Publications by authors named "Fernanda Loureiro"

11 Publications

  • Page 1 of 1

Neuroanatomical Correlates of Macrolinguistic Aspects in Narrative Discourse in Unilateral Left and Right Hemisphere Stroke: A Voxel-Based Morphometry Study.

J Speech Lang Hear Res 2021 May 12;64(5):1650-1665. Epub 2021 Apr 12.

Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Background A growing body of literature has demonstrated the importance of discourse assessment in patients who suffered from brain injury, both in the left and right hemispheres, as discourse represents a key component of functional communication. However, little is known about the relationship between gray matter density and macrolinguistic processing. Purpose This study aimed to investigate this relationship in a group of participants with middle-low to low socioeconomic status. Method Twenty adults with unilateral left hemisphere ( = 10) or right hemisphere ( = 10) chronic ischemic stroke and 10 matched (age, education, and socioeconomic status) healthy controls produced three oral narratives based on sequential scenes. Voxel-based morphometry analysis was conducted using structural magnetic resonance imaging. Results Compared to healthy controls, the left hemisphere group showed cohesion impairments, whereas the right hemisphere group showed impairments in coherence and in producing macropropositions. Cohesion positively correlated with gray matter density in the right primary sensory area (PSA)/precentral gyrus and the pars opercularis. Coherence, narrativity, and index of lexical informativeness were positively associated with the left PSA/insula and the superior temporal gyrus. Macropropositions were mostly related to the left PSA/insula and superior temporal gyrus, left cingulate, and right primary motor area/insula. Discussion Overall, the present results suggest that both hemispheres are implicated in macrolinguistic processes in narrative discourse. Further studies including larger samples and with various socioeconomic status should be conducted. Supplemental Material
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May 2021

A Reflection on the Article by 'A Description of Approachable Nurses: An Exploratory Study, the Voice of the Hospitalized Child'.

J Pediatr Nurs 2021 Mar-Apr;57:92. Epub 2020 Oct 23.

Universidade Católica Portuguesa, Institute of Health Sciences, Center for Interdisciplinary Research in Health (CIIS), Portugal. Electronic address:

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October 2020

The experience of school-aged children with hospitalisation.

J Clin Nurs 2021 Feb 5;30(3-4):550-558. Epub 2020 Dec 5.

Universidade Católica Portuguesa, Lisboa, Portugal.

Aims And Objectives: This study intended to contribute to the improvement of nursing care for both children and their parents and aimed to identify the best and worst experiences of school-aged children during hospitalisation.

Background: Child hospitalisation has traditionally been studied from the parent's perspective, but studies in which the child is the subject are scarce and mainly focus on to the hospitalisation experiences.

Design: A cross-sectional, observational and descriptive exploratory design was used, and STROBE reporting guidelines were followed.

Methods: A paper survey was applied by the primary researcher within a 3 months period to 252 children. It presented two open-ended statements: 'In my opinion the best thing about the hospital is …' and 'In my opinion the worst thing about the hospital is…'. The study was submitted and approved by the national data protection commission and also by the ethics committees of each of the six institutions where the study was undertaken. Informed consent was also obtained from children and parents.

Results: Answers were analysed through content analysis. Five categories were identified for each of the open-ended statements. Children identified 'people', 'physical environment', 'activities', 'outcomes' and 'food' as best experiences. The worst experiences included: 'feelings', 'activities', 'food', 'environment' and 'outcomes'.

Conclusions: The results allowed the identification of the children's most valued aspects of hospitalisation.

Relevance To Clinical Practice: The results should be considered by healthcare professionals in order to make the hospitalisation experience more positive from the perspective of the school-aged children.
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February 2021

Letter to the Editor.

J Pediatr Nurs 2020 Sep - Oct;54:101. Epub 2020 Feb 7.

Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Escola Superior de Saúde Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, Portugal. Electronic address:

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April 2021

Nursing care satisfaction from school-aged children's perspective: An integrative review.

Int J Nurs Pract 2019 Dec 17;25(6):e12764. Epub 2019 Jul 17.

Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, Portugal.

Aim: This integrative review synthesizes the current knowledge on school-aged children's satisfaction with nursing care in acute care settings.

Background: Children identify aspects of nursing care that are not valued by their parents. This fact confirms the relevance of properly assessing children's satisfaction.

Design: An integrative review was performed.

Data Sources: A search for empirical studies was carried out in databases using the following search terms: satisfaction AND views OR opinions OR perceptions AND child AND nurs*.

Review Methods: The search was limited to full-text studies involving children from 6 to 12 years old, written in English or Portuguese, and published between 1 January 2000 and 31 August 2016. Twenty qualitative studies and three quantitative studies were included for revision and were analysed by two independent reviewers.

Results: Three themes emerged: expectations of nursing care, experiences with care, and suggested strategies. Expectations and experiences allowed us to identify work within three main domains: personal domain (nurses' characteristics), professional domain (nurses' activities), and environmental domain (interaction between nurses and the environment).

Conclusion: It is important to recognize children's rights to express their opinions about the nursing care they receive. Evaluation of both patients' and children's satisfaction should be systematically performed.
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December 2019

The Swallowing Clinical Assessment Score in Parkinson's Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study.

J Aging Res 2019 13;2019:7984635. Epub 2019 Mar 13.

Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Background: Dysphagia is a predictor of mortality in Parkinson's disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The is an alternative and low-cost tool for diagnosis of dysphagia, but had not been properly validated in comparison to the gold-standard method. The objective of this study was to assess the validity and reliability of the SCAS-PD.

Methods: SCAS-PD was applied to 31 patients with PD, and VFSS was conducted concurrently. This clinical assessment uses different volumes and viscosities to identify signs of swallowing impairments. For validation purposes, the interclass correlation coefficient and the weighted kappa were calculated. The AUC of the ROC curve, sensitivity, and specificity values for detection of penetration/aspiration (PA) were assessed. Internal consistency was calculated by Cronbach's alpha.

Results: Fifty-one percent of patients were classified with dysphagia. SCAS-PD was differentiated between normal/functional deglutition and dysphagia with AUC 0.97, 95% CI 0.92-1.00, and an optimal cutoff at 19 (sensitivity 100% and specificity 87.5%). The internal consistency was  = 0.91 for the total score. The internal consistency of the SCAS-PD domains was oral phase ( = 0.73), pharyngeal phase ( = 0.86), and signs of PA ( = 0.95). The weighted kappa analysis demonstrated a high rate of concordance at 0.71 ( < 0.001) between SCAS-PD and VFSS.

Conclusions: SCAS-PD has been shown to have a good concordance with the VFSS. Considering this, SCAS-PD is highly applicable in clinical settings, since it is a simple and low-cost diagnostic tool for detecting dysphagia in PD patients.
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March 2019

Translation and Brazilian adaptation of the Relationship Scales Questionnaire (RSQ).

Trends Psychiatry Psychother 2019 Jan-Mar;41(1):69-77. Epub 2019 Apr 11.

Programa de Pós-Graduação em Gerontologia Biomédica, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Objectives: To describe the process of translating and adapting the Relationship Scales Questionnaire (RSQ) from English into Brazilian Portuguese and to present the results of its test-retest reliability using the version developed for interview application.

Methodology: The process was based on the guidelines of the International Society for Pharmaeconomics and Outcomes Research (ISPOR), which propose 10 steps for the translation and cross-cultural adaptation of self-administered instruments. The original authors of the RSQ have agreed to the translation. The interview version was applied to a sample of 43 healthy elders (≥60 years old) enrolled in a primary health care program in the city of Porto Alegre, state of Rio Grande do Sul, southern Brazil, and then reapplied. The scores of the two applications were compared using the paired sample t-test.

Results: Only 6 of the 30 items required the adaptation of words or expressions to maintain its conceptual and semantic equivalence. The self-administered form of the RSQ posed difficulties for elders due to visual deficiencies and lower education level, both common in this age group, demonstrating a need for the development of a version of the RSQ in a structured interview format. Only the measure for secure attachment presented significant differences after the application of the retest, indicating reliability of the version being proposed.

Conclusion: Translation of the RSQ is the first step towards the validation of an attachment evaluation instrument for use in the elderly population in Brazil, allowing for future studies on this topic.
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May 2019

Naming and verbal learning in adults with Alzheimer's disease, mild cognitive impairment and in healthy aging, with low educational levels.

Arq Neuropsiquiatr 2018 Feb;76(2):93-99

Instituto do Cérebro, Porto Alegre RS, Brasil.

Language assessment seems to be an effective tool to differentiate healthy and cognitively impaired aging groups. This article discusses the impact of educational level on a naming task, on a verbal learning with semantic cues task and on the MMSE in healthy aging adults at three educational levels (very low, low and high) as well as comparing two clinical groups of very low (0-3 years) and low education (4-7 years) patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy controls. The participants comprised 101 healthy controls, 17 patients with MCI and 19 with AD. Comparisons between the healthy groups showed an education effect on the MMSE, but not on naming and verbal learning. However, the clinical groups were differentiated in both the naming and verbal learning assessment. The results support the assumption that the verbal learning with semantic cues task is a valid tool to diagnose MCI and AD patients, with no influence from education.
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February 2018

Double Invasive Blood Pressure Monitoring for Cesarean Delivery in a Pregnant Woman With Aortic Coarctation.

A A Case Rep 2016 Aug;7(3):67-70

From the *Department of Anesthesiology, and †Department of Obstetrics and Gynecology, Hospital Universitário Antônio Pedro, Rio de Janeiro, Brazil.

Aortic coarctation is a discrete narrowing of the proximal thoracic aorta. It is poorly tolerated during pregnancy because of its association with hypertension, cerebrovascular accident, and aortic rupture. We report a case of severe uncorrected congenital aortic coarctation in a 31-year-old symptomatic pregnant woman at 29 weeks of gestation who underwent successful cesarean delivery with an epidural anesthetic technique. Transthoracic echocardiography showed a gradient of 75 mm Hg. To avoid undiagnosed arterial hypotension and inadequate uteroplacental flow distal to the coarctation, double (radial and femoral) invasive arterial blood pressure measurement was used to monitor both pre- and postcoarctation arterial blood pressure.
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August 2016

Performance of low-educated elders with depression on Addenbrooke's Cognitive Examination-Revised (ace-r) test.

Dement Neuropsychol 2016 Jan-Mar;10(1):19-25

Neurologist, MD, PhD, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, RS, Brazil.

Along with cognitive disorders, depression has been a concern for mental health services due to its highly debilitating effect on the functioning and quality of life of the elderly. However, there is still little understanding of the cognitive alterations resulting from depression or of the difficult differential diagnosis with mild cognitive impairment (MCI). It is known that performance on cognitive tests is strongly influenced by education but few studies have been conducted involving low-educated populations.

Objective: To evaluate the performance of elders with low education and no dementia on Addenbrooke's Cognitive Examination-Revised (ACE-R) test and its cognitive domains, and compare patients with Current Major Depressive Episode (CMDE) against those without depressive symptoms.

Methods: A retrospective, cross-sectional analytical study was conducted based on medical files of patients treated at the Cerebral Aging Clinic of the Hospital São Lucas of the PUCRS. The study included 116 individuals with low education (< 8 years of education) aged between 60 and 84 (69.6 ± 6.4) years, with MCDE (N = 41) and controls (N = 75).

Results: No significant difference was observed between control and MCDE groups in median scores on the ACE-R, Mini-Mental State Examination, and the five cognitive domains. There was also no difference between the groups on separate analyses of results on the clock drawing test, the categorical verbal and phonological fluency test, and the naming test.

Conclusion: The results of this study showed that depressive symptoms did not influence scores on the ACE-R tests conducted in elders with low education.
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December 2017

[Participated observation of nursing child health consultation].

Rev Esc Enferm USP 2012 Dec;46(6):1294-9

Instituto Ciências da Saúde, Universidade Católica Portuguesa, Lisboa, Portugal.

Situation diagnosis using exploratory and descriptive scientific methodology (participant observation with descriptive statistical treatment) in order to identify nursing' practices in the area of health promotion during a nursing child health consultation. The 31 consultations observed (n = 31) showed that the majority of observations occurred in children younger than 2 years being the most discussed topic feed with predominant use of expository methodology. There was also little use of informational support and when used relate to the themes of security and nutrition. Most providers raised questions and there was limited registration of the interaction between provider and child with an expenditure averaging of 23 minutes per consultation. Given the results and reflecting about them stands out as intervention the construction of a health promotion manual with the integration of theory and evidence of good practice in this area.
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December 2012