RESUMO
OBJECTIVE: This paper summarizes the findings of the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project and offers a roadmap for future research. METHODS: The NP-NUMBRS project represents the largest and most comprehensive co-normed neuropsychological battery to date for native Spanish-speaking healthy adults from the U.S. (California/Arizona)-Mexico borderland region (N = 254; ages 19-60 years). These norms provide demographic adjustments for tests across numerous domains (i.e., verbal fluency, processing speed, attention/working memory, executive function, episodic memory [learning and delayed recall], visuospatial, and fine motor skills). CONCLUSIONS: This project: 1) shows that the NP-NUMBRS norms consistently outperformed previously published norms for English-speaking non-Hispanic (White and African-American) adults in identifying impairment; 2) explores the role of Spanish-English bilingualism in test performance; and 3) provides support for the diagnostic validity of these norms in detecting HIV-associated neurocognitive impairment. Study limitations include the limited assessment of sociocultural variables and generalizability (e.g., other Latina/o populations, age limit [19 - 60 years]). Future research is needed to: 1) investigate these norms with U.S.-dwelling Spanish-speakers of non-Mexican heritage and other clinical subpopulations; 2) expand coverage of cognitive domains (e.g. language, visuospatial); 3) develop large normative datasets for children and older Latina/o populations; 4) examine how sociocultural factors impact performance (e.g., bilingualism, acculturation); 5) investigate these norms' diagnostic and ecological validity; and 6) develop norms for neurocognitive change across time. It is hoped that the NP-NUMBRS norms will aid researchers and clinicians working with U.S.-dwelling Spanish-speakers from the U.S.-Mexico borderland to conduct research and evidence-based neuropsychological evaluations in a more culturally responsive and ethical manner.
Assuntos
Idioma , Longevidade , Testes Neuropsicológicos , Adulto , Criança , Prática Clínica Baseada em Evidências , Humanos , México , Pessoa de Meia-Idade , Valores de Referência , Adulto JovemRESUMO
BACKGROUND: Research has begun to document the bivariate connections between pain in individuals with spinal cord injury (SCI) and various aspects of health related quality of life (HRQOL), such as fatigue, social functioning, mental health, and physical functioning. OBJECTIVE: The purpose of this study was to construct and test a theoretical path model illuminating the stage-wise and sequential (cascading) HRQOL pathways through which pain increases physical disability in individuals with SCI in a sample from Colombia, South America. It was hypothesized that increased pain would lead to decreased energy, which would lead to decreased mental health and social functioning, which both would lead to emotional role limitations, which finally would lead to physical role limitations. METHODS: A cross-sectional study assessed individuals with SCI (nâ=â40) in Neiva, Colombia. Participants completed a measure indexing various aspects of HRQOL. RESULTS: The path model overall showed excellent fit indices, and each individual path within the model was statistically significant. Pain exerted significant indirect effects through all possible mediators in the model, ultimately suggesting that energy, mental health, social functioning, and role limitations-emotional were likely pathways through which pain exerted its effects on physical disability in individuals with SCI. CONCLUSIONS: These findings uncover several potential nodes for clinical intervention which if targeted in the context of rehabilitation or outpatient services, could result in salubrious direct and indirect effects reverberating down the theoretical causal chain and ultimately reducing physical disability in individuals with SCI.
Assuntos
Pessoas com Deficiência/psicologia , Dor/psicologia , Qualidade de Vida , Traumatismos da Medula Espinal/psicologia , Adulto , Colômbia , Pessoas com Deficiência/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Dor/epidemiologia , Ajustamento Social , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/reabilitaçãoRESUMO
BACKGROUND Stroke is the second most common cause of death around the world, and little is known about long-term HRQOL outcomes for Latino American individuals after stroke. OBJECTIVE The purpose of the study is to compare HRQOL trajectories in stroke survivors to a group of healthy controls from Colombia first year post-stroke. METHODS Forty individuals diagnosed with stroke and 50 controls were recruited from the Psychological Attention Center of Antonio Nariño University. RESULTS Hierarchical linear models suggested that trajectories of all eight indices of HRQOL were lower over time in stroke individuals compared to controls. Stroke patients showed gains in the HRQOL domains of physical functioning, role limitations - physical, role limitations - emotional, pain, and social functioning, although only pain in stroke individuals approached that of controls at 12 months. Despite these improvements, seven of the eight indices of HRQOL in stroke individuals remained very low over time, suggesting that the vast majority of rehabilitation gains in HRQOL, even when present, were extremely limited. CONCLUSIONS The current findings suggest a need in Latin America for mental health services after stroke, as well as other interventions designed to increase social and family support, which may thereby improve mental health.