Autobiographical narratives in the elderly with neurocognitive disorder: an integrative literature review / Narrativas autobiográficas en la persona adulta mayor con trastorno neurocognitivo: revisión integrativa da literatura

ABSTRACT Objective: to carry out an integrative review of the literature on autobiographical narratives as a discursive activity in the older adult with neurocognitive disorder. Methods: a descriptive study that covered the Scopus, SciELO, PubMed, and Science Direct databases, from 2009 to 2019, using the keywords autobiographical, narrative, dementia, reminiscence, the elderly, and the Boolean operator. A narrative synthesis was adopted considering the characteristics of the clinical, and methodological heterogeneity of the studies. Results: the results included 3 articles published between 2012 and 2018, in the English language, from the United Kingdom, Brazil, and Argentina, which highlighted the autobiographical narratives. Although in a strict sense they did not present the narrative as a specific objective of the autobiographical study, they did provide interesting and related data which justified their inclusion. Conclusion: it is observed that the literature researched presents a limited number of articles, adressing the autobiographical narrative as a discursive activity in the elderly with neurocognitive disorder.

RESUMEN Objetivo: realizar una revisión integrativa de la literatura sobre la narrativa autobiográfica como actividad discursiva del adulto mayor con trastorno neurocognitivo. Métodos: estudio descriptivo que cubrió las bases de datos Scopus, SciELO, PubMed y Science Direct, en el periodo de 2009 a 2019, con las palabras clave: narrativa autobiográfica, demencia, reminiscencia, adulto mayor y el operador booleano and. Se adoptó una síntesis narrativa considerando las características de la heterogeneidad clínica y metodológica de los estudios. Resultados: los resultados comprenden 3 artículos, publicados entre 2012 a 2018, en Reino Unido, Brasil y Argentina. Aunque en stricto sensu no presentan como objetivo específico el estudio de aspectos discursivos de la narrativa autobiográfica, entregan datos interesantes y relacionados a ella, lo que justifica su inclusión Conclusión: se observa que todavía hay un número limitado de artículos en la literatura con el enfoque de la narrativa autobiográfica como actividad discursiva de la persona mayor con trastorno neurocognitivo.

Effects of Reminiscence Therapy on Depressive Symptoms in Older Adults with Dementia: A Systematic Review and Meta-Analysis / 간호학회지

PURPOSE: The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis. METHODS: Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment. RESULTS: Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was −0.62 (95% Cl: −0.92 to −0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes. CONCLUSION: Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.

Agreement between different recall periods in drug utilization studies / Concordância entre diferentes períodos recordatórios em estudos de utilização de medicamentos

ABSTRACT: Objective: To assess the agreement between three recall periods for self-reported drug use using a 24-hour recall period as reference. Methods: Participants were allocated into three groups with different recall periods of 7, 14 and 30 days and were interviewed at two different times. A 24-hour recall questionnaire was answered during the first interview, and a questionnaire on drug use over the different recall periods tested was answered during the second interview. The agreement between the questionnaires was evaluated using percent agreement and kappa. Results: For continuous drugs, percent agreement varied between 92 and 99% and kappa varied between 0.71 and 0.97 for three periods tested. For drugs of occasional use, percent agreement varied between 63 and 81% and kappa varied between 0.27 and 0.52. The prevalence of drugs, particularly those of occasional use, increases with time. Conclusions: The high level of agreement between the three recall periods suggests that all of them are valid for the investigation of drugs of continuous use.

RESUMO: Objetivo: Avaliar a concordância entre três períodos recordatórios para o auto-relato do uso de medicamentos, utilizando o período recordatório de 24 horas como referência. Métodos: Os participantes foram alocados em três grupos de acordo com os períodos recordatórios de 7, 14 e 30 dias e entrevistados em dois momentos. Um recordatório de 24 horas foi respondido na primeira entrevista e, um questionário sobre o uso de medicamentos com os diferentes períodos recordatórios avaliados foi respondido na segunda entrevista. A concordância entre os questionários foi avaliada pelo percentual de concordância e kappa. Resultados: O percentual de concordância variou entre 92 a 99% e o kappa de 0,71 a 0,97 para os medicamentos de uso contínuo nos três períodos recordatórios. Para os medicamentos de uso eventual, o percentual de concordância variou entre 63 a 81% e o kappa oscilou entre 0,27 a 0,52. A prevalência do uso de medicamentos, particularmente para os de uso eventual, aumentou com o tempo. Conclusão: A análise de concordância sugere que os três períodos recordatórios avaliados são válidos para a investigação da utilização de medicamentos de uso contínuo.

Contributos da estimulação da recordação para identificar e promover estratégias de autorregulação da aprendizagem durante o estágio em educação física / Contributions of stimulated recall to identify and promote strategies for self-regulated learning during physical education internships / Contribuciones de la estimulación de los recuerdos para identificar e impulsar estrategias de autorregulación del aprendizaje durante la práctica en educación física

Compreender as potencialidades da técnica da estimulação da recordação na promoção da reflexão de seis estagiários de um curso de licenciatura em Educação Física sobre o seu desempenho constitui o objetivo deste estudo. Por meio da análise textual discursiva emergiram quatro categorias (planejamento; antecipação de resultados e previsão de solução; promoção da autorregulação da aprendizagem dos aluno; autorreflexão), as quais buscam responder às questões levantadas no estudo. Os dados sugerem que a utilização da estimulação da recordação contribuiu para a promoção da autorregulação da aprendizagem dos estagiários e para a formulação de diferentes soluções frente aos desafios do estágio.

The purpose of this study is to understand the potential of the technique of stimulated recall to promote reflection by six interns in a Physical Education course about their performance. Through discursive textual analysis, four categories emerged – planning, anticipation of results and solution forecasting; promotion of self-regulation of student learning; and self-reflection – in order to seek to answer the questions raised in the study. Data suggest that the use of recall stimulation contributed to promote selfregulation of interns’ learning and to formulate different solutions to internship challenges.

Entender las potencialidades de la técnica de estimulación de los recuerdos en el estímulo de la reflexión de seis estudiantes en práctica de un curso de licenciatura en Educación Física sobre su desempeño es el objetivo de este estudio. A través del análisis textual discursivo surgieron cuatro categorías (planificación, anticipación de resultados y la previsión de solución, promoción de la autorregulación del aprendizaje de los alumnos y autorreflexión), que intentan responder a las preguntas planteadas en el estudio. Los datos sugieren que el uso de la estimulación de los recuerdos contribuyó a la promoción de la autorregulación del aprendizaje en los estudiantes en práctica y a la formulación de diferentes soluciones frente a los desafíos de la práctica.

Uso de monitorizacion cerebral para el despertar intraoperatorio / The use of cerebral monitoring for intraoperative awareness

Introduction: the bispectral index monitoring system (BIS) was introduced in the United States in 1994 and approved by the FDA in 1996 with the objective of measuring the level of consciousness through an algorithm analysis of the electroencephalogram (EEG) during general anesthesia. This novelty allowed both the surgeon and the anesthesiologist to have a more objective perception of anesthesia depth. The algorithm is based on different EEG parameters, including time, frequency, and spectral wave. This provides a non-dimensional number, which varies from zero to 100; with optimal levels being between 40 and 60. Objectives: Perform an analysis of the advantages and limitations of the anesthetic management with the bispectral index monitoring, specifically for the management and prevention of intraoperative awareness. Methodology: A non-systematic review was made from literature available in PubMed between the years 2001 and 2015, using keywords such as "BIS", "bispectral monitoring", "monitoreo cerebral", "despertar intraoperatorio", "recall" and "intraoperative awareness". Results: A total of 2526 articles were found, from which only the ones containing both bispectral monitoring and intraoperative awareness information were taken into consideration. A total of 68 articles were used for this review. Conclusion: BIS guided anesthesia has documented less immediate postoperative complications such as incidence of postoperative nausea/vomit, pain and delirium. It also prevents intraoperative awareness and its complications.

Introducción: El índice de monitoreo biespectral (BIS) fue introducido en Norte América en 1994 y aprobado por la FDA en 1996 con el objetivo de medir el nivel de conciencia realizando un análisis algorítmico del electroencefalograma (EEG) durante la anestesia general. Esta novedad permitió que tanto el cirujano como el anestesiólogo tuvieran una percepción más objetiva de la profundidad anestésica. El algoritmo está basado en diferentes parámetros del EEG, incluyendo tiempo, frecuencia y onda espectral. Esto provee un número no dimensional, que varía desde cero, hasta 100; siendo los niveles óptimos entre 40 y 60. Objetívos: Realizar un análisis de las ventajas y limitaciones del manejo anestésico con el monitor de análisis biespectral, específicamente en el manejo y prevención del despertar intraoperatorio. Metodología: Se realizó una revisión no sistemática de literatura disponible en PubMed entre los años 2001-2015, utilizando palabras clave como "BIS", "bispectral monitoring" "moni-toreo cerebral", "despertar intraoperatorio" "recall" y "intraoperative awareness". Resultados: Se encontraron un total de 2526 artículos, de los cuales solo se tomaron en cuenta aquellos que contenían información de tanto monitoria biespectral como despertar intraoperatorio. Un total de 68 artículos fueron utilizados para esta revisión. Conclusión: En la anestesia guiada por BIS se han documentado menores complicaciones postoperatorias inmediatas como la incidencia de nausea/vómito, dolor y delirium. Además de prevenir el despertar intraoperatorio y sus complicaciones.

Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement

Background: The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. Objectives: (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. Method: A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. Results: There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa=0.595) and recurrent fallers (Kappa=0.589). The limits of agreement were 0.35±1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Conclusion: Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning. .

The influence of colour on memory performance: A Review

Human cognition involves many mental processes that are highly interrelated, such as perception, attention, memory, and thinking. An important and core cognitive process is memory, which is commonly associated with the storing and remembering of environmental information. An interesting issue in memory research is on ways to enhance memory performance, and thus, remembering of information. Can colour result in improved memory abilities? The present paper highlights the relationship between colours, attention, and memory performance. The significance of colour in different settings is presented first, followed by a description on the nature of human memory. The role of attention and emotional arousal on memory performance is discussed next. The review of several studies on colours and memory are meant to explain some empirical works done in the area and related issues that arise from such studies.

Awake during General Anesthesia with BispectralIndex Value of 35

Awareness of intraoperative events in patients under general anesthesia is rare, but awareness during anesthesia is a serious complication that leads to anxiety and post-traumatic stress disorder. The Bispectral Index (BIS) has generally been accepted as a measurement of hypnosis under anesthesia. It is derived from a processed electroencephalogram and computer algorithm that assigns a numerical value based on the probability of consciousness. A 46-year-old, 65-kg male without underlying disease underwent elective surgery for ventral hernia. The patient in this case was administered an anesthetic that we frequently use and then average BIS value are 35. But he experienced awake during general anesthesia. We describe the first case of intraoperation awake under BIS 40 using desflurane.

Validación de la prueba de memoria episódica de repetición de la Universidad del Sur de California (USC-REMT) / Validation of the University of Southern California Repeatable Episodic Memory Test

Background: Memory is affected differently with the passage of time; specifically, episodic memory presents a clear decline. There is a relationship of this memory impairment and degenerative and psychiatric diseases. Aim: To determine the reliability and validity of the University of Southern California Repeatable Episodic Memory Test (USC-REMT) in a sample of Chilean adults. Material and Methods: The instrument was administered to 178 subjects living in the Metropolitan Region of Santiago. The sessions were individual, during the morning, lasting approximately 15 minutes. Results: The ANOVA indicates that subjects over 61 years old had lower scores in the test than their younger counterparts. There was an inverse correlation between age and success in "Free recall" (r =- 0.570), "Recognition indicating yes-no" (r = -0.412) and "forced-choice recognition" (r =- 0.371). Regression analysis showed that age explained 32.1 percent "free recall" variance. The three components were grouped into a single factor. Conclusions: The USC-REMT meets the criteria for validity and reliability to be applied for clinical and research purposes.

The Effect of Video-assisted Informed Consent for Central Venous Catheterization in the Emergency Department

PURPOSE: Informed consent is a basic right of patients undergoing medical procedures, but the effect of the type of consent form on the risk of invasive procedures is controversial, and the recall of information by patients has been poor. This trial was designed to assess the effect of video-assisted information on verbal informed consent to allow central venous catheter (CVC) insertion in the emergency department. METHODS: A prospective, randomized controlled trial was done on adult emergency department patients undergoing CVC insertion. Patients were randomized to the intervention or the control group. The intervention group had consent obtained with the assistance of video information (video group). The control group received a conventional education process that was conducted by the physician (verbal group) regarding indications, risks, and treatment of complications due to the procedure. Outcome variables consisted of an anxiety score, heart rate, and systolic and diastolic blood pressure at baseline and immediately after informed consent. All participants completed a 5-question knowledge measurement and graded their satisfaction level after the explanation. RESULTS: Of 208 patients enrolled, nine withdrew, leaving 199 for analysis (video n=99; verbal n=100). The two groups were similar with regard to their baseline characteristics. The video group was significantly less anxious after informed consent (4.5+/-0.8 vs 5.8+/-1.0, p=0.029) and had a significantly lower heart rate (64+/-12 vs 73+/-10, p=0.027). Mean knowledge scores were higher in the video group (3.82+/-0.55) compared to the verbal group (2.94+/- 0.75) (p=0.01). Satisfaction regarding the information received was higher in the video group (4.09+/-1.08) than in the verbal group (3.15+/-1.04) (p=0.00). CONCLUSION: Video-assisted informed consent decreases anxiety and improves satisfaction scales in patients undergoing CVC insertion. The Video group showed better recall of information compared with the verbal group.

Recollections of learning-disabled adolescents of their schooling experiences : A qualitative study.

Background: Little is known about the actual impact of the schooling experience on adolescents with specific learning disability (SpLD). Aims: To analyze the recollections of adolescents with SpLD who were undergoing education in regular mainstream schools. Settings And Design: Prospective interview-based study conducted in our clinic. Materials And Methods: Adolescents' responses to a semi-structured interview were audio-taped, transcribed verbatim and interpreted by content analysis. The number of participants was determined by 'saturation sampling,' resulting in a total of 30 adolescents. Results: Twelve (40%) adolescents had 'overall' neutral recollections, 9 (30%) had 'overall' positive recollections and 9 (30%) had 'overall' negative recollections about having SpLD during their schooling. Fourteen (46.7%) adolescents stated 'getting provisions' as good features, whereas 7 (23.3%) stated 'feeling different from classmates' and 6 (20%) stated 'being teased by classmates about their disability' as bad features of having SpLD. Nineteen (63.3%) adolescents remembered classroom teachers being supportive, while 7 (23.3%) remembered being insulted by them. Of the 21 adolescents who had undergone remedial education, only 10 (47.6%) acknowledged that it had benefited them. Twenty-one (70%) adolescents stated that availing provisions helped in getting better marks in examinations. Ten (33.3%) adolescents had negative recollections about their parents' behavior in relation to their disability. Twenty (66.7%) adolescents wanted changes in their school to help students with SpLD. Conclusion: Improving the knowledge of classroom teachers, classmates and family members about SpLD and about the rationale of provisions will help reduce the unpleasant experiences students with SpLD undergo during their schooling years.