Individuals diagnosed with schizotypal personality disorder (SPD) exhibit patterns of cognitive deficits, neuromotor disturbances, and behavior problems similar to individuals with schizophrenia, and thus SPD is thought to represent one point on the continuum of schizophrenia spectrum disorders (SSDs). Deficits in behavior, cognition, and motor functioning have been implicated as childhood precursors of SSDs and appear to also vary as a function of gender and family history of psychopathology. As such, studies of youth may help in further identification of individuals at risk for SSDs. The current study examined the prospective associations between problem behaviors, neuromotor and neurocognitive functioning, as well as SSD symptoms, at baseline and 2-year follow-up in youth meeting criteria for SPD, other personality disorders, or healthy controls. The neuromotor and neurocognitive measures were able to significantly predict SSD symptoms and behavior problems above and beyond baseline predictors. Overall, the findings provide further support for the role of subcortical motor centers operating together with prefrontal cortical areas in the regulation of higher-order cognitive functioning and in producing the psychiatric features of SSDs. Significant correlations between gender, family history of schizophrenia, and history of head injury with symptoms, behavior, cognition, and motor functioning were also found and highlight the importance of examining the effects of these variables in future investigations. In sum, the current study helped in identifying factors that predict the clinical course of schizotypy and may shed light on the disturbed neural circuitry underlying SSDs.

Orientador: Flávia Heloísa dos Santos / Resumo: Introdução: A doença renal crônica (DRC) atinge um percentual significativo de idosos, além de estar relacionada a uma série de comorbidades, em especial, o transtorno neurocognitivo leve (TNL). A diminuição da taxa de filtração glomerular está significativamente associada a déficits globais na cognição, função executiva, linguagem e memória. Em virtude disso, a triagem cognitiva é fundamental para a população com DRC. Objetivo geral: Estimar a prevalência de TNL em doentes renais crônicos em tratamento dialítico, comparando com um grupo controle (GC) pareado por sexo e idade, e contrastar o uso de diferentes instrumentos de screening para esta finalidade. Material e método: Estudo transversal, caso-controle, no qual foram avaliados 54 pacientes em HD (GHD) e 54 controles saudáveis (GC), pareados por sexo e idade. Os pacientes foram submetidos a avaliação neuropsicológica, compreendida por testes de triagem (Mini-Exame do Estado Mental – MEEM; Avaliação Cognitiva de Montreal – MoCA; Mini-Cog), teste de inteligência (Escala Wechsler Abreviada de Inteligência – WASI), avaliação de qualidade de vida (QV) (The Medical Outcomes Study 36 item Short-Form Health Survey- SF-36), sintomas de ansiedade e depressão (Inventário de Ansiedade de Beck – BAI; Inventário de Depressão de Beck), complementados por dados sociodemográficos, clínicos e laboratoriais. Resultados: O GHD tinha medianas de 60 anos (50-67; intervalo interquartil) de idade, tempo de tratamento de 23 meses (10-51) e 40,74... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Chronic kidney disease (CKD) affects a significant percentage of the elderly, and is also related to a series of comorbidities, especially mild neurocognitive disorder (mNCD). The decrease in the glomerular filtration rate is significantly associated with global deficits in cognition, executive function, language and memory. As a result, cognitive screening is essential for the population with CKD. General objective: To estimate the prevalence of mNCD in patients with CKD undergoing dialysis, comparing to a control group (CG) matched by sex and age, and to contrast the use of different screening instruments for this purpose. Material and methods: Cross-sectional, case-control study, in which 54 patients on HD (HDG) and 54 healthy controls (CG), matched by sex and age, were evaluated. Patients underwent neuropsychological assessment, comprising screening tests (Mini-Mental State Examination - MMSE; Montreal Cognitive Assessment - MoCA; Mini-Cog), intelligence test (Wechsler Abbreviated Intelligence Scale - WASI), assessment of quality of life (QOL) (The Medical Outcomes Study 36 item Short-Form Health Survey- SF-36), symptoms of anxiety and depression (Beck Anxiety Inventory - BAI; Beck Depression Inventory - BDI), complemented by sociodemographic, clinical and laboratory data. Results: The HDG had medians of 60 years-old (50-67; interquartile range), treatment time of 23 months (10-51) and 40.74% had DM as the underlying disease. The groups did not differ in age... (Complete abstract click electronic access below) / Doutor

I Sverige lever cirka 160 000 personer med en kognitiv sjukdom. Flertalet av dessa personer löper risk att utveckla en försämrad förmåga att själv kunna förmedla eventuell smärtupplevelse, vilket leder till ett ökat lidande och försämrad livskvalitet. För att vårdpersonal ska kunna utföra en personcentrerad och säker vård för personer med kognitiv sjukdom och lindra lidande behövs vissa förutsättningar. Syfte med litteraturöversikten var att synliggöra vilka förutsättningar som behövs för att vårdpersonal ska kunna identifiera och lindra smärta hos personer med kognitiv sjukdom. Som metod för det självständiga arbetet valdes en allmän litteraturöversikt. I denna har befintlig forskning sammanställts för att besvara litteraturöversikten syfte. Sökning av artiklar har genomförts i databaserna Cinahl och Pubmed vilket resulterade i att 16 artiklar kvalitetsgranskades av författarna och inkluderades i litteraturöversikten. I litteraturöversiktens resultat framkom att det behövs ett flertal förutsättningar för att vårdpersonal ska kunna identifiera och lindra smärta hos personer med kognitiv sjukdom. Det behövs en adekvat personalbemanning, rutiner och riktlinjer att följa, att vård och omsorgsarbetet utgår från multiprofessionella team samt att vårdpersonal har möjlighet till kompetensutveckling inom området. Dessa förutsättningar är grunden för att vårdpersonal ska kunna arbeta utifrån ett personcentrerat förhållningssätt och ha möjlighet att skapa en god relation med personen, vilket främjar möjligheten att identifiera och lindra smärta. Slutsatsen var att en personcentrerad vård är en förutsättning för att identifiera och lindra smärta hos personer med kognitiv sjukdom. För detta behövs ett flertal fungerande organisatoriska faktorer samt en ökad kunskap inom området. / In Sweden approximately 160.000 individuals live with a cognitive disorder. The majority of these individuals are at risk of impaired ability to convey eventual pain, which increases suffering and decreases quality of life. Certain conditions are necessary in order for healthcare professionals to care for patients living with a cognitive disorder that is based on patient- centered care and safe healthcare. The aim of this study was to explore the conditions required for healthcare professionals to be able to identify and alleviate suffering in people with cognitive disorder. A literature review was chosen as the method. Existing research has been compiled in order to answer the aim of the study. In order to find appropriate scientific articles, Cinahl and Pubmed were used as databases. This resulted in 16 scientific articles, quality reviewed by the authors and included in the literature review. The results showed that there are a number of conditions required in order to alleviate pain in individuals that live with a cognitive disorder. There is a need for adequate staffing, routines and guidelines to act in accordance with, a care that is based on multi-professional teams as well as an opportunity for health care staff to develop skills within their profession. These conditions constitute the bases that are necessary in order for health care staff to work based on a person-centered approach along with the opportunity to create a good relationship with the regarding person. This promotes the ability to identify and alleviate pain. The conclusion was that a person-centered care is a necessity in order to identify and alleviate pain in individuals that live with a cognitive disorder. That requires a number of functioning organizational factors as well as increased knowledge within this area.

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Introduction: Many studies have found an association between Toxoplasma gondii seropositivity and behavioral and cognitive changes in animal models and in humans. In addition, early findings have suggested an association between T. gondii seropositivity and Alzheimer's disease (AD). We sought to determine whether there is an association between T. gondii seropositivity and AD as well as cognitive functioning (including memory, working memory, processing speed, language functioning, executive functioning) in a large, well-characterized sample of subjects with AD and matched controls without dementia. Method: Using ELISA assays, we determined anti-T. gondii IgG antibody titers in 114 control subjects and in 105 subjects diagnosed with AD through an Alzheimer's Disease Research Center. We compared the seroprevalence between the two groups using propensity score matching (PSM). We also compared associations between T. gondii seropositivity and cognitive functioning using both PSM and linear regressions. Results: We found no differences between groups in age, ethnicity, or gender. Education and socioeconomic status was slightly higher in the control group. Using PSM, we did not find a significant difference in having AD due to T. gondii seropositivity between the two groups. Using PSM, we found T. gondii seropositivity was associated with worse performance on the WAIS-R Digit Symbol test. Within the AD group, we found T. gondii seropositivity was associated with worse performance on the WAIS Block Design and Trail Making B tests. Conclusion: In this sample, we found no evidence of an association between T. gondii seropositivity and AD in a larger study than previous studies. We found evidence of a negative association between processing speed and T. gondii seropositivity as well as a negative association between processing speed, executive functioning, and T. gondii seropositivity in those with AD.

Introduction: Many studies have found an association between Toxoplasma gondii seropositivity and behavioral and cognitive changes in animal models and in humans. In addition, early findings have suggested an association between T. gondii seropositivity and Alzheimer's disease (AD). We sought to determine whether there is an association between T. gondii seropositivity and AD as well as cognitive functioning (including memory, working memory, processing speed, language functioning, executive functioning) in a large, well-characterized sample of subjects with AD and matched controls without dementia. Method: Using ELISA assays, we determined anti-T. gondii IgG antibody titers in 114 control subjects and in 105 subjects diagnosed with AD through an Alzheimer's Disease Research Center. We compared the seroprevalence between the two groups using propensity score matching (PSM). We also compared associations between T. gondii seropositivity and cognitive functioning using both PSM and linear regressions. Results: We found no differences between groups in age, ethnicity, or gender. Education and socioeconomic status was slightly higher in the control group. Using PSM, we did not find a significant difference in having AD due to T. gondii seropositivity between the two groups. Using PSM, we found T. gondii seropositivity was associated with worse performance on the WAIS-R Digit Symbol test. Within the AD group, we found T. gondii seropositivity was associated with worse performance on the WAIS Block Design and Trail Making B tests. Conclusion: In this sample, we found no evidence of an association between T. gondii seropositivity and AD in a larger study than previous studies. We found evidence of a negative association between processing speed and T. gondii seropositivity as well as a negative association between processing speed, executive functioning, and T. gondii seropositivity in those with AD.

Background: Primary CNS Lymphoma is a rare and severe but potentially curable disease. In the last thirty years treatment has changed significantly. Survival times increased due to high-dose methotrexate-based chemotherapy. With intensive regimens involving autologous stem cell transplantation (ASCT), 4-year survival rates of more than 80% can be reached. However, this treatment regimen is not feasible in all patients, and is associated with some mortality. Methods: In this review, current evidence regarding the efficacy and toxicity of radiotherapy in PCNSL shall be summarized and discussed mainly based on data of controlled trials. Results: Being the first feasible treatment whole brain radiotherapy (WBRT) was initially used alone, and later as a consolidating treatment after high-dose methotrexate-based chemotherapy. More recently, concerns regarding activity and neurotoxicity of standard dose WBRT limited its use. On the contrary, latest evidence of some phase II trials suggests efficacy of consolidating WBRT is comparable to ASCT. After complete remission reduced dose WBRT appears as a feasible concept with decreased neurotoxicity. Evidence for use of local stereotactic radiotherapy is very limited. Conclusion: Radiotherapy has a role in the treatment of PCNSL patients not suitable to ASCT, e.g., as consolidating reduced dose WBRT after complete response. Local stereotactic radiotherapy for residual disease should be examined in future trials.

Bakgrund   Kognitiv sjukdom är ett av de ledande globala hälsoproblemen och förekomsten ökar i takt med en åldrande världspopulation. Att leva med en kognitiv sjukdom drabbar individers hälsa på ett multidimensionellt plan med lidande i form av besvärliga symtom, social stigmatisering, en hotad autonomi och nedsatt livskvalitet. Sjuksköterskans omvårdnadsåtgärder är en central del i att lindra lidande i vården av dessa människor. Det finns dock fortfarande brister inom omvårdnaden av personer med kognitiv sjukdom. Musikinterventioner har visats vara effektiva som alternativa omvårdnadsåtgärder som kan bidra till en mer holistisk och personcentrerad vård. Syfte Syftet var att belysa betydelsen av musik som omvårdnadsåtgärd för hälsan hos personer med kognitiv sjukdom.  Metod Arbetet utgjordes av en icke-systematisk litteraturstudie med en induktiv ansats. Systematiska sökningar utfördes i databaserna PubMed, CINAHL och PsycINFO för att besvara syftet utifrån specificerade urvalskriterier. Insamlade artiklar kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Totalt 15 vetenskapliga artiklar med kvantitativ och kvalitativ ansats inkluderades i resultatet och analyserades med en integrerad dataanalys.  Resultat En sammanställning av resultatet presenterades i tre huvudkategorier: Betydelse som symtomlindrande åtgärd, Betydelse för sociala interaktioner och Betydelse för välmående. Resultatet visade att musik som omvårdnadsåtgärd främjar symtomlindring av beteendemässiga och psykiska symtom samt kognitiva symtom. Det framkom också att musiken hade stor betydelse i att frambringa sociala interaktioner i form av ett ökat socialt engagemang och samarbete samt en förbättrad kommunikation. Musiken visades även vara av betydelse för ett förbättrat humör och välbefinnande hos personer med kognitiv sjukdom. Slutsats Litteraturöversikten belyste musikens potential inom omvårdnaden av personer med kognitiv sjukdom. Personcentrering framkom som en central del i att stärka musikens betydelse för hälsan genom att bidra till en känsla av välbefinnande, meningsfullhet och sammanhang. En ökad förståelse kring musikens betydelse för hälsan anses som värdefull kunskap i sjuksköterskans arbete med personer med kognitiv sjukdom. / Background Neurocognitive disorders are one of the leading global health concerns and the occurrence is increasing as the world's population ages. Living with a neurocognitive disorder affects the health of individuals on a multidimensional level, leading them to suffer from difficult symptoms, social stigmatization, a threatened autonomy and a decreased quality of life. Nursing interventions play a central role in alleviating the suffering of these people in healthcare situations. However, the nursing care of people living with neurocognitive disorders is insufficient. Music interventions have been shown to be effective as alternative nursing tools to contribute to a more holistic and person-centered care.   Aim The aim was to illuminate the value of music as a nursing intervention for the health of people living with neurocognitive disorders. Method The study consisted of an unsystematic literature review with an inductive approach. Systematic searches were conducted in the databases PubMed, CINAHL and PsycINFO in order to achieve the aim using a specific selection of criteria. Collected data was examined using a quality-assessment tool from Sophiahemmet University. A total of 15 scientific articles with quantitative and qualitative approaches were included in the results and were analyzed using an integrative data analysis. Results A compilation of the results was presented within three main categories: Value as a symptom-relieving measure, Value for social interactions and Value for well-being. The results show that music as a nursing intervention relieves behavioral and psychological symptoms as well as cognitive symptoms. The results also show that music is of great value in encouraging social interactions, with an increase of social engagement, cooperation and communication. The music was also shown to be of value in promoting an improved mood and well-being for people living with a neurocognitive disorder. Conclusions The literature review highlighted the potential of music to be used in the care of people with neurocognitive disorders. Person-centeredness emerged as a central element in strengthening the effects of music on health by contributing to a sense of well-being, meaningfulness and social connection. An increased understanding regarding the value of music for health is considered valuable knowledge for nurses in their care of people with neurocognitive disorders.

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