plant. High levels of MnH were associated with lower performance on neuropsychological and behavioral measures. The results corroborate growing evidence that indicate increased impulsivity and externalizing behaviors, as well as difficulty to inhibition of responses, associated with Mn exposure and possible effects on the dopamine system and self-regulation.

Depressive disorder is the most widespread psychological illness and is responsible for the disability of many. However, this disease is not only a pathological change of mood, current research shows that depression can also be connected with a cognitive impairment, a pathological changes in optimal functioning. This impairment can not only deepen the illness but as well worsen work and personal life of a patient. This paper aims on presenting the basics of the disease, its causes, and the ways in which depression and cognitive deficits are currently treated. Since the research is carried out in an intercultural context, the studied cultures of the Czech Republic and Mexico are presented in the context of current theories. The intecultural research examines the cognitive deficit of depressed patients. The results of depth of depression, neuropsychological tests, and tests evaluating rumination are compared interculturally. There were no important statistically significant differences found between the two cultures. On the other hand, the results show some impairment in cognitive functioning in depressive patients. Keywords: depression cognitive functions cognitive impairment ruminations intercultural comparison study Mexico Czech republic