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BACKGROUND: Research has found that Hispanics with traumatic brain injury (TBI) have reduced functional outcomes compared to non-Hispanic Whites, including lower probabilities of post-injury employment. However, previous studies were cross-sectional, combined racial/ethnic minority groups, and did not examine the factors that predict return to work of Hispanics longitudinally. OBJECTIVE: To determine the demographic and injury-related predictors of employment probability trajectories during the first 10 years after TBI. METHODS: 1,346 Hispanics in the TBI Model Systems Database were included. Hierarchical linear modeling was used to examine baseline predictors of employment probability trajectories across this time period. RESULTS: Employment probability demonstrated a quadratic movement over time, with an initial increase followed by a plateau or slight decrease. Hispanics with TBI had higher employment probability trajectories if they had been younger at the time of injury, spent less time in posttraumatic amnesia, had greater years of education, had been employed at the time of injury, had higher annual earnings at the time of injury, and had experienced a non-violent mechanism of injury. CONCLUSION: Culturally adapted treatment programs with a focus on early intervention incorporating vocational rehabilitation and employment programs for Hispanics with TBI who present with these risk factors are needed.

Background Sexual changes are an area of primary concern for individuals with spinal cord injury (SCI) and their partners, but the topic has gone largely unexplored in the research literature. Objectives This study examined how individuals with SCI in Latin America experience their sexuality and what issues they and their partners face in this area. Methods A total of 248 individuals with SCI from Latin America completed an online 60-item survey regarding sexuality. Results The majority of participants (87.7%) reported that they had noticed changes in sexuality after the injury, mainly physical problems (50.7%), emotional problems (38.7%), and changes in relationships with partners (27.5%). Regarding sexual desire, 47.2% indicated that desire remained the same after SCI. The majority of participants (81.9%) indicated not having received any information about sexuality after SCI during their hospital stay but reported that they would have liked to have received information (98.1%). Of all participants, 66.1% reported never having been asked about problems or difficulties in their sexual life after SCI by any health professional. Conclusion Interventions designed to educate individuals with SCI regarding the effect of injury on their sexual functioning, responsiveness, and expression, as well as to support them in maintaining and enhancing their sexual well-being, may be extremely beneficial, particularly in Latin America. Findings highlight the distinct need for professionals to introduce the topic of sexuality by discussing it in a straightforward, nonjudgmental manner and to integrate discussions about sex and related issues into assessment, planning, and ongoing treatment.

First published online March 11, 2022 The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the European Commission (H2020-MSCA-IF-2018-837228-ENGRAVING). Daniela Ramos-Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164).

(1) Background: Psychometric network analysis provides a novel statistical approach allowing researchers to model clusters of related symptoms as a dynamic system. This study applied network analysis to investigate the patterns of somatic, cognitive, and affective neurobehavioral symptoms in an international sample of Spanish-speaking individuals with a history of COVID-19 positivity and non-COVID controls; (2) methods: the sample (n = 1093) included 650 adults from 26 countries who reported having previously tested positive for COVID-19 (COVID+) through a viral and/or antigen test (average of 147 days since diagnosis). The control group (COVID−) was comprised of 443 adults from 20 countries who had completed the survey prior to the COVID-19 pandemic; (3) results: relative to the COVID− network, the COVID+ network was very well-connected, such that each neurobehavioral symptom was positively connected to the network. The organize-to-headache and dizzy-to-balance connections in the COVID+ network were stronger than in the COVID− network. The hearing, numbness, and tense symptoms were more central to the COVID+ network with the latter connected to the sleep, fatigue, and frustrated symptoms. The COVID− network was largely disjointed, with most of the somatosensory symptoms forming their own cluster with no connections to other symptom groups and fatigue not being connected to any other symptom. The cognitive and affective symptoms in the COVID− network were also largely connected to symptoms from within their own groups; (4) conclusions: These findings suggest that many of the long-term neurobehavioral symptoms of COVID-19 form a discernable network and that headaches, frustration, hearing problems, forgetfulness, and tension are the most central symptoms. Cognitive and behavioral rehabilitation strategies targeting these central symptom network features may hold promise to help fracture the lingering symptom network of COVID-19.

The purpose of this study was to investigate the demographic characteristics, academic training and types of professional activities of clinical neuropsychologists in Canada. 282 participants completed an online-based survey. Respondents were women for the most part and had a mean age of 43 years. They typically had doctoral-level training (85%) and about one-quarter had postdoctoral training (23%). Nearly half (47%) had a lifespan practice, over one-third (37%) had an adults-only practice, and about one-sixth (16%) had an exclusively pediatric practice. Most worked full-time (79%). Respondents were almost evenly split three ways between those who worked in the public sector, those who worked in the private sector, and those who worked in both. The most common professional activities related to assessment (95%), although clinical supervision (43%) and rehabilitation (42%) were also quite frequent, whereas research (27%) and teaching (18%) were less so. The most common reason for referral was to determine a diagnosis (79%). Pediatric neuropsychologists worked primarily with individuals with neurodevelopmental disorders and neuropsychologists working with adult populations worked primarily with individuals with emotional disorders, acquired neuropsychological disorders (traumatic brain injury, stroke/vascular), and neurocognitive disorders (dementia). At time of study, Canadian neuropsychologists seemed to enjoy a fairly balanced situation: Their level of training and the ratio of neuropsychologists per population were both high. However, these varied widely across Canada. This suggests that the profession and public interest would stand to gain from seeing training standardized to some extent nationwide.

To determine Spanish-speaking school professionals’ level of knowledge and attitudes regarding pediatric TBI. School professionals(n = 2,238) from 19 countries completed an online-survey regarding their training, knowledge and misconceptions, attitudes and perceptions about TBI. Of the full sample 75% (n = 1689) knew what TBI was, though only 18% (n = 350) reported having experience with a student with TBI. Only 7.7% (n = 143) and 3% (n = 55) of participants could identify all of the common short- and long-term TBI sequelae, respectively. Special education professionals, those with experience with a student with TBI, and those who had received training regarding TBI showed greater knowledge in these areas. Although participants showed high levels of knowledge in 6/24 misconceptions of TBI, they endorsed others. Group, sex, experience with students with TBI, training in TBI, and number of years working were significantly linked to some misconceptions about TBI; however, the effect sizes were small. The knowledge and experience that Spanish-speaking school professionals have regarding childhood TBI are minimal. It is therefore critical that these professionals receive a more comprehensive education during their academic training and the practice of their profession about TBI.

(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people’s daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 1001 adults from 34 countries who had previously tested positive for COVID-19 completed the Neurobehavioral Symptom Inventory reporting the symptoms before their COVID-19 diagnosis, during the COVID-19 infection, and currently; (3) Results: Participants reported large-sized increases before vs. during COVID-19 in all domains. Participants reported a medium-sized improvement (during COVID-19 vs. now) in somatic symptoms, a small-sized improvement in affective symptoms, and very minor/no improvement in cognitive symptoms. The risk factors for increased neurobehavioral symptoms were: being female/trans, unemployed, younger age, low education, having another chronic health condition, greater COVID-19 severity, greater number of days since the COVID-19 diagnosis, not having received oxygen therapy, and having been hospitalized. Additionally, participants from North America, Europe, and Central Asia reported higher levels of symptoms across all domains relative to Latin America and Sub-Saharan Africa; (4) Conclusions: The results highlight the importance of evaluating and treating neurobehavioral symptoms after COVID-19, especially targeting the higher-risk groups identified. General rehabilitation strategies and evidence-based cognitive rehabilitation are needed in both the acute and Long COVID phases. Daniela Ramos Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164).

Objectives: COVID-19 has infected millions of people worldwide with growing evidence showing that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID-19.Design: Cross-sectional.Setting. Online survey, in English and Spanish, distributed online between March 4–June 15, 2021.Participants. 1001 individuals who reported a positive diagnosis of COVID-19 across different geographical regions, including North and South America, Sub-Saharan Africa, and Europe.Measurements: Self-reported sleep health, using the RU-SATED scale, as recalled before a COVID-19 diagnosis and also reported currently.Results: Individuals reported worse overall current sleep health, with lower ratings across the six dimensions of sleep health (sleep regularity, satisfaction, alertness, timing, efficiency, and duration) compared to their ratings as recalled before COVID-19 infection. Greater severity of COVID-19 symptoms was the strongest predictor of poor current sleep health (p < .001), independent of demographics, presence of a pre-existing chronic health condition, and time since infection. Poor current sleep health was associated with poorer current quality of life (p

Purpose The COVID-19 outbreak escalated into a global pandemic, forcing governments around the world to impose measures affecting all aspects of life. Like other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the impact of social restriction measures on mental health in a Greek adult sample. Method An online questionnaire collected data during the second national lockdown (February to May 2021). A total of 650 participants (M age: 33.13, 71.5% female) comprised the final sample. Results 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants moved away from social support and into more individual strength and resilience-based coping strategies to cope with challenges. Conclusion These findings suggest that in addition to the detrimental effects on physical health, COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people.

BACKGROUND: Despite numerous calls throughout the years for an increase in ethnic, cultural, and racial diversity within the field of psychology, it remains an elusive reality for Hispanic neuropsychology practitioners in the United States (U.S.). OBJECTIVE: 1. Determine the background and current work situation of Hispanic clinical neuropsychologists in the U.S. (e.g., professional training, assessment and diagnostic procedures used, rehabilitation techniques employed, populations targeted, teaching responsibilities, and research activities), and 2. Examine issues related to perceived discrimination in the field of neuropsychology and what this means for our profession. METHODS: The sample consisted of 107 Hispanic neuropsychologists residing among the 50 United States, District of Columbia, and Puerto Rico who took a survey of professional practices and experiences in clinical neuropsychology. RESULTS: Our findings confirm that Hispanic neuropsychologists in the U.S. are culturally diverse, present with varied levels of bilingualism, have been faced with discrimination during training and in their workplace, and compare favorably with non-Hispanic neuropsychologists in terms of education and clinical training. CONCLUSIONS: Transforming neuropsychology into a diverse and inclusive field requires intentional, strategic, and systematic interventions in education, academia, training, professional organizations and in research.

This study sought to cross-validate the utility of Test of Memory Malingering (TOMM) cut-offs derived in a large Colombian sample with further exploration of the impact of age, education, and Mini-Mental Status Examination (MMSE) scores on TOMM trials. To address these aims, the study examines concordance rates of the TOMM scores by demographics and Hopkins Verbal Learning Test-Revised (HVLT-R) test performance. Additionally, item response theory analysis (IRT) focused on the interaction between demographic variables and the psychometric properties of the TOMM items. Data were collected from 1416 healthy controls (58.6% female; M age = 58.19; M education = 9 years) who completed the TOMM, MMSE, and HVLT-R as part of a comprehensive battery conducted in Spanish. Frequency analysis was used to assess for concordance rates of passing TOMMe10, Trial 1, and Trial 2 scores, further broken down by median split for MMSE, education, and age. Additionally, IRT is used to examine, in detail, the psychometric properties of the TOMM items and relationships to demographic variables. Validity classification differed across the TOMM trials, with 82.8% passing e10, 88.6% Trial 1, and 92.5% Trial 2. When dichotomized by a median split, passing rates across all TOMM trials were significantly different (p ≤ .001) for MMSE scores, education, and age with the largest discrepancy (~ 21%) observed on TOMMe10. IRT confirmed that all TOMM items are easy to answer correctly with Trial 2 items being appreciably easier (difficulty range = − 4.90 to − 1.52) than Trial 1 items (difficulty range = − 6.22 to − 3.50). Age, education, MMSE, and HVLT-R scores all were significantly related to latent trait scores on the TOMM (p

Background: In December 2019, China reported a severe upper respiratory failure syndrome caused by a new virus identified as coronavirus COVID-19. Aims and Objectives: The aim of this exploratory study is to outline the current state of pulmonary rehabilitation in Latin American (LA) countries during the COVID-19 pandemic. Materials and Methods: A total of 1162 rehabilitation professionals (rehabilitation medicine specialists and residents, physiotherapists, occupational therapists, and speech therapists) from 20 countries in LA answered a 34-question online survey related to the current state of pulmonary rehabilitation in LA during the COVID-19 pandemic. Results: More than half of the professionals reported the absence of pulmonary rehabilitation services in their work centers, limited or non-existent pulmonary rehabilitation materials or equipment, and little or no training by their multidisciplinary team and themselves. Regarding COVID-19, 49.2% of the respondents indicated not receiving the necessary material for the protection against COVID-19, and more than half reported limited equipment to perform interventions in patients hospitalized by this disease, and not to have clear about the recommendations to prescribe pulmonary physiotherapy in these patients. Moreover, almost all the professionals did not feel capable of treating patients with lung disease from COVID-19 and felt anxiety doing it. Conclusion: Pulmonary rehabilitation is vital for providing optimal care for respiratory impairments, and this relationship has been magnified by the COVID-19 pandemic. This manuscript highlights the limited professional training and resource availability in LA and provides recommendations to improve the current situation.

The characteristics and current situation of pediatric neuropsychologists across Spanish-speaking countries was examined. A total of 409 self-identified professionals working in child neuropsychology from 12 Latin American countries and Spain completed an online survey between June and October 2018. Results revealed that pediatric neuropsychology as a related but distinct discipline within neuropsychology presents with a series of unique challenges to practitioners in Spanish-speaking countries. Efforts and initiatives are required to increase awareness of the field, define the core competencies, foster more opportunities for training, and conduct research to understand sociocultural characteristics and develop culturally specific tools.

Objective: In this study, the prevalence of low scores for two neuropsychological tests of language has been determined.Methods: In total, N = 5218 healthy adults from 11 countries in Latin America (LA) were administered the Boston Naming Test (BNT) and the Verbal Fluency Test (VFT) as part of a comprehensive neuropsychological evaluation. Z-scores were calculated for BNT Total score, and phonological (letters F, A, S, M) and semantic (Animals, Fruits). Scores were adjusted for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the seven test-scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd).Results: Between 53% (Paraguay) and 71% (Mexico) of the sample had at least 1-score below the 25th percentile, and between 41% (Paraguay) and 55% (Cuba) scored below the 16th percentile. Between 27% (Paraguay) and 39% (Peru) scored below the 10th percentile on at least 1-score, and between 17% (Chile) and 23% (Argentina) scored below the 5th percentile.Conclusions: Clinicians should use these data to reduce false-positive diagnoses and to improve the neuropsychological assessments in Spanish-speaking individuals from LA countries.

Objective: The purpose of this study was to generate normative data for five tests of attention and executive functions (M-WCST, Stroop test, TMT, BTA, and SDMT), in a group of 322 Ecuadorian adults from Quito between the ages of 18 and 85. Method: Multiple regression analyzes taking into account age, education, and gender were used to generate the normative data. Results: Age and education were significantly related to test performance such that scores decreased with age and improved as a function of education. An online calculator is provided to generate normative test scores. Conclusions: This is the first study that presents normative data for tests of executive functions and attention in an Ecuadorian adult population. This data will improve the clinical practice of neuropsychology and help to develop the field in the country.

Objectives COVID-19 escalated into a global pandemic affecting countries around the world. As communities shut down to reduce disease spread, all aspects of life have been altered, including sleep. This study investigated changes in sleep patterns and correlates of sleep health in a global sample and examined relationships between sleep health and psychological distress. Design Cross-sectional. Settings Online survey distributed between April 19 and May 3, 2020. Participants Total 6882 participants (18-94 years) across 59 countries. Measurements Sleep health (RU-SATED), demographics, pandemic-related factors, mood. Results More than half the sample shifted their sleep toward later bed- and wake-times, and more than a third reported increased sleep disturbances during the pandemic. Older age, being partnered, and living in a higher income country were associated with better sleep health, while a stricter level of quarantine and pandemic-related factors (being laid off from job, financial strain, or difficulties transitioning to working from home) were associated with poorer sleep health. Domestic conflict was the strongest correlate of poorer sleep health. Poorer sleep health was strongly associated with greater depression and anxiety symptoms. Participants from Latin America reported the lowest sleep health scores. Conclusions COVID-19-associated factors have impacted sleep health on a global level. While our data are correlational, sleep health is strongly linked with mental health and could play a protective role against developing mental distress during pandemic-related isolation. Sleep health should be incorporated into public health messages aimed at helping people cope with the effects of a pandemic to maintain optimal mental and physical health.

Between 50-60% of Multiple Sclerosis (MS) patients have cognitive alterations. There are several batteries to assess cognitive impairments in MS, however, few exist for Latin Americans. The objective of this study is to evaluate the neuropsychological profile of Mexican people with MS (PwMS) and assess the utility of Norma Latina, a new battery for cognitive assessment in Latin America, in differentiating cognitive test performance between PwMS and healthy controls (HCs).100 PwMS and 100 HCs from Mexico were evaluated with the Norma Latina battery. The following analyses were conducted: 1) low-percentiles of each participant were calculated, 2) Area Under the Curve was used to determine whether the battery discriminated between PwMS and HCs, 3) four composite scores were calculated, and student's t-test was used to compare groups according to these domains.PwMS obtained a greater number of impaired scores compared to HCs, principally in executive function. The battery successfully discriminated between PwMS and HCs, with the strongest capacity to discriminate in the executive functions, and the weakest in memory.Establishing validation of a neuropsychological battery for Mexican PwMS will help to more accurately detect cognitive alterations, which will guide the decisions of professionals in terms of cognitive rehabilitation.

Version of Record online: 31 October 2020 Objective: This study examined the impact of the COVID‐ 19 pandemic and subsequent social restrictions or quarantines on the mental health of the global adult population. Method: A sample of 6,882 individuals (Mage = 42.30; 78.8% female) from 59 countries completed an online survey asking about several pandemic‐related changes in life and psychological status. Results: Of these participants, 25.4% and 19.5% reported moderate‐to‐severe depression (DASS‐21) and anxiety symptoms (GAD‐7), respectively. Demographic characteristics (e.g. higher‐income country), COVID‐19 exposure (e.g., having had unconfirmed COVID‐19 symptoms), government‐imposed quarantine level, and COVID‐19‐ based life changes (e.g., having a hard time transitioning to working from home; increase in verbal arguments or conflict with other adult in home) explained 17.9% of the variance in depression and 21.5% in anxiety symptoms. Conclusions: In addition to posing a high risk to physical health, the COVID‐19 pandemic has robustly affected global mental health, so it is essential to ensure that mental health services reach individuals showing pandemic‐related depression and anxiety symptoms. Ramos‐Usuga, D. was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164).

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context. This study was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Medical Research Service of the Veterans Affairs Central Virginia Health Care System, and the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC). Ramos-Usuga, D. was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164).

Neuroimaging studies describing brain circuits&acute, alterations in cobalamin (vitamin B12)-deficient patients are limited and have not been carried out in patients with inborn errors of cobalamin metabolism. The objective of this study was to assess brain functionality and brain circuit alterations in a patient with an ultra-rare inborn error of cobalamin metabolism, methylmalonic aciduria, and homocystinuria due to cobalamin D disease, as compared with his twin sister as a healthy control (HC). We acquired magnetic resonance imaging (including structural, functional, and diffusion images) to calculate brain circuit abnormalities and combined these results with the scores after a comprehensive neuropsychological evaluation. As compared with HC, the patient had severe patterns of damage, such as a 254% increment of ventricular volume, pronounced subcortical and cortical atrophies (mainly at striatum, cingulate cortex, and precuneus), and connectivity alterations at fronto-striato-thalamic circuit, cerebellum, and corpus callosum. In agreement with brain circuit alterations, cognitive deficits existed in attention, executive function, inhibitory control, and mental flexibility. This is the first study that provides the clinical, genetic, neuroanatomical, neuropsychological, and psychosocial characterization of a patient with the cobalamin D disorder, showing functional alterations in central nervous system motor tracts, thalamus, cerebellum, and basal ganglia, that, as far as we know, have not been reported yet in vitamin B12-related disorders.

Objective The principal goal of this study was to produce adjusted normative data for European Portuguese native speakers from Portugal on 2 neuropsychological tests widely used to assess learning and memory: the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Rey–Osterrieth Complex Figure Test (ROCF). Method The study included 300 individuals aged 18–92 years (M = 50.4, SD = 21.2), who had educational backgrounds ranging from 3 to 25 years (M = 10.4, SD = 5.2). Results Age, education, and sex were significantly associated with HVLT-R and ROCF performance. These demographic variables accounted for 61% of the variance in HVLT-R total recall, 54% in HVLT-R delayed recall, 18% in HVLT-R recognition, 55% in ROCF copy, and 39% in ROCF immediate recall. Conclusions The normative data are presented as regression-based algorithms to adjust direct and derived test scores for age, education, and sex. This study provides a calculator of normative data derived from the results of the regression models.

Background Children with traumatic brain injury (TBI) usually displayed substantial neuropsychological impairment at short and long term after injury. Objective To compare the course of cognitive functioning among children with TBI and healthy controls over the first-year post-injury in Guadalajara, Mexico. Methods A sample of 46 children with TBI and 46 healthy controls from Guadalajara, Mexico were recruited. Both groups received a comprehensive neuropsychological evaluation at three-time (3, 6, and 12 months) with measures of memory, attention, executive function, processing speed, language, perceptual reasoning, visuo-spatial abilities, and intellectual functioning. Sixteen hierarchical linear models (HLMs) were performed to examine whether linear trajectories of cognitive functioning differed over time between groups. Results Trajectories of neuropsychological performance were significantly worse over time among children with TBI than healthy controls across every cognitive domain. HLMs suggested that cognitive performance increased over time in both groups, however, TBI group scored significantly lower at each time point compare to the control group, except in Stroop-Interference. Conclusions Cognitive deficits are common during the first-year after pediatric TBI. Thus, it is imperative to implement early rehabilitation programs to mitigate the consequences of these problems in the social, academic, and family reintegration of these children.

Background and Objectives: There is strong evidence in the literature that women experience psychological disorders at significantly higher rates than men. The higher rates of psychological disorders in women may partly be attributable to gender differences in response to stressors and coping styles. The objective of this study was to contribute to the growing body of literature investigating gender differences in mental health outcomes and coping styles during the coronavirus disease 2019 pandemic in a large sample of individuals from 59 countries with variable demographic and socio-cultural characteristics. Materials and Methods: Survey data were collected from the general population following a snowball sampling method, and the survey was promoted through social media platforms and mailing lists. Participants included 6882 individuals from the general population from 59 countries around the world. A combination of both standardized and adapted measures was used to create a survey, originally in English and then translated to Spanish, Italian, French, German, and Turkish. Results: Compared with men, women presented with higher levels of trauma-related distress, had a harder time decompressing, were more depressed, anxious and stressed, showed decreased frustration tolerance and reported lower quality of sleep and an increased likelihood of taking sleep medication or other natural sleep remedies. Overall, women tended to be more vulnerable during the pandemic in developing symptoms consistent with various forms of mental disorders such as depression, anxiety and post-traumatic distress. However, they also were more likely than men to use a variety of adaptive coping strategies, including concentrating on doing something about the situation and getting emotional support from others. Conclusions: A high prevalence of mood symptoms was noted among women. In addition to meeting the physical health needs of the population, emphasis needs to be given to mental health and the prevention of psychiatric disorders, particularly in women.

OBJECTIVE: To generate normative data for the Concentration Endurance Test (d2) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the d2 test as part of a larger neuropsychological battery. The Total number of items processed (TN), Total number of correct responses (CR), Total performance (TP), and Concentration performance (CP) scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. TN scores were affected by age2 for Guatemala and Puerto Rico; CR scores were affected by age2 for Mexico; TP scores were affected by age2 for Chile, Mexico, Puerto Rico, and Spain; and CP scores for Mexico and Spain. Models indicated that children whose parents had a MLPE >12 years obtained higher scores compared to children whose parents had a MLPE≤12 years for Mexico and Spain in all scores, and Puerto Rico for TN, CR, and TP, and Guatemala and Paraguay for CP scores. Sex affect the scores for Ecuador and Honduras (CP scores). CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the d2 test in pediatric populations.

OBJECTIVE: To generate normative data for the Trail Making Test (TMT) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 3,337 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the TMT as part of a larger neuropsychological battery. The TMT-A and TMT-B scores were normed using multiple linear regressions and standard deviations of residual values. Age, age 2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age on both scores, such that as children needed less time to complete the test while they become older. TMT-A scores were affected by age 2 for all countries except, Cuba, Guatemala, and Puerto. TMT-B scores were affected by age 2 for all countries except, Guatemala and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years of education needed less time to complete the test compared to children whose parent(s) had a MLPE ≤12 years for Mexico and Paraguay in TMT-A scores; and Ecuador, Mexico, Paraguay, and Spain for TMT-B scores. Sex affected TMT-A scores for Chile, Cuba, Mexico, and Peru, in that boys needed less time to complete the test than girls. Sex did not affect TMT-B scores. CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the TMT in pediatric populations. © 2017 - IOS Press and the authors. All rights reserved.

Objective To generate normative data for the phonological and semantic verbal fluency tests (VFT) in Spanish-speaking pediatric populations. Method The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the VFT as part of a larger neuropsychological battery. Scores for letters F, A, S, and animals and fruit categories were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. Results The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. Age2 had a significant effect in Chile (animals), Cuba (A letter, fruits), Ecuador (animals, fruits), Honduras (F letter), Mexico (animals, fruits), Peru (fruits), and Spain (S letters, animals, fruits). Models showed an effect for MLPE in Chile (A letters, animals, fruits), Ecuador (S letter, animals, fruits), Guatelama (F, S letter, animals), Honduras (animals), Mexico (F, A, S letters, animals, fruits), Puerto Rico (A, letters, animals), and Spain (all scores). Sex scores were found significant in Chile (animals), Ecuador (A letter, fruits), Mexico (F letter, fruits), Paraguay (F, A, S letters, fruits), Puerto Rico (F letter, animals, fruits), and Spain (F letter, fruits). Conclusions This is the largest multi-national Spanish speaking-pediatric normative study in the world, and as such it will allow neuropsychologists from these countries to have a more accurate way to interpret the phonological and semantic VFT in pediatric populations.

Introduction The novel COVID-19 disease rapidly escalated into a global pandemic affecting people around the world. While communities imposed mitigation measures to stop the spread of the disease, the mass (home) confinement in addition to the uncertainty of the pandemic led to drastic changes in all aspects of life, including sleep. Sleep health is strongly linked with mental and overall health and could play a protective role against the development of mental distress during the pandemic. Here, we investigated sleep health in a global multicultural sample of adults during the COVID-19 pandemic. Methods We surveyed 6,882 adults (18-94 years) across 59 countries about their sleep health (RU-SATED scale), sleep behaviors, demographics, pandemic-related factors, and mood between late April and early May 2020. A hierarchical stepwise multiple linear regression was performed to investigate correlates of sleep health. Results Compared with pre-pandemic times, more than one third of the sample reported an increase in sleep disturbances, and more than half of the sample shifted their sleep schedule towards later bed- and wake-up times. Better sleep health was associated with being partnered, older age and living in a higher-income country (p Conclusion Our findings highlight how sleep behavior has changed during the international quarantine- and isolation measurements and show the association between pandemic-related factors and poor sleep health, which, in turn, is closely linked with poorer mental health. These results emphasize the importance of maintaining good sleep health during the pandemic, since poorer sleep health may trigger or exacerbate mental disorders. Maintenance of good sleep health should be incorporated into public health messages aimed at helping people maintain optimal mental and physical health during major stressful life events like the COVID-19 pandemic. Support (if any)

Highlights • Multiorgan failure (MOF) might produce long-term neurological and cognitive sequelae. • Functional MRI revealed abnormal default mode network (DMN) connectivity in MOF. • DMN connectivity 6 months after MOF was associated with clinical severity during ICU . • DMN connectivity was associated with attention and visual-constructional abilities. • Resting-state fMRI is a potential tool for predicting long-term deficits in MOF., Multiorgan failure (MOF) is a life-threating condition that affects two or more systems of organs not involved in the disorder that motivates admission to an Intensive Care Unit (ICU). Patients who survive MOF frequently present long-term functional, neurological, cognitive, and psychiatric sequelae. However, the changes to the brain that explain such symptoms remain unclear. Objective To determine brain connectivity and cognitive functioning differences between a group of MOF patients six months after ICU discharge and healthy controls (HC). Methods 22 MOF patients and 22 HC matched by age, sex, and years of education were recruited. Both groups were administered a 3T magnetic resonance imaging (MRI), including structural T1 and functional BOLD, as well as a comprehensive neuropsychological evaluation that included tests of learning and memory, speed of information processing and attention, executive function, visual constructional abilities, and language. Voxel-based morphometry was used to analyses T1 images. For the functional data at rest, functional connectivity (FC) analyses were performed. Results There were no significant differences in structural imaging and neuropsychological performance between groups, even though patients with MOF performed worse in all the cognitive tests. Functional neuroimaging in the default mode network (DMN) showed hyper-connectivity towards sensory-motor, cerebellum, and visual networks. DMN connectivity had a significant association with the severity of MOF during ICU stay and with the neuropsychological scores in tests of attention and visual constructional abilities. Conclusions In MOF patients without structural brain injury, DMN connectivity six months after ICU discharge is associated with MOF severity and neuropsychological impairment, which supports the use of resting-state functional MRI as a potential tool to predict the onset of long-term cognitive deficits in these patients. Similar to what occurs at the onset of other pathologies, the observed hyper-connectivity might suggest network re-adaptation following MOF.

Multiple Organ Dysfunction Syndrome (MODS) is a systemic physiological disorder affecting two or more body organs triggered after an insult complication. Beyond the systemic failure, patients who survive MODS present cognitive and neurological impairments that remain stable even several years after Intensive Care Unit (ICU) discharge. Here, we focus on the specific situation of MODS patients with no apparent brain damage (NABD), where the mechanisms driving cognitive impairment at long term are not well-understood. We recruit N1 = 13 MODS patients with NABD at 6 months after ICU discharge, together with N2 = 13 healthy controls (matched by age, sex and years of education), and acquire functional magnetic resonance imaging at rest to find that, as compared to control, MODS patients with NABD present an overall increase of the functional connectivity (FC) at rest. In particular, we find that the default mode network (DMN) hyperconnects (increasing the node strength of the FC matrix) to three classes of networks: primary sensory (such as auditory, sensory-motor and visual), multimodal integration (such as dorsal attention and salience) and higher order cognition networks (such as fronto-parietal, language and executive control). Therefore, although these patients do not have an apparent structural damage after MODS, at the functional level, we found brain network alterations coexisting with hyperconnectivity of the DMN, that similar to what happens at the onset of other pathologies, might indicate a possible mechanism for brain compensation occurring after MODS.