Food packaging and endocrine disruptors

Abstract Objectives Narrative review evaluating food contamination by endocrine disruptors present in food packaging. Data source The terms "endocrine disruptors" and "food packaging" were used in combination in the PubMed, MEDLINE and SciELO databases, evaluating studies, in humans, published in Portuguese, English, French and Spanish between 1990 and 2023. Data synthesis Packaging, especially those made from plastic or recycled material, is an important source of food contamination by endocrine disruptors. Bisphenols and phthalates are the endocrine disruptors most frequently associated with food contamination from packaging. However, many unknown substances and even those legally authorized can cause harm to health when exposure is prolonged or when substances with additive effects are mixed. Furthermore, the discarding of packaging can cause contamination to continue into the environment. Conclusion Although packaging materials are essential for the transport and storage of food, many of them are associated with chemical contamination. As it is not possible to exclude them from our routine, it is important to develop research aimed at identifying the endocrine disruptors present in them, including the effects of chronic exposure; and that regulatory agencies and industry come together to reduce or prevent this risk. Additionally, consumers must be instructed on how to purchase products, handle them and prepare them to reduce the migration of chemical substances into food.

The relationship between mean daily step counts and pulmonary complications after thoracoscopic lobectomy in elderly patients: A propensity score matching study / 中国胸心血管外科临床杂志

@#Objective     To investigate the relationship between preoperative mean daily step counts and pulmonary complications after thoracoscopic lobectomy in elderly patients. Methods     From 2018 to 2021, the elderly patients with pulmonary complications after thoracoscopic lobectomy were included. A 1∶1 propensity score matching was performed with patients without pulmonary complications. The clinical data were compared between the two groups. Results    Totally, 100 elderly patients with pulmonary complications were enrolled, including 78 males and 22 females, aged 66.4±4.5 years. And 100 patients without pulmonary complications were matched, including 71 males and 29 females aged 66.2±5.0 years. There was no significant difference in the preoperative data between the two groups (P>0.05). Compared to the patients with pulmonary complications, the ICU stay was shorter (8.1±4.4 h vs. 12.9±7.5 h, P<0.001), the first out-of-bed activity time was earlier (8.8±4.5 h vs. 11.2±6.1 h, P=0.002), and the tube incubation time was shorter (19.3±9.2 h vs. 22.5±9.4 h, P=0.015) in the patients wihout pulmonary complications. There was no statistical difference in other perioperative data between the two groups (P>0.05). The mean daily step counts in the pulmonary complications group were significantly less than that in the non-pulmonary complications group (4 745.5±2 190.9 steps vs. 6 821.1± 2 542.0 steps, P<0.001). The daily step counts showed an upward trend for three consecutive days in the two groups, but the difference was not significant. Conclusion     The decline of preoperative mean daily step counts is related to pulmonary complications after thoracoscopic lobectomy in elderly patients. Recording daily step counts can promote preoperative active exercise training for hospitalized patients.

Construction of air quality health index for respiratory diseases in Urumqi / 环境与职业医学

Background Air quality health index (AQHI) is derived from exposure-response coefficients calculated from air pollution and morbidity/mortality time series, which helps to understand the overall short-term health impacts of air pollution. Objective To study the effects of common air pollutants on respiratory diseases in Urumqi and to develop an AQHI for the risk of respiratory diseases in the city. Methods The daily outpatient volume data of respiratory diseases from The First Affiliated Hospital of Xinjiang Medical University, meteorological data (daily mean temperature and daily mean relative humidity), and air pollutants [fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon dioxide (CO), and ozone (O3)] in Urumqi City, Xinjiang, China were collected from January 1, 2017 to December 31, 2021. A distributed lag nonlinear model based on quasi-Poisson distribution was constructed by time-stratified case crossover design. Adopting zero concentration of air pollutants as reference, the exposure-response coefficient (β value) was used to quantify the impact of included air pollutants on the risk of seeking medical treatment for respiratory diseases, and the AQHI was established. The association of between AQHI and the incidence of respiratory diseases and between air quality index (AQI) and the incidence of respiratory diseases was compared to evaluate the prediction effect of AQHI. Results Each 10 µg·m−3 increase in PM10, SO2, NO2, and O3 concentrations presented the highest excess risk of seeking outpatient services at 3 d cumulative lag (Lag03) and 2d cumulative lag (Lag02), with increased risks of morbidity of 0.687% (95%CI: 0.101%, 1.276%), 17.609% (95%CI: 3.253%, 33.961%), 13.344% (95%CI: 8.619%, 18.275%), and 4.921% (95%CI: 1.401%, 8.502%), respectively. There was no statistically significant PM2.5 or CO lag effect. An AQHI was constructed based on a model containing PM10, SO2, NO2, and O3, and the results showed that the excess risk of respiratory disease consultation for the whole population, different genders, ages, or seasons for each inter-quartile range increase in the AQHI was higher than the corresponding value of AQI. Conclusion PM10, SO2, NO2, and O3 impact the number of outpatient visits for respiratory diseases in Urumqi, and the constructed AQHI for the risk of respiratory diseases in Urumqi outperforms the AQI in predicting the effect of air pollution on respiratory health.

Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study / 中国康复理论与实践

ObjectiveTo explore the impact of subjective vertical perception impairment after stroke on visuospatial cognition, balance, walking and activities of daily living, to investigate the mediating role of visuospatial cognition and lateropulsion. MethodsFrom February to December, 2023, 96 stroke patients were selected from the Rehabilitation Medicine Center of the First Affiliated Hospital of Nanjing Medical University. They were divided into vertical perception impairment group (n = 53) and non-vertical perception impairment group (n = 43). They were assessed with National Institutes of Health Stroke Scale (NIHSS), the Scale for Contraversive Pushing (SCP), Burke Lateropulsion Scale (BLS), Line Bisection Test (LBT), Line Cancellation Test (LCT), Star Cancellation Test (SCT), Subjective Visual Vertical (SVV), Berg Balance Scale (BBS), Holden Functional Ambulation Categories (FAC) and Barthel Index (BI). ResultsScores of SVV orientation, SVV uncertainty, NIHSS, SCT, SCP, BLS, BBS, FAC and BI were worse in the vertical perception impairment group than in the non-vertical perception impairment group (|t| > 2.414, Z = -3.481, P < 0.05). Scores of SVV were correlated with SCT, BLS and BBS (|r| ≥ 0.273, P < 0.05). After controlling for age and gender, SVV orientation score did not directly impact BBS score (β = -0.011, P = 0.920). However, it exerted a partial mediating effect through BLS (effect = -0.173, 95%CI -0.278 to -0.076) and a chain-mediated effect through SCT and BLS (effect = -0.073, 95%CI -0.137 to -0.027), impacting BBS score. ConclusionSubjective vertical perception impairment results in poorer visuospatial cognition, balance, walking and activities of daily living in stroke patients. This influence on balance function is mediated through the mediating effects of visuospatial cognition and lateropulsion.

Obstacles and Facilitators in Daily Living Activities Among Persons with Spinal Cord Injury: A Systemic Review

@#Introduction: This systematic review aimed to investigate the level of participation, obstacles, and facilitator factors that influence activities of daily living among persons with spinal cord injury (SCI). Methods: A comprehensive search was conducted in four online databases, namely Google Scholar, PubMed, OT Seeker, and Cochrane Library covering the ten-years period from January 2012 to December 2022. Inclusion criteria encompassed original published studies in English focusing on daily activities, work, participation, obstacles, and facilitators in persons with SCI. Non-peer review sources (e.g., abstracts, grey literature, preprints), and studies unrelated to occupational therapy were excluded. The selected studies were assessed for quality using McMaster University Occupational Therapy Evidence-Based Practice critical review form. Results: Out of the 678 articles identified, ten studies were included after the screening, exploring participation in daily living activities, employment, return to work, leisure activities, family tasks, and community mobility among persons with SCI. Obstacles and facilitators influencing participation in activities of daily living were classified using the International Classification of Functioning, Disability, and Health (ICF) framework. This review highlighted that long-term participation is challenging for persons with SCI, affected by obstacles such as body functions, pain, low self-esteem, and environmental and social factors. Conclusion: The findings underscore the importance of adopting a multidisciplinary rehabilitation approach to enhance participation in daily activities for persons with SCI. Occupational therapy plays a significant role in improving participation levels among persons with SCI.

Multimorbidade em idosos e seus fatores associados em 2010 e 2021 / Multimorbidity in older adults and its associated factors in 2010 and 2021

Resumo O presente estudo teve como objetivo comparar os fatores associados à multimorbidade em idosos de 60 a 69 anos, em 2010 e 2021. Trata-se de um estudo transversal comparativo, composto por dois estudos transversais. Ambas as coletas de dados foram realizadas de forma individual por entrevistadores treinados e deu-se por inquérito domiciliar, no município de Coxilha-RS, Brasil. Utilizou-se para análise inferencial bivariada, exato de Fisher e qui-quadrado, e multivariada o teste de regressão de Poisson com variância robusta com nível de significância de p 0,05. Detectou-se que a prevalência de multimorbidade teve uma diminuição significativa, passando de 66,5% em 2010, para 41,6% em 2021. Ser dependente para atividades básicas e instrumentais da vida diária associou-se a maior prevalência para a multimorbidade no ano de 2010, contudo no ano de 2021 o ser dependente para atividades instrumentais, não saber ler/escrever e não trabalhar apresentou maior prevalência para a multimorbidade. Por fim, concluise que as condições de saúde dos idosos diferiram significativamente apontando que os cuidados de saúde também precisam ser reavaliados para tornarem-se mais efetivos

Abstract The present study aimed to compare the factors associated with multimorbidity in older adults aged 60 to 69 years, in 2010 and 2021. This is a comparative cross-sectional study, comprised of other two cross-sectional studies. Both data collections were individually conducted by trained interviewers through household surveys in the municipality of Coxilha-RS, Brazil. Bivariate inferential analysis was conducted using Fisher's exact test and chi-square test, while multivariate analysis employed Poisson regression with robust variance with a significance level of p 0.05. It was observed that the prevalence of multimorbidity significantly decreased, decreasing from 66.5% in 2010 to 41.6% in 2021. Dependency for basic and instrumental activities of daily living was associated with higher prevalence of multimorbidity in the year 2010. However, in 2021, being dependent on instrumental activities, being unable to read/write, and being unemployed showed higher prevalence for multimorbidity. In conclusion, it is evident that the health conditions of older adults differed significantly over the years, highlighting the necessity for a reevaluation of healthcare practices to become more effective

O processo de envelhecimento de uma pessoa com autismo na perspectiva do cuidador: estudo de caso / El proceso de envejecimiento de una persona con autismo desde la perspectiva del cuidador: Estudio de caso / The aging process of a person with autism from the caregiver's perspective: A case study

O artigo propõe a discussão sobre o cotidiano e as ocupações de uma pessoa adulta com autismo. Neste sentido, apresenta-se um estudo que buscou com-preender como se estrutura o cotidiano de uma mulher adulta com autismo, a partir da perspectiva de um dos cuidadores principais. Trata-se de um estudo qualitativo, do tipo estudo de caso, realizado em Santos, São Paulo, Brasil. A partir de uma entrevista semiestruturada, foram selecionadas e analisadas as categorias: atividades cotidianas e ocupações e desafios enfrentados pela pessoa e sua família. Os resultados destacam a importância de criar espaços de discussão que abordam diferentes maneiras de vivenciar a vida adulta e o processo de envelhecimento com autismo, além de dialogar sobre formas de envelhecer ativamente, participando das atividades da comunidade, exercendo a cidadania e acessando direitos. Os resultados também apontam a necessidade de construção de serviços que apoiem a transição ao longo da vida de pessoas que apresentam condição do espectro do autismo, além de estimular profissionais a desenvolverem ações de cuidado voltadas às demandas específicas dessas pessoas e suas famílias

El artículo propone una discusión sobre la vida cotidiana y las ocupaciones de personas adultas con autismo. En este sentido, se presenta un estudio que buscó comprender cómo se estructura la vida cotidiana de una mujer adulta con autismo, desde la perspectiva de uno sus cuidadores principales. Se trata de un estudio cualitativo, del tipo estudio de caso, realizado en Santos, São Paulo, Brasil. A través de una entrevista semiestructurada, se seleccionaron y analizaron las categorías: actividades cotidianas y ocupaciones, y desafíos enfrentados por la persona y su familia. Los resultados destacan la importancia de crear espacios de discusión que aborden diferentes formas de experimentar la vida adulta y el proceso de envejecimiento con autismo. Además, abogan por el diálogo sobre formas de envejecer activamente, participando en las actividades de la comunidad, ejerciendo la ciudadanía y accediendo a los derechos. También se señala la necesidad de construir servicios que apoyen la transición a lo largo de la vida de las personas que tienen condiciones del espectro autista, así como de estimular a las y los profesionales a desarrollar acciones de cuidado orientadas a las demandas específicas de estas personas y sus familias

The article proposes a discussion on the daily life and occupations of an adult with autism. In this regard, a study that sought to understand how the daily life of an adult woman with autism is structured, from the perspective of one of the main caregivers, is presented. This was a qualitative study, a case study, conducted in Santos, São Paulo, Brazil. Through a semi-structured interview, categories such as daily activities and occupations, and the challenges faced by the individual and their family were selected and analyzed. The results emphasize the importance of creating spaces for discussion that address different ways of experiencing adulthood and the aging process with autism. Furthermore, it advocates for dialogue on active aging, participating in community activities, exercising citizenship, and accessing rights. The findings also highlight the need for the development of services that support transitions across the lifespan of people with autism spectrum conditions and encourage professionals to develop care actions aimed at the specific demands of these people and their families.

Fatores associados a incapacidade funcional após acidente vascular cerebral isquêmico / Factores asociados a incapacidad funcional después de accidente cerebrovascular isquémico / Factors associated with functional disability after ischemic stroke

Resumo Objetivo Avaliar o nível de incapacidade funcional e identificar os fatores associados em pessoas após Acidente Vascular Cerebral Isquêmico. Métodos Coorte prospectiva, realizada em hospital de referência em neurologia, com 224 pessoas com acidente vascular cerebral isquêmico. A coleta de dados ocorreu entre março a outubro de 2019. Os participantes foram acompanhados durante a internação, quando as variáveis sociodemográficas e clínicas foram levantadas empregando-se instrumentos específicos e contatados após 90 dias, por ligação telefônica, para aplicação do Índice de Barthel modificado. Na análise, aplicou-se estatística descritiva e o teste Qui-quadrado de Pearson. Adotou-se significância estatística de 5%. Resultados A maioria apresentou algum grau de incapacidade funcional (58,5%), sendo que 29,5% apresentaram dependência moderada e 29,0% severa ou grave. As variáveis sexo feminino (p=0,011), tempo de chegada ao hospital de referência maior ou igual a 4,5h (p=0,017), Acidente vascular cerebral prévio (p=0,031), não ter realizado trombólise (p=0,023), ter hipertensão arterial (p=0,032) e maior gravidade estimada pela National Institute of Health Stroke Scale (p=0,000) foram associadas a maior nível de incapacidade. Conclusão Predominou a dependência de moderada a grave. A gravidade do evento, evento prévio, hipertensão, não submissão à trombólise, retardo à chegada ao hospital e sexo feminino foram associados a maior nível de incapacidade funcional.

Resumen Objetivo Evaluar el nivel de incapacidad funcional e identificar los factores asociados en las personas después de un accidente cerebrovascular isquémico. Métodos Cohorte prospectiva, realizada en un hospital de referencia en neurología, con 224 personas con accidente cerebrovascular isquémico. La recopilación de datos se llevó a cabo entre marzo y octubre de 2019. Se acompañó a los participantes durante la internación, momento en que se recopilaron las variables sociodemográficas y clínicas mediante la utilización de instrumentos específicos, y se los contactó 90 días después, por teléfono, para aplicar el Índice de Barthel modificado. En el análisis se aplicó estadística descriptiva y la prueba χ2 de Pearson. Se adoptó significación estadística de 5 %. Resultados La mayoría presentó algún nivel de incapacidad funcional (58,5 %), de los cuales el 29,5 % presentó dependencia moderada y el 29,0 % dependencia severa o grave. Las siguientes variables fueron asociadas a un mayor nivel de incapacidad: sexo femenino (p=0,011), tiempo de llegada al hospital de referencia mayor o igual a 4,5 h (p=0,017), accidente cerebrovascular previo (p=0,031), no haber realizado trombólisis (p=0,023), tener hipertensión arterial (p=0,032) y mayor gravedad estimada por la National Institute of Health Stroke Scale (p=0,000). Conclusión Predominó la dependencia de moderada a grave. La gravedad del evento, evento previo, hipertensión, no realización de trombólisis, retraso de la llegada al hospital y sexo femenino fueron las variables asociadas a un mayor nivel de incapacidad funcional.

Abstract Objective To assess the functional disability level and identify associated factors in people after Ischemic Cerebral Vascular Accident. Methods A prospective cohort, carried out in a reference hospital in neurology with 224 people with ischemic stroke. Data collection took place between March and October 2019. Participants were followed up during hospitalization, when sociodemographic and clinical variables were collected using specific instruments and contacted after 90 days, by telephone call, to apply the Modified Barthel Index. In the analysis, descriptive statistics and Pearson's chi-square test were applied. Statistical significance of 5% was adopted. Results Most had some degree of functional disability (58.5%), with 29.5% having moderate dependence and 29.0% having severe dependence. The variables being female (p=0.011), time of arrival at the reference hospital greater than or equal to 4.5 hours (p=0.017), previous stroke (p=0.031), not having undergone thrombolysis (p=0.023), having high blood pressure (p=0.032) and greater severity estimated by the National Institute of Health Stroke Scale (p=0.000) were associated with a higher disability level. Conclusion Moderate to severe dependence predominated. The severity of the event, previous event, hypertension, non-submission to thrombolysis, delay in arriving at the hospital and female gender were associated with a higher functional disability level.

Dependência de cuidados pré-operatórios e qualidade de recuperação pós-operatória de pacientes cirúrgicos / Dependencia de cuidados preoperatorios y calidad de recuperación posoperatoria de pacientes quirúrgicos / Preoperative care dependency and postoperative quality of recovery of the surgical patients

Resumo Objetivo O objetivo do estudo foi determinar a relação entre a dependência de cuidados pré-operatórios e a qualidade de recuperação no pós-operatório de pacientes submetidos à cirurgia. Métodos A amostra do estudo descritivo, transversal e correlacional foi composta por 215 pacientes. Um formulário de informações do paciente, a Care Dependency Scale e o questionário Quality of Recovery-40 item foram aplicados aos pacientes usando a técnica de entrevista face a face para a coleta de dados entre junho e dezembro de 2018. A ferramenta Strengthening the Reporting of Observational Studies in Epidemiology foi utilizada neste estudo. Resultados Houve uma diferença estatisticamente significativa entre as pontuações médias da Care Dependency Scale e do Quality of Recovery-40 item Scale dos pacientes e seus domínios conforto físico, independência física e dor em termos de faixas etárias e sexo (p<0,05). Foi encontrada uma correlação positiva e moderada entre a dependência de cuidados dos pacientes e a independência física. Conclusão Quando o nível de dependência de cuidados diminuiu, os pacientes precisaram de menos assistência durante a recuperação no período pós-operatório, pois conseguiram realizar suas atividades diárias de forma independente.

Resumen Objetivo El objetivo del estudio fue determinar la relación entre la dependencia de cuidados preoperatorios y calidad de recuperación en el posoperatorio de pacientes sometidos a cirugía. Métodos La muestra del estudio descriptivo, transversal y correlacional estuvo compuesta por 215 pacientes. Se aplicó a los pacientes un formulario de información del paciente, la Care Dependency Scale y el cuestionario Quality of Recovery-40 item, mediante la técnica de entrevista cara a cara para la recopilación de datos, entre junio y diciembre de 2018. Se utilizó la herramienta Strengthening the Reporting of Observational Studies in Epidemiology en este estudio. Resultados Hubo una diferencia estadísticamente significativa entre el puntaje promedio de la Care Dependency Scale y del Quality of Recovery-40 item Scale de los pacientes y los dominios bienestar físico, independencia física y dolor en términos de grupos de edad y sexo (p<0,05). Se observó una correlación positiva y moderada entre la dependencia de cuidados de los pacientes y la independencia física. Conclusión Cuando el nivel de dependencia de cuidados disminuyó, los pacientes necesitaron menos atención durante la recuperación en el período posoperatorio, ya que pudieron realizar sus actividades diarias de forma independiente.

Abstract Objective The purpose of the study was to determine the relationship between preoperative care dependency and postoperative quality of recovery in patients undergoing surgery. Methods The sample of the descriptive, cross-sectional and correlational study consisted of 215 patients. A Patient Information Form, the Care Dependency Scale and the Recovery Quality-40 Scale were applied to the patients through face-to-face interview technique in order to collect the data between June and December 2018. This study adhered to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results There was a statistically significant difference between Care Dependency Scale and the Recovery Quality-40 Scale mean scores of the patients and their physical comfort, physical independence, and pain in terms of age groups and genders (p<.05). A positive and moderate correlation was found between the patients' care dependency and physical independence. Conclusion It was observed that when the care dependency level decreased, the patients needed less assistance throughout the postoperative recovery period, as they were able to carry out their daily activities independently.

Análisis desde una perspectiva ocupacional al uso de la telesalud en terapia ocupacional en tiempos de confinamiento / Análise sob a perspectiva ocupacional do uso da telesaúde na terapia ocupacional em tempos de confinamento / Analysis from an occupational perspective of the telehealth use in occupational therapy in times of confinement

Resumen Introducción Las acciones adoptadas con el propósito de evitar los contagios comunitarios, durante la pandemia por COVID-19, significó una interrupción ocupacional ya que estas medidas impidieron o restringieron la participación en ocupaciones significativas de las personas. Al mismo tiempo, las distintas instituciones sanitarias y los profesionales del área de la salud tuvieron que acudir a la telesalud para dar continuidad a la atención y cuidados. Objetivo Analizar desde una perspectiva ocupacional el uso de la telesalud en Terapia Ocupacional en contextos de confinamiento. Metodología De tipo cualitativa. La información se produce a través de grupos de discusión y entrevistas individuales. Participaron de este estudio 9 estudiantes, 10 docentes, 5 usuarios/as y/o familiares y 5 integrantes de los equipos de atención. Se realizó un análisis del contenido temático a través de la triangulación de actores para integrar las opiniones de todos/as los/as participantes, posteriormente con el fin de profundizar desde una perspectiva ocupacional el uso de la telesalud se incluye la triangulación teórica. Resultados La telesalud como ocupación materializa la posibilidad de contar con apoyo socioemocional y permite la colaboración en busca del bienestar en tiempos de aislamiento social. También es una ocupación que permitió reconocer el hogar como un territorio, en el que se produce la apropiación de recursos materiales y relacionales de una manera colaborativa entre el equipo tratante y los/as usuarios/as. Conclusiones La telesalud es una ocupación colectiva que permite la re-existencia en tiempos de interrupción ocupacional y de nuevas formas de dislocación ocupacional.

Resumo Introdução As ações adotadas com o objetivo de evitar infecções comunitárias, durante a pandemia de COVID-19, significaram uma interrupção ocupacional, uma vez que essas medidas impediram ou restringiram a participação em ocupações significativas de pessoas. Ao mesmo tempo, as diferentes instituições de saúde e profissionais de saúde tiveram que recorrer à telessaúde para dar continuidade aos cuidados. Objetivo Analisar numa perspetiva ocupacional a utilização da telessaúde em Terapia Ocupacional em contextos de confinamento. Metodologia Qualitativa. A informação é produzida através de grupos focais e entrevistas individuais. Participaram deste estudo 9 alunos, 10 professores, 5 usuários e/ou familiares e 5 integrantes das equipes assistenciais. É realizada uma análise do conteúdo temático através da triangulação de atores para integrar as opiniões de todos os participantes, posteriormente para aprofundar o uso da telessaúde do ponto de vista ocupacional, inclui-se a triangulação teórica. Resultados A telessaúde como ocupação materializa a possibilidade de ter suporte socioemocional e permite a colaboração na busca do bem-estar em tempos de isolamento social. É também uma ocupação que permitiu reconhecer a casa como um território, no qual a apropriação de recursos materiais e relacionais ocorre de forma colaborativa entre a equipe de tratamento e os usuários. Conclusões: A telessaúde é uma ocupação coletiva que permite a reexistência em tempos de interrupção ocupacional e novas formas de deslocamento ocupacional.

Abstract Introduction The actions adopted with the purpose of avoiding community infections, during the COVID-19 pandemic, meant an occupational interruption since these measures prevented or restricted the participation in significant occupations of people. At the same time, the different health institutions and health professionals had to resort to telehealth to provide continuity of care. Objective To analyze from an occupational perspective the use of telehealth in Occupational Therapy in confinement contexts. Methodology Qualitative. Information is produced through focus groups and individual interviews. 9 students, 10 teachers, 5 users and/or family members and 5 members of the care teams participate in this study. An analysis of the thematic content is carried out through the triangulation of actors to integrate the opinions of all the participants, later in order to deepen the use of telehealth from an occupational perspective, theoretical triangulation is included. Results Telehealth as an occupation materializes the possibility of having socio-emotional support and allows collaboration in search of well-being in times of social isolation. It is also an occupation that allowed recognizing the home as a territory, in which the appropriation of material and relational resources occurs in a collaborative way between the treatment team and the users. Conclusions Telehealth is a collective occupation that allows re-existence in times of occupational interruption and new forms of occupational dislocation.

Rehabilitation interventions targeting the activity and participation of patient with neuromuscular diseases: what do we know? A systematic review / Reabilitação com foco na atividade e participação para pessoas com doenças neuromusculares: o que sabemos? Uma revisão sistemática

Abstract Background To be objective and achievable, the rehabilitation goals must be focused on the functional expectations of patients with neuromuscular disease (NMD). Objective Investigate rehabilitation programs that are able to modify the activity/participation of patients with NMD. Data search: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO, and Medline were searched in June 2021. It was last updated in March 2023. Methods Randomized controlled trials investigating any rehabilitation therapy for patients with NMD with an outcome encompassing the activity/participation components of the International Classification of Functioning, Disability and Health (ICF) were included. Pharmacological therapy studies were excluded. The results were synthesized according to the ICF core sets for NMD. The methodological quality and level of evidence were assessed using PEDro criteria and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This systematic review followed the PRISMA 2020 guideline and was registered at PROSPERO (CRD42020209359). Results Of a total of 1943 identified studies, 12 were included in this review with a methodological quality between regular and good. Light to moderate-intensity aerobic exercise was the most studied intervention. The mobility was assessed in all included studies. Conclusion The variability of the types of NMD and the small sample size of the included studies demonstrates that there is very limited evidence of interventions focused on the activity/participation of individuals with NMD. Light to moderate-intensity aerobic exercise seems to improve the mobility, self-care, and social participation of patients with NMD, especially those with slow progression.

Resumo Antecedentes As metas de reabilitação devem ser focadas nas expectativas funcionais de pessoas com doenças neuromusculares (DNM) para que sejam objetivas e alcançáveis. Objetivo Investigar programas de reabilitação capazes de modificar a atividade/participação de pessoas com DNM. Foi realizada busca nas bases de dados: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO e Medline em junho/2021. A última atualização foi realizada em março de 2023. Métodos Foram incluídos estudos clínicos randomizados investigando qualquer terapia de reabilitação para pessoas com DNM com desfecho voltado para atividade/participação da Classificação Internacional de Funcionalidade e Saúde (CIF). Terapias farmacológicas foram excluídas. Os resultados foram sintetizados de acordo com os Core Sets da CIF para DNM. A qualidade metodológica e o nível de evidência foram avaliados usando os critérios PEDro e Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Esta revisão sistemática foi registrada na PROSPERO (CRD42020209359). Resultados De 1943 estudos identificados, 12 foram incluídos com uma qualidade metodológica entre regular e boa. O exercício aeróbio de intensidade leve a moderada foi a intervenção mais estudada. A mobilidade foi avaliada em todos os estudos incluídos. Conclusão A variabilidade dos tipos de DNM e o baixo número amostral dos estudos incluídos contribuem para uma evidência muito limitada de intervenções focadas na atividade/participação de pessoas com DNM. O exercício aeróbio de baixa a moderada intensidade parece melhorar a mobilidade, autocuidado e participação de pessoas com DNM, especialmente para as DNM de progressão lenta.

Occupational complexity of paid work and housework, and its impact on the cognitive performance in community dwelling older adults, preliminary results / Complexidade ocupacional do trabalho remunerado e o trabalho doméstico e seu impacto no desempenho cognitivo de idosos residentes na comunidade, resultados preliminares

ABSTRACT Work and activity could be an important source of cognitive enrichment. Activities that are more challenging concerning the cognitive functions that are put into practice are associated with lower risk of cognitive decline in old age. Objective: The present study aimed to assess the impact of occupational complexity and household tasks in three cognitive domains (verbal episodic memory, language, and executive functions) in older adults residing within the community. Methods: A trail analysis was executed, using the structural equations procedure in 120 participants assessed with main lifetime occupational activity and household tasks questionnaire, as well as a neuropsychological assessment battery for memory, language, and executive functions. Results: The regression weights analysis indicated that complexity in household chores showed moderate effects on executive functions (β=0.19; p=0.027) and that occupational complexity of paid work showed effects on memory (β=0.26; p=0.008), language (β=0.38; p<0.001), and executive functions (β=0.55; p<0.001). Conclusion: Paid work promotes cognitive reserve, contrary to household activities which seem to have a moderate impact on cognition. Differences in activity complexity not only impact people´s economic and social status and possibilities but can also determine different courses of aging and cognitive risk.

RESUMO Trabalho e atividade podem ser importantes fontes de enriquecimento cognitivo. Atividades que são mais desafiadoras quanto às funções cognitivas postas em prática se associam a menor risco de declínio cognitivo em idade avançada. Objetivo: O objetivo do presente estudo é avaliar o impacto da complexidade ocupacional e das tarefas domésticas em três domínio cognitivos (memória episódica verbal, linguagem e funções executivas) em idosos residentes na comunidade. Métodos: Foi realizada uma análise de trilha com o uso de procedimento de equações estruturais em 120 participantes, avaliados por meio de: questionário das principais atividades ocupacionais e tarefas domésticas da vida, bem como bateria de avaliação neuropsicológica para memória, linguagem e funções executivas. Resultados: A análise dos pesos de regressou mostrou que a complexidade nas tarefas domésticas apresenta efeitos moderados nas funções executivas (β=0,19; p=0,027) e que a complexidade ocupacional do trabalho remunerado teve efeitos sobre a memória (β=0,26; p=0,008), linguagem (β=0,38; p<0,001) e funções executivas (β=0,55; p<0,001). Conclusão: O trabalho remunerado promove a reserva cognitiva, em contraste com as atividades domésticas, que parecem ter impacto moderado na cognição. As diferenças na complexidade das atividades não apenas impactam o status econômico e social e as possibilidades das pessoas, mas também podem determinar diferentes cursos de envelhecimento e risco cognitivo.

Quality of life of women who underwent breast cancer treatment relative to sociodemographic, behavioral, and clinical factors

ABSTRACT Objective Patients with cancer often undergo multiple extended treatments that decrease their quality of life. However, the quality of life of women with breast cancer after they undergo treatment remains underexplored in Brazil. Therefore, this study determined sociodemographic, behavioral, and clinical factors related to the post-treatment quality of life of women with breast cancer. Methods This cross-sectional study involved 101 women diagnosed with breast cancer between 2014 and 2016 and treated at a Brazilian Oncology Reference Service. Data were collected from them using face-to-face surveys. Quality of life was evaluated using the European Organization for the Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) and EORTC Breast Cancer-specific Quality of Life questionnaire (EORTC QLQ-BR23). The data collected were analyzed using Student's t-test and Mann-Whitney U test. Results The median score on the global health, functional, and symptom scales of the EORTC QLQ-C30 was 75.00 (Interquartile range=33.33), 75.99 (Standard deviation [SD]=19.26), and 19.67 (SD=16.91), respectively. The mean score on the functional and symptom scales of the EORTC QLQ-BR23 was 61.89 (SD=17.21) and 20.12 (SD=16.94), respectively. Furthermore, higher post-treatment quality of life was found to be associated with being aged 50 or more, being Black, having eight or more years of education, having a partner, having a paying job, receiving treatment from the private healthcare system, having a higher income, living in the municipality where healthcare services are availed, engaging in physical activity, not smoking, being more religious, having more social support, not being overweight, having no comorbidities, and undergoing lumpectomy. Conclusion Sociodemographic, behavioral, and clinical factors significantly impact the quality of life of women who undergo breast cancer treatment. Implementing interventions that improve health and reducing inequalities in the access to healthcare services can improve the quality of life of these patients.

Independência funcional, aspectos clínicos e fatores sociodemográficos em pacientes na fase aguda do Acidente Vascular Cerebral: uma análise de associação / Functional independence, clinical aspects, and sociodemographic factors in patients in the acute phase of stroke: an association analysis

RESUMO Objetivo Analisar a associação da independência funcional com aspectos clínicos de comprometimento neurológico, a localização e extensão do dano neuronal e os fatores sociodemográficos em pacientes na fase aguda do AVC. Método Estudo analítico de recorte transversal, realizado com 90 pacientes adultos e idosos acometidos por AVC isquêmico, que tiveram admissão no ambiente hospitalar nas primeiras 24 horas após o evento vascular. A coleta dos dados referentes aos aspectos clínicos e fatores sociodemográficos foi realizada pelo prontuário eletrônico e/ou entrevista para descrever o perfil dos pacientes, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale e a Medida de Independência Funcional. Resultados O comprometimento neurológico, de acordo com a National Institute of Health Stroke Scale, foi associado à funcionalidade nas primeiras 24 horas após o AVC. Além disso, a presença de hipertensão arterial, idade, trabalho inativo, tabagismo e extensão do dano neuronal estiveram associados à dependência funcional, mas não permaneceram no modelo final deste estudo. Conclusão A dependência funcional está associada à hipertensão arterial, idade, trabalho inativo, tabagismo, extensão do dano neuronal e grau de comprometimento neurológico nas primeiras 24 horas após o evento vascular. Além disso, um nível mais elevado de comprometimento neurológico foi independentemente associado a níveis aumentados de dependência funcional.

ABSTRACT Purpose To analyze the association of functional independence with clinical aspects of neurological impairment, the location and extent of neuronal damage and sociodemographic factors in patients in the acute phase of stroke. Methods Analytical cross-sectional study in 90 adult and older patients affected by ischemic stroke, admitted to the hospital within 24 hours of the vascular event. Sociodemographic factors and clinical aspects data were collected from electronic medical records and/or interviews in order to depict the patients'profile, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale, and Functional Independence Measure. Results Neurological impairment, according to the National Institute of Health Stroke Scale, was associated with functioning in the first 24 hours after the stroke. Furthermore, the presence of arterial hypertension, age, inactive work, smoking and extent of neuronal damage were associated with functional dependence, but did not remain in the final model of this study. Conclusion Functional dependence is associated with arterial hypertension, age, inactive work, smoking, extent of neuronal damage, and degree of neurological impairment in the first 24 hours after the vascular event. Furthermore, a higher level of neurological impairment was independently associated with increased levels of functional dependence.

Percepção de cuidadores de pré-escolares com TEA sobre seu comportamento e desempenho ocupacional durante a pandemia da COVID-19 / Perception of caregivers of preschool children with ASD on their behavior and occupational performance during the COVID-19 pandemic

Resumo Introdução Crianças com Transtorno do Espectro Autista (TEA) podem apresentar questões comportamentais, no processamento sensorial, na cognição e na linguagem, que afetam seu desempenho ocupacional, necessitando de acesso a serviços escolares, terapêuticos e de saúde. O acesso a esses serviços esteve restrito durante a pandemia de COVID-19, tornando essa população particularmente ainda mais vulnerável às restrições sociais impostas à época. Objetivo Descrever a percepção dos pais cuidadores de pré-escolares com TEA acerca do comportamento e desempenho ocupacional de seus filhos durante a pandemia da COVID-19. Método Estudo transversal, descritivo, quantitativo e qualitativo baseado em entrevistas com 60 cuidadores de pré-escolares com TEA. Os participantes responderam à seguinte pergunta: Você está notando alguma diferença no comportamento e desempenho da criança durante a pandemia? Para caracterização das crianças, foram utilizados o Sistema de Classificação de Funcionalidade no Autismo: Comunicação Social (ACSF:SC), o Inventário de Avaliação Pediátrica de Incapacidade - Teste Adaptativo de Computador (PEDI-CAT) e o Perfil Sensorial 2 (SP-2). Todas as entrevistas foram anotadas e 15 delas foram gravadas e transcritas. O material foi submetido à análise temática de conteúdo. Resultados Foram entrevistadas 43 mães, 15 casais e dois pais de crianças com TEA. Das 60 crianças, 46 (76,7%) eram meninos, com idade de 3 a 5 anos (53,6 ±10,18 meses). Os cuidadores perceberam mudanças no comportamento e desempenho ocupacional, com prevalência de relatos de piora. Houve aumento nas estereotipias, rigidez e hiperfoco, bem como menor engajamento nas atividades cotidianas. A presença dos cuidadores beneficiou algumas crianças, mas há relato de estresse, especialmente por parte das mães. Conclusão Houve variação nos relatos, com maior tendência à piora no comportamento e desempenho ocupacional das crianças com TEA.

Abstract Introduction Children with Autism Spectrum Disorder (ASD) face behavioral, sensory processing, cognitive, and language challenges that affect their ability to perform activities of daily living (ADL) and necessitate access to educational, therapeutic, and health services. The COVID-19 pandemic limited access to these essential services, exacerbating the challenges faced by this vulnerable population due to imposed social distancing measures. Objective To explore the perceptions of parent caregivers of preschoolers with ASD regarding their children's behavior and performance in ADL during the COVID-19 pandemic. Method This cross-sectional, descriptive study utilized both quantitative and qualitative approaches, interviewing 60 caregivers of preschoolers with ASD. Participants were asked about any observed changes in their child's behavior and ability to engage in ADL during the pandemic. Child characterization involved the Autism Classification System of Functioning: Social Communication (ACSF:SC), the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT), and the Sensory Profile 2 (SP-2). Interviews were documented, with 15 recorded and transcribed for thematic content analysis. Results Participants included 43 mothers, 15 couples, and two fathers, totaling 60 children, of whom 46 (76.7%) were boys aged between 3 and 5 years (mean age 53.6 ±10.18 months). Caregivers reported changes in behavior and performance in ADL, predominantly noting deterioration. Increases in stereotypic behaviors, rigidity, and hyperfocus were observed, along with decreased participation in ADL. While the presence of caregivers benefited some children, it also led to reported stress, particularly among mothers. Conclusion The study found a predominant trend of deteriorating behavior and performance in ADL among children with ASD during the pandemic, based on caregiver reports.

Reliability and construct validity of the Long Version of Disability Assessment for Dementia (Brazilian Version) / Confiabilidade e validade de construto da Escala de Avaliação de Incapacidade na Demência - Versão Longa (DADL-BR)

Abstract Objectives Evaluate the reliability test-retest (intra and inter-examiner) and construct validity of the Long Version of Disability Assessment for Dementia (Brazilian Version - DADL-BR). Methods The DADL-BR was applied to 58 caregivers/family of older adults with dementia. The inter-examiner (n = 30) and intra-examiner (n = 28) reliability was assessed using the kappa test and Pearson's correlation coefficient, and the internal consistency was assessed using Cronbach's alpha. The construct validity (n = 48) was performed by comparing DADL-BR with MMSE. Results The results of the intra and inter-examiner demonstrated good reliability (0.72 and 0.74), as well as nearly perfect correlations (0.99) for both inter- and intra-examiner reliability. The internal consistency was excellent (0.87) and the results demonstrated a good correlation (0.74) between DADL-BR and MMSE in construct validity analysis. Conclusions DADL-BR can be considered reliable instrument and with good construct validity, considering internal consistency and test-retest reliability and may be constitute a useful instrument for assessing the occupational performance profile of older adults with dementia.

Resumo Objetivos Avaliar a confiabilidade teste-reteste (intra e inter-examinadores) e a validade de construto da Versão Longa da Escala de Avaliação de Incapacidade na Demência - Versão Longa (DADL-BR). Métodos O DADL-Br foi aplicado em 58 cuidadores/familiares de idosos com demência. A confiabilidade inter-examinadores (n = 30) e intrae-xaminadores (n = 28) foi avaliada pelo teste kappa e coeficiente de correlação de Pearson, e a consistência interna foi avaliada pelo Alfa de Cronbach. A validade de construto (n = 48) foi realizada comparando-se o DADL-BR com o Mini Exame do Estado Mental (MEEM). Resultados Os resultados intra e inter-examinadores demonstraram boa confiabilidade (0,72 e 0,74), bem como correlações quase perfeitas (0,99) tanto para confiabilidade inter quanto intra-examinadores. A consistência interna foi excelente (0,87) e os resultados demonstraram boa correlação (0,74) entre o DADL-BR e o MEEM na análise de validade de constructo. Conclusões O DADL-BR pode ser considerado um instrumento confiável e com boa validade de constructo, considerando-se a consistência interna e a confiabilidade teste-reteste, e útil para avaliar o perfil de desempenho ocupacional de idosos com demência.

Low grip strength and gait speed as markers of dependence regarding basic activities of daily living: the FIBRA study

ABSTRACT Objective To determine whether low muscle strength and low gait speed increase the risk of disability related to basic activities of daily living in community-dwelling older adults. Methods A longitudinal study (9 years of follow-up) was conducted with 390 older adults who were independent in basic activities of daily living at baseline and answered the Katz Index at follow-up. Associations were determined using Pearson's χ2 test with a 5% significance level and logistic regression analysis. Results Increases in prevalence between baseline and follow-up were observed for low muscle strength (17.5%-38.2%), slow gait speed (26.0%-81.1%), and functional dependence (10.8%-26.6%). At follow-up, 11.7% of the participants had concomitant functional dependence, slow gait speed, and low muscle strength. Slow gait speed remained a predictor of dependence in basic activities of daily living (odds ratio=1.90; 95% confidence interval=1.06-3.41). Conclusion Slow gait speed is a predictor of functional dependence, constituting an important variable for screening functional decline.

Histerectomía abdominal y deterioro de la función física en mujeres adultas mayores colombianas / Abdominal hysterectomy and impaired physical function in colombian older women

Resumen OBJETIVO: Estimar, en mujeres adultas mayores colombianas, la asociación entre histerectomía abdominal con el deterioro de la función física y con la limitación para las actividades de la vida diaria. MATERIALES Y MÉTODOS: Estudio transversal llevado a cabo en mujeres colombianas entre 60 y 75 años que firmaron el consentimiento informado, permitieron mediciones antropométricas y contestaron un formulario con preguntas acerca de datos sociodemográficos y clínicos. Se aplicó la subescala de función física del Cuestionario SF-36. Se realizaron regresiones logísticas bivariadas: limitación para las actividades habituales o deterioro en la función física (variables dependientes) con el antecedente de histerectomía con o sin ooforectomía en la pre o posmenopausia (variables independientes). Además, se aplicaron cuatro modelos de regresión logística ajustada. RESULTADOS: Se evaluaron 700 mujeres con promedio de edad de 67.0 ± 4.8 años y 18.9 ± 6.3 años trascurridos a partir de la menopausia. A todas se les practicó histerectomía con ooforectomía durante los años de premenopausia (4.2%); histerectomía sin ooforectomía en la premenopausia (18.1%); histerectomía con ooforectomía en la posmenopausia (2.1%) e histerectomía sin ooforectomía en la posmenopausia (8.4). La histerectomía con ooforectomía, o sin esta última en la premenopausia, se relacionó con deterioro de la función física (RM: 2.67; IC95%:1.19-5.97) y 2.02 (IC95%:1.34-3.09). Igual sucedió con las actividades habituales (p < 0.05). La histerectomía con preservación o extirpación ovárica durante la posmenopausia no se asoció con deterioro de la función física (p > 0.05). CONCLUSIÓN: En la muestra estudiada se encontró relación entre la histerectomía con limitación para actividades diarias y con deterioro de la función física. La histerectomía con o sin ooforectomía practicada durante los años de premenopausia, a diferencia de la adelantada en posmenopausia, se asoció, significativamente, con deterioro del funcionamiento físico.

Abstract OBJECTIVE: To estimate the association of abdominal hysterectomy with impaired physical function and limitation of activities of daily living in elderly Colombian women. MATERIALS AND METHODS: Cross-sectional study in Colombian women aged 60-75 years who signed informed consent, allowed anthropometric measurements, and completed a form with questions on socio-demographic and clinical data. The physical function subscale of the SF-36 questionnaire was used. Bivariate logistic regressions were performed: limitation of usual activities or impairment of physical function (dependent variables) with history of hysterectomy with or without oophorectomy in pre- or postmenopause (independent variables). Four adjusted logistic regression models were also used. RESULTS: Seven hundred women with a mean age of 67.0 ± 4.8 years and 18.9 ± 6.3 years since menopause were evaluated. All had undergone hysterectomy with oophorectomy in the premenopausal years (4.2%); hysterectomy without oophorectomy in the premenopausal years (18.1%); hysterectomy with oophorectomy in the postmenopausal years (2.1%); and hysterectomy without oophorectomy in the postmenopausal years (8.4%). Hysterectomy with or without oophorectomy in premenopause was associated with impaired physical function (MR: 2.67; 95%CI: 1.19-5.97) and 2.02 (95%CI: 1.34-3.09), respectively. The same was true for usual activities (p < 0.05). Postmenopausal hysterectomy with ovarian preservation or removal was not associated with impaired physical function (p > 0.05). CONCLUSION: In the sample studied, an association was found between hysterectomy with limitation of daily activities and impaired physical function. Hysterectomy with or without oophorectomy in the premenopausal years, as opposed to early postmenopausal hysterectomy, was significantly associated with physical function impairment.

Relación entre el índice CPOD y la limitación para socializar en escolares de Ecuador / Relationship between the DMFT index and the limitation to socialize in schoolchildren from Ecuador

Introducción: La Organización Mundial de la Salud define a la caries dental como un problema de salud mundial que afecta entre el 60 al 90% de la población. Se considera una enfermedad transmisible de origen multifactorial, que evoluciona de manera progresiva hasta ocasionar la destrucción de los tejidos duros. Objetivo: Determinar la relación entre dientes cariados, perdidos y obturados, y la limitación para socializar en escolares de Ecuador. Métodos: Se realizó un estudio descriptivo de tipo correlacional sobre una población de 154 escolares de 12 años de la parroquia el Batán, de Cuenca-Ecuador (2016); para el análisis estadístico los datos fueron ingresados al programa SPSS, donde se efectuó estadística descriptiva para cada una de las variables y la limitación para socializar. Resultados: Se logró constatar que la población objeto presentó un índice de CPOD muy bajo (32,5 %), de igual forma se evidenció que el 62,7% no presentó limitación a la hora de socializar. En cuanto a la correlación entre ambas variables, se mostró una asociación positiva con un nivel de significancia de p=0,002. Una de las principales limitaciones del estudio fue el escaso contacto con los participantes. Se recomienda, efectuar investigaciones epidemiológicas longitudinales con la finalidad de observar la variación del coeficiente de correlación de las variables en fases de pretratamiento y de postratamiento. Conclusión: Al finalizar el estudio, se demostró que existe correlación estadística entre el índice CPOD y la limitación en el desempeño socializar en los escolares de 12 años de la parroquia el Batán.

Introduction: the World Health Organization defines dental caries as a global health problem that affects between 60 and 90% of the population. It is considered a communicable disease of multifactorial origin, which evolves progressively until it causes the destruction of hard tissues. Objective: to determine the relationship between decayed, missing and filled teeth and the limitation to socialize in schoolchildren from Ecuador. Methods: a descriptive correlational study was carried out on a population of 154 schoolchildren aged 12 years from the El Batán parish, Cuenca-Ecuador (2016); data was entered into the SPSS program for the statistical analysis, where descriptive statistics were performed for each of the variables and for the limitation to socialize. Results: it was possible to verify that the target population had a very low DMFT index (32.5%); in the same way it was evidenced that 62.7% did not have limitations when socializing. A positive association, with a significance level of p=0.002, was shown regarding the correlation between both variables. One of the main limitations of the study was the limited contact with the participants. We recommend to carry out longitudinal epidemiological investigations in order to observe the variation of the correlation coefficient of the variables in the pre-treatment and post-treatment phases. Conclusion: we showed, at the end of the study, that there is a statistical correlation between the DMFT index and the limitation in socializing performance in 12-year-old schoolchildren from the El Batán parish.

Diagnóstico de la variante conductual de demencia frontotemporal basado en estadios clínicos adaptado para países con baja educación: el caso de Perú

Demencia frontotemporal (DFT) es una condición neurodegenerativa escasamente reconocida en personas menores a 65 años de edad. El diagnóstico de DFT variante conductual (DFTvc) se basa en una entrevista clínica comprehensiva, complementada por una evaluación multidimensional (neurológica, cognitiva, neuropsiquiátrica, de biomarcadores e imágenes cerebrales) adaptada y validada a la población a estudiar; sin embargo, a pesar del incremento de su prevalencia en Latinoamérica y el Caribe, existe necesidad de herramientas estandarizadas y un consenso para el diagnóstico de DFTvc. El artículo intenta realizar una aproximación del enfoque de diagnóstico de DFTvc en escenario de paises con bajos y medianos ingresos, como el Perú.

Frontotemporal dementia (FTD) is a widely recognized neurodegenerative condition in people under 65 years old. The diagnosis of behavioral variant FTD (bvFTD) is based on a comprehensive clinical assessment, complemented by a multidimensional assessment (neurological, cognitive, neuropsychiatric, biomarker and brain imaging) adapted and validated to the population to be studied; however, despite its increasing prevalence in Latin America and the Caribbean, there is a need for standardized tools and consensus for the bvFTD diagnosis. The manuscript attempts to approximate the approach for the diagnosis of bvFTD in the setting of low and middle-income countries, including Peru.