Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors / Avaliação cognitiva em crianças pré-termo usando Bayley-III: desenvolvimento no primeiro ano de vida e fatores associados

ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.

Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors.

OBJECTIVE: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. METHODS: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. RESULTS: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. CONCLUSIONS: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

Predictive validity of the Denver developmental screening test (Denver-II) to detect risk of developmental coordination disorder in preterm children.

INTRODUCTION: The Denver-II is widely used as a screening tool, however, no studies were found about its validity to predict the risk of Developmental Coordination Disorder (DCD) in preterm children. OBJECTIVE: To verify the predictive validity and accuracy of the Denver-II to identify the risk of DCD in preterm children. METHODS: Methodological study with 121 preterm children, evaluated with the Denver-II at ages 1, 2, 3, 4 and/or 5 years and with the Movement Assessment Battery for Children (MABC-2) at 7 years. Univariate binary logistic regression analyses were performed and ROC curves were derived. RESULTS: Children classified as suspect by Denver-II at 2, 3, and 4 years were, respectively, 3.45, 7.40 and 6.06 times more likely to have a risk of DCD on the MABC-2 (p < 0.05). The area under the ROC curve was considered fair for ages 2 (0.60, 95 % CI 0.50-0.70), 3 (0.61, 95 % CI 0.51-0.71) and 4 (0.64, 95 % CI 0.54-0.74) years. The greater the number of suspects in Denver-II over time, the greater the probability of risk of DCD in the MABC-2 (p < 0.001). CONCLUSIONS: Global developmental assessment with the Denver-II at ages 2 to 4 years is considered to have fair accuracy to discriminate risk of DCD at school age in children born preterm.

The potential of COPCA's coaching for families with infants with special needs in low- and middle-income countries.

Infants at high biological risk of or with a neurodevelopmental disorder run a high risk of delayed school readiness. This is especially true for infants in low- and middle-income countries (LMICs). This perspective paper first summarizes evidence on intervention elements that are effective in promoting family well-being and child development in infants at high biological risk in high income countries. Crucial elements are family centeredness, goal orientation, a home setting, focus on activity and participation, and challenging the infant to explore the world and the own body by means of self-produced movements. The studies revealed that coaching as applied in COPCA (COPing and CAring for infants with special needs) is a pivotal element determining the success of intervention.The paper continues by describing COPCA and its coaching. Next, we report on two pilot studies addressing COPCA's implementation in Brazil. Finally, we discuss why COPCA is a promising early intervention program for infants at high biological risk of neurodisability in LMICs: COPCA is adapted to the families' strengths and needs, it empowers families and promotes child development therewith facilitating school readiness. Moreover, it may be delivered by tele-coaching therewith eliminating families' burden to travel to distant intervention clinics.

Catquest-9SF questionnaire: validation of the Portuguese version using the Rasch analysis / Questionário Catquest-9SF: validação da versão em português utilizando análise Rasch

ABSTRACT Purpose: The aim of this study was to validate the Portuguese version of Catquest-9SF through its application in a native Brazilian population with cataracts and to determine the correlation of the questionnaire scores with preoperative visual acuity. Methods: A prospective study was conducted to validate the Catquest-9SF questionnaire, which was translated and back-translated, generating a final version in Portuguese. A total of 120 Brazilian patients awaiting cataract surgery were recruited to answer the questionnaire and to document their preoperative data and visual acuity. The Rasch analysis was used to assess the instrument's psychometric properties. Results: The Portuguese version of Catquest-9SF demonstrated an acceptable adjustment of the items (item fit statistics ranging from 0.7 to 1.3), unidimensionality (principal component analysis), and good organization in the item response categories (thresholds of the categories: -2.79, 0.57, and 2.22, respectively). The questionnaire contains items with stable relationships if considered at the same level of visual impairment in the comparison between the two groups (absence of differential item functioning). The separation of people (person separation index, 3.07) was adequate. The visual acuity in the logarithm of the minimum angle of resolution (logMAR) in the best eye with the best optical correction showed a statistically significant correlation with the Catquest-9SF logit score (r=0.282 and p=0.004). Conclusions: The Portuguese version of Catquest-9SF presents evidence of validity and reliability, in addition to being linguistically and culturally understandable for Portuguese-speaking patients born in Brazil. The questionnaire is easy to understand and quick to apply, as it could adequately estimate the subjective visual functioning in patients with cataracts. We found a significant correlation between visual acuity and the questionnaire score.

RESUMO Objetivos: Validar a versão em português do Catquest-9SF através de sua aplicação em uma população nativa do Brasil com catarata e determinar a correlação da pontuação obtida no questionário com a acuidade visual pré-operatória. Métodos: Realizou-se um estudo prospectivo para validação de questionário. O Catquest-9SF foi traduzido e retro traduzido gerando uma versão final em português. Um total de 120 pacientes brasileiros que aguardavam realização de cirurgia de catarata foram recrutados para responder ao questionário e para documentação de dados pré-operatórios e acuidade visual. Análise Rasch foi utilizada para acessar as propriedades psicométricas do instrumento. Resultados: A versão em português do Catquest-9SF demonstrou ajuste aceitável dos itens (item fit statistics variando entre 0,7 e 1,3), unidimensionalidade (Principal Component Analisis) e boa organização nas categorias de resposta dos itens (limiares das categorias: -2,79; 0,57; 2,22). O questionário contém itens com relação estável, se considerado um mesmo nível de deficiência visual, na comparação entre dois grupos (ausência de differential item functioning). Existe adequada separação de pessoas (Person Separation Index 3,07). A acuidade visual em LogMAR no melhor olho com melhor correção óptica mostrou correlação estatisticamente significativa com a pontuação em logit do Catquest-9SF (r=0,282 e p=0,004). Conclusões: A versão em português do Catquest-9SF apresenta evidência de validade e confiabilidade, além de ser linguística e culturalmente compreensível para pacientes de língua portuguesa naturais do Brasil. Trata-se de questionário de fácil entendimento e rápida aplicação, sendo capaz de estimar de maneira adequada o funcionamento visual subjetivo em pacientes com catarata. Existe correlação significativa com a acuidade visual e a pontuação obtida no questionário.

Catquest-9SF questionnaire: validation of the Portuguese version using the Rasch analysis.

PURPOSE: The aim of this study was to validate the Portuguese version of Catquest-9SF through its application in a native Brazilian population with cataracts and to determine the correlation of the questionnaire scores with preoperative visual acuity. METHODS: A prospective study was conducted to validate the Catquest-9SF questionnaire, which was translated and back-translated, generating a final version in Portuguese. A total of 120 Brazilian patients awaiting cataract surgery were recruited to answer the questionnaire and to document their preoperative data and visual acuity. The Rasch analysis was used to assess the instrument's psychometric properties. RESULTS: The Portuguese version of Catquest-9SF demonstrated an acceptable adjustment of the items (item fit statistics ranging from 0.7 to 1.3), unidimensionality (principal component analysis), and good organization in the item response categories (thresholds of the categories: -2.79, 0.57, and 2.22, respectively). The questionnaire contains items with stable relationships if considered at the same level of visual impairment in the comparison between the two groups (absence of differential item functioning). The separation of people (person separation index, 3.07) was adequate. The visual acuity in the logarithm of the minimum angle of resolution (logMAR) in the best eye with the best optical correction showed a statistically significant correlation with the Catquest-9SF logit score (r=0.282 and p=0.004). CONCLUSIONS: The Portuguese version of Catquest-9SF presents evidence of validity and reliability, in addition to being linguistically and culturally understandable for Portuguese-speaking patients born in Brazil. The questionnaire is easy to understand and quick to apply, as it could adequately estimate the subjective visual functioning in patients with cataracts. We found a significant correlation between visual acuity and the questionnaire score.

Can tactile reactivity in preterm born infants be explained by an immature cortical response to tactile stimulation in the first year? A pilot study.

This study aimed to compare preterm (PT) and full-term (FT) infants' adaptive behavior and functional cortical response to tactile stimulus, as measured by Test of Sensory Functions in Infants and functional Near-Infrared Spectroscopy (fNIRS). Outcome measures were taken at 6 (PT = 26/FT = 21 infants) and 12 months (PT = 15/FT = 14 infants). At 6 months, poorer tactile reactivity was observed in PT, but not confirmed at 12 months. At 6 months, cortical response to tactile stimulus was found in the primary sensorimotor cortex and differences between groups did not reach significance. At 12 months, cortical response was found in the primary sensorimotor cortex and premotor area and in the somatosensory associative area, with significant less frequent response in premotor area in PT. The findings reinforce fNIRS as a tool to complement the knowledge of tactile adaptive behaviors in PT in early life.

Terapia motora cognitiva: descrição e análise clínica de crianças com Transtorno do Desenvolvimento da Coordenação (TDC), / Cognitive motor therapy: description and clinical analysis of children with Developmental Coordination Disorder (DCD)

Resumo Introdução Estima-se que 6% das crianças em idade escolar apresentam Transtorno do Desenvolvimento da Coordenação (TDC), caracterizado por dificuldades motoras que restringem a participação em casa, na comunidade e na escola. A Cognitive Orientation to Daily Occupational Performance Approach (CO-OP) é efetiva para melhorar o desempenho funcional dessas crianças, mas há poucos dados clínicos sobre variações na resposta à intervenção. Objetivo Identificar e descrever as características mais relevantes de crianças com TDC que influenciam sua resposta à CO-OP. Método Estudo de caso conduzido com quatro crianças com TDC submetidas à CO-OP: as duas que obtiveram maior e menor ganho com a intervenção. Os dados obtidos no estudo foram categorizados e sintetizados para compor uma descrição clínica das características dos participantes. Resultados Os pais das crianças com melhor desempenho apresentaram melhor estilo parental. A observação não estruturada das pesquisadoras durante as coletas identificou que as famílias das crianças com maior progresso compareceram mais vezes às coletas e eram mais engajadas. Maior apoio familiar parece proporcionar mais confiança às crianças, além de aumentar a motivação para alcançar os objetivos em terapia. Conclusão O apoio oferecido pelos pais é fator relevante para o bom desempenho de crianças com TDC na intervenção usando a CO-OP. A descrição clínica de crianças com TDC auxilia o raciocínio durante a prática profissional por identificar características que podem influenciar o progresso na intervenção.

Abstract Introduction It is estimated that 6% of school-age children have Developmental Coordination Disorder (DCD), characterized by motor difficulties that restrict participation at home, in the community and at school. The Cognitive Orientation to Daily Occupational Performance Approach (CO-OP) is effective in improving the functional performance of these children, but there is little clinical data on variations in the response to the intervention. Objective To identify and describe the most relevant characteristics of children with DCD that influence their response to CO-OP. Method Case study conducted with four children with DCD who underwent CO-OP: the two who had the highest gain and the two who had the lowest gain with the intervention. The data obtained in this study were categorized and synthesized to compose a clinical description of the participants' characteristics. Results Parents of children with better performance showed better parenting style. Unstructured observation of the researchers during the collections showed that the families of the children with greater progress attended the collections more often and were more engaged. Greater family support seems to provide children with more confidence, as well as increase motivation to achieve goals in therapy. Conclusion The support offered by parents is a relevant factor for the good performance of children with DCD in the intervention using the CO-OP. The clinical description of children with DCD assists in the reasoning during professional practice because it identifies characteristics that can influence progress in the intervention.

Survey of Well-Being of Young Children (SWYC): Preliminary Norms for Screening for Developmental Delay in Brazilian Children Younger than 65 Months.

OBJECTIVE: The objective of this study was to investigate the reliability and validity of the Developmental Milestones Questionnaire of the Survey of Wellbeing of Young Children Brazilian version (DM-SWYC-BR) and establish the preliminary norms to identify suspected developmental delay in Brazilian children up to 65 months. METHODS: A psychometric study was conducted on 1535 children from 3 Brazilian regions. The caregivers answered the Brazilian Portuguese cross-culturally adapted version of the DM-SWYC. We calculated the internal consistency and performed an exploratory factor analysis (EFA). The clinical threshold for the suspected developmental delay was set at 85% from the DM-SWYC-BR mean score for each age. The prevalence of suspected delay was calculated using current preliminary cutoffs and original norms. RESULTS: EFA confirmed the unidimensionality of the DM-SWYC-BR items (average variance extracted = 0.78). Cronbach's alpha was 0.97. At most ages, the difference between the cutoff points in the Brazilian and North American samples was lower than or equal to 2 points, except at 18, 23, 29, 44, 45, 46, and from 54 to 58 months. There was a marked divergence in the prevalence of suspected developmental delay by age ranges using the Brazilian or North American cutoff points. However, the general mean prevalence was quite similar (27.5% vs. 28.2%, respectively). CONCLUSIONS: We established the cutoff points to interpret the DM-SWYC-BR results when screening for developmental delays in Brazilian children. The satisfactory psychometric properties support its use for screening developmental delays in the public health system. Reliable assessment tools are critical to promoting child development effectively, ensuring timely intervention.

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children.

INTRODUCTION: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. OBJECTIVE: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). METHODS AND PROCEDURES: Parents of 3- and 4-year-old children (n = 312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic questionnaire. One sub-set of children (n = 119) was assessed with the Movement Assessment Battery for Children-2nd Edition; another sub-set (n = 77) completed the LDCDQ-BR a second time. RESULTS: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children's measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r = 0.30, p < 0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. CONCLUSION: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD.

Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the spinal cord injury - Falls Concern Scale.

STUDY DESIGN: Psychometric study. OBJECTIVES: To cross-culturally adapt the spinal cord injury-falls concern scale (SCI-FCS) to the Brazilian Portuguese language and to evaluate its measurement properties. SETTING: SARAH Network of Rehabilitation Hospitals, Belo Horizonte, Brazil. METHODS: The SCI-FCS was translated and culturally adapted to the Brazilian- Portuguese language, following recommended guidelines. The following measurement properties were verified: internal consistency (Cronbach's α), test-retest reliability (ICC and quadratic-weighted kappa coefficients), and construct validity (Rasch analysis). RESULTS: One-hundred and thirty individuals participated. The median SCI-FCS-Brazil score was 27 (22-34). The Cronbach's α was 0.95; ICC was 0.92 (95% CI, 0.86-0.95) for the total test-retest scores, and the Kappa coefficients ranged from 0.04 to 0.87 (95% CI, 0.01-1) for the item-level reliability. Rasch analysis reliability index was 0.81 and 0.98 and the separation index was 2.10 and 6.25 for the persons and items, respectively. Both items and persons fitted the statistics model's expectations, ensuring its unidimensionality. CONCLUSIONS: The SCI-FCS-Brazil showed adequate measurement properties. Its use in manual wheelchair users with SCI is recommended to help defining rehabilitation strategies.

Maternidade em tempos de pandemia de Covid-19: o que nos revelam as mães atendidas em um hospital de referência / Maternidad en tiempos de pandemia de Covid-19: lo que nos revelan las madres atendidas en un hospital de referencia / Maternity in times of the Covid-19 pandemic: what mothers admitted in a reference hospital have to tell us

A pandemia de Covid-19 afetou todas as esferas da nossa vida. Mulheres no período perinatal têm necessidades únicas, demandando diretrizes de saúde e segurança devido aos riscos do isolamento social. Objetivou-se conhecer a vivência de mulheres na gestação ou puerpério no contexto da pandemia durante atendimento em hospital de referência. Estudo qualitativo pautado em referenciais da integralidade do cuidado e cotidiano. Participaram 18 mulheres, gestantes e puérperas. Três temas emergiram: repercussões na gestação e puerpério; repercussões na vida prática; e estratégias de enfrentamento criadas pelas mulheres. Os relatos desvelam diferentes repercussões da pandemia na vida das mulheres e de suas famílias, bem como estratégias e cuidados usados para mitigar os efeitos adversos. Sugere-se o direcionamento de medidas preventivas e políticas públicas que priorizem mulheres grávidas e puérperas, reconhecendo e acolhendo questões subjetivas envolvidas nesse momento na vida da mulher.(AU)

La pandemia de Covid-19 afectó todas las esferas de nuestra vida. Mujeres en el período perinatal tienen necesidades únicas, que demandan directrices de salud y seguridad con relación a los riesgos debido al aislamiento social. El objetivo fue conocer la experiencia de mujeres en la gestación o el puerperio en el contexto de la pandemia durante su atención en un hospital de referencia. Estudio cualitativo pautado en factores referenciales de la integralidad del cuidado y del cotidiano. Participaron 18 mujeres, gestantes y puérperas. Surgieron tres temas: Repercusiones en la gestación y el puerperio, repercusiones en la vida práctica y estrategias de enfrentamiento creadas por las mujeres. Los relatos muestran diferentes repercusiones de la pandemia en la vida de las mujeres y sus familias, así como estrategias y cuidados usados para mitigar los efectos adversos. Se sugiere la dirección de medidas preventivas y políticas públicas para que se prioricen las mujeres embarazadas y puérperas, reconociendo y recogiendo cuestiones subjetivas presentes en ese momento en la vida de la mujer.(AU)

The Covid-19 pandemic has affected all aspects of our lives. Women in the perinatal period have unique needs, demanding health and safety guidelines regarding the risks associated to social isolation. The objective was to know the women's experience during pregnancy or puerperium in the pandemic while being cared at a hospital. Qualitative study referenced on concepts of integrality of care and daily life. Eighteen pregnant and postpartum participated. Three themes emerged: Repercussions on pregnancy and puerperium, repercussions on practical life, and coping strategies created by women. The reports reveal different repercussions of the pandemic in the lives of women and their families, also the strategies and precautions used to mitigate its adverse effects. We suggest directing preventive measures and public health policies to prioritize pregnant and postpartum women, recognizing and embracing subjective issues involved at this moment in women's lives.(AU)

Quality of the home, daycare and neighborhood environment and the cognitive development of economically disadvantaged children in early childhood: A mediation analysis.

The objective of this study was to investigate how socioeconomic factors and the quality of ecological environments affect motor and cognitive development of economically disadvantaged children. This is a cross-sectional, predictive and correlational study using structural equation modeling to analyze data on 147 economic disadvantage children of 24-36 months attending public daycare. The Bayley-III Scales, the Home Observation for Measurement of the Environment Inventory, the Infant/Toddler Environment Rating Scale-Revised Edition, a socioeconomic index and a specifically designed questionnaire on neighborhood quality were applied. The ecological environments did not affect motor development, but 25 % of variations in cognitive development were explained by socioeconomic differences and differences in the quality of the neighborhood, home and daycare. However, only the quality of the home and daycare had a direct impact, with the other factors affecting the outcome indirectly and to a lesser extent. In conclusion, this study investigated the association between the ecological contexts of economically disadvantaged children and their cognitive and motor development. The findings showed that the environmental context had effect on cognitive development. The home was the environment that exerted the most significant direct effect, followed by daycare and, indirectly and to a lesser extent, the neighborhood. Therefore, the coordination of public policies between health, education and social assistance sectors, aiming at the three ecological environments is important in order to promote the cognitive development of economically disadvantaged children.

Efficacy of CO-OP Approach With and Without Parental Coaching: RCT Study Protocol: Efficacité de l'approche CO-OP avec et sans coaching parental : protocole d'essai clinique randomisé.

BACKGROUND.: Developmental coordination disorder (DCD) leads to decreased occupational performance and restricted participation. Cognitive Orientation to daily Occupational Performance Approach (CO-OP) is effective, and as parental support is a key element, it seems relevant to investigate. PURPOSE.: To describe a study protocol that will compare CO-OP with and without Occupational Performance Coaching (OPC) on activity and participation of children with DCD. METHOD.: Randomized controlled with seven to 12-year-olds, assigned to either experimental (CO-OP+OPC) or control (CO-OP) group, both receiving traditional CO-OP, with four additional parental group sessions for the experimental group. KEY ISSUES.: Actual and perceived occupational performance and satisfaction of children's chosen goals and participation, motor performance and executive function. Measures will be obtained at baseline, post-intervention, and at 3-month follow-up. IMPLICATIONS.: Detailed description of an intervention protocol may help further replication and may contribute to clarify if a boost on parents' participation promotes better outcomes for children with DCD. TRIAL REGISTRATION.: Clinical Trials, NCT02893852. (https://clinicaltrials.gov/ct2/show/NCT02893852).

Efficacy of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach with and without parental coaching on activity and participation for children with developmental coordination disorder: A randomized clinical trial.

BACKGROUND: Cognitive Orientation to daily Occupational Performance (CO-OP) is recommended for its effectiveness in improving activity performance in children with Developmental Coordination Disorder (DCD). Since parental support is a key element in CO-OP, parental coaching seems relevant to be investigated. AIMS: Compare the efficacy of the CO-OP Approach with and without additional parental coaching to improve activity and participation in children with DCD. METHODS AND PROCEDURES: Randomized clinical trial with 7-12-years-old children with DCD, randomly assigned to experimental (E-group) or active control (AC-group) groups, with 11 children each. Both groups received traditional CO-OP, E-group received four additional parental group-coaching sessions. Occupational performance and satisfaction on intervention goals were measured at baseline, post-intervention, and follow-up. Participation, motor performance and executive function were assessed at baseline and post-intervention. OUTCOMES AND RESULTS: CO-OP with and without additional parental coaching resulted in improved occupational performance according to children, parents, and external evaluators. Children showed statistically significant gains in motor performance and cognitive flexibility. Participation measures did not change. CONCLUSIONS AND IMPLICATIONS: As coaching did not add additional gains, parent's required participation in CO-OP might be enough to support children's occupational performance.

Ovarian gene expression in collared peccary (Pecari tajacu Linnaeus, 1758) subjected to gonadotropin stimulation protocols.

Ovarian response of collared peccaries (Pecari tajacu), after hormonal stimulation with gonadotropin association (eCG/hCG), was accessed by both gene expression and follicular development. Thus, collared peccaries (n = 8) were treated with the dose used for sows (swine dose, SWD) or with dose adjusted for peccary's weight (allometric dose, ALD). The gene expression of receptors was evaluated for both gonadotropins (FSHR and LHCGR) and growth factors (proteins codified by TGFßR-1, BMPR1-A and BMPR2 genes) in antral follicles, cortex and corpora haemorrhagica (CH). Five days after gonadotropin injection, all females presented CH. The ovulation rate was similar (p > .05) between SWD (4.00 ± 1.17) and ALD (2.50 ± 0.43) group. The total number of follicles per animal and amounts of small (<3 mm), medium (3-5 mm) and large (>5 mm) follicles was similar among groups. However, SWD produced large follicles heavier than ALD group, as accessed by weight of follicular wall biopsies. Ovarian follicles expressed both gonadotropin and growth factor receptors at levels which are independent from gonadotropin dose. In conclusion, the two gonadotropin doses (SWD and ALD) can be used for ovarian stimulation of collared peccary. Additionally, FSH and growth factors (TGFßR-1, BMPR1-A and BMPR2) receptors are more expressed in the early follicle development, while LH receptor seems to be more important in the final of follicular growth.

Relação entre integração visomotora e destreza manual em crianças com transtorno do desenvolvimento da coordenação / Relationship between visual-motor integration and manual dexterity in children with developmental coordination disorder

Resumo O objetivo deste estudo foi examinar as habilidades de integração visomotora e destreza manual em crianças com Transtorno do Desenvolvimento da Coordenação (TDC). Estudo descritivo transversal com 22 crianças de 7 a 11 anos com TDC, avaliadas com o Developmental Coordination Disorder Questionnaire (DCDQ-Brasil), Movement Assessment Battery for Children Second Edition (MABC-2) e Beery-Buktenica Developmental Test of Visual-Motor Integration Sixth Edition (VMI). A amostra contou com 4 meninas e 18 meninos. Considerando o percentil 25 no VMI como ponto de corte, 12 crianças apresentaram desempenho abaixo da média no domínio integração visomotora, 13 no domínio visual e 19 no domínio de coordenação motora. Foi observada correlação significativa entre o percentil de destreza motora e o percentil total do MABC-2, mas não entre os escores do MABC-2 e os diferentes domínios avaliados com o VMI. Os resultados sugerem que é necessário e importante o uso combinado de testes para melhor avaliação das crianças com TDC, a fim de detectar suas possíveis dificuldades na integração visomotora e destreza manual e suas implicações no desempenho de tarefas funcionais das crianças no dia a dia.

Abstract This study aimed to examine the visual-motor integration and manual dexterity skills in children with Developmental Coordination Disorder (DCD). A cross-sectional descriptive study of 22 children aged 7 to 11 years old with DCD, assessed with the Brazilian version of the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil), Movement Assessment Battery for Children Second Edition (MABC-2) and Beery-Buktenica Developmental Test of Visual-Motor Integration Sixth Edition (VMI). Four girls and 18 boys participated. Considering the 25th percentile in VMI as the cutoff point, 12 children presented a below-average performance in the visual-motor integration domain, 13 in the visual domain, and 19 in the motor coordination domain. We observed a statistically significant correlation between the motor dexterity and the total MABC-2 percentiles, but not between the MABC-2 percentiles and the different domains evaluated with the VMI. The results suggest that the combined use of tests for better assessment of children with DCD is needed and important to detect their real difficulties in both visuomotor integration and manual dexterity and their implications on the performance of children's daily activities.

A Collaborative and Cognitive-based Intervention for Young People with Cerebral Palsy.

BACKGROUND.: Evidence-based approaches to improve function in individuals with cerebral palsy are needed. PURPOSE.: To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy. METHOD.: Crossover design with 12 participants, aged 6-15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations. FINDINGS.: There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills. IMPLICATIONS.: CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.

In Vitro Development and Mitochondrial Gene Expression in Brown Brocket Deer (Mazama gouazoubira) Embryos Obtained by Interspecific Somatic Cell Nuclear Transfer.

The genetic diversity of Neotropical deer is increasingly jeopardized, owing to declining population size. Thus, the formation of cryobanking of somatic cells is important for the preservation of these species using cloning. The transformation of these cells into viable embryos has been hampered by a lack of endangered species oocytes. Accordingly, the aim of this study was to produce brown brocket deer embryos by interspecific somatic cell nuclear transfer (iSCNT), using goat or cattle oocytes as cytoplasts, and to elucidate embryo mitochondrial activity by measuring the expression levels of ATP6, COX3, and ND5. Cattle embryos produced by in vitro fertilization (IVF) were used as a control. There were no differences in the development of embryos produced by traditional SCNT and iSCNT when using either the goat cytoplasts (38.4% vs. 25.0% cleaved and 40.0% vs. 50.0% morula rates, respectively) or cattle cytoplast (72.8% vs. 65.5% cleaved and 11.3% vs. 5.9% blastocyst rates, respectively). Concerning the gene expression, no significant difference was observed when goat oocytes were used as cytoplasts. However, when using cattle oocytes and 16S as a reference gene, the iSCNT upregulated COX3, when compared with SCNT group. In contrast, when GAPDH was used as a reference gene, all the evaluated genes were upregulated in the iSCNT group, when compared with the IVF group. When compared with the SCNT group, only the expression of ATP6 was statistically different. In conclusion, it was demonstrated that interspecific nuclear transfer is a potentially useful tool for conservation programs of endangered similar deer species.

Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta-analysis.

OBJECTIVE: To verify whether early intervention focused on the family improves the cognitive, motor, and language development of children born preterm and/or at social risk in the first 3 years of life. SOURCE OF DATA: Meta-analysis of clinical trials published between 2008 and 2018, in the following databases: CINAHL, MEDLINE - PubMed, MEDLINE - BVS, LILACS - BVS, IBECS - BVS, PEDro and Cochrane Reviews. Experimental studies on early interventions focused on the family, whose target groups were children born preterm and/or at social risk, with assessment of cognitive and/or motor and/or language development up to 3 years were included. The studies were rated using the PEDro Scale. DATA SYNTHESIS: Twelve studies were included from a total of 3378 articles. Early intervention focused on the family contributed to the development of the cognitive (Standardized Mean Difference - SMD=0.48, 95% CI: 0.34-0.61) and motor (SMD=0.76, 95% CI: 0.55-0.96) domains of preterm infants. Regarding cognitive development, performance improvement was observed at 12, 24 and 36 months, while in the motor domain, the effect was observed only at 12 months in preterm infants. There was no benefit of the intervention in the cognitive, motor, and language outcomes of children with the social risk factor associated to biological risk. CONCLUSION: Early intervention focused on the family has a positive effect on the cognition of preterm infants. The effect on motor development was lower, possibly due to the emphasis on interventions in family-child interaction. The effect of interventions on the development of children at social risk and on the language domain was inconclusive, due to the scarcity of studies in the area.