Reliability and Validity of the Spanish-Language Version of the NIH Toolbox

Effectiveness of an Ecological Model-Based Active Transport Education Program on Physical and Mental Health in High School Students (MOV-ES Project): Study Protocol for a Randomized Controlled Trial

The United Nations, through its 2030 Agenda and Sustainable Development Goals, advocates for the establishment of conducive environments for physical activity, following the ecological model. In line with this initiative, active transportation emerges as an accessible, cost-effective, and sustainable approach to augmenting daily physical activity levels. This study protocol endeavors to assess the impact of an active transportation education program rooted in the ecological model on the physical and mental well-being of high school students. Drawing upon scientific insights, we hypothesize that a 16-week active transportation intervention will lead to a 3% reduction in average body fat percentage and a noteworthy enhancement in executive function (including inhibition, cognitive flexibility, and working memory), physical fitness (comprising cardiorespiratory fitness and muscle strength), and mental health (encompassing mood disorders and cognitive functioning). If this intervention proves effective, it could offer a viable solution for the school community, especially in reducing congestion within the school environment. The study protocol aims to evaluate the impact of an active transportation educational program based on the ecological model on the physical and mental well-being of high school students. Three high schools located in the urban area of Talca, Chile, will be randomly selected (one public, one privately subsidized, and one private non-subsidized). Each high school will be randomly assigned an experimental group (n = 30) and a control group (n = 30; without intervention). The experimental groups will receive an active transportation educational intervention during their physical education classes for four months (60 to 90 min sessions, once a week), while the control group will receive no intervention. The primary outcome will provide information on body composition and executive function. Secondary outcomes will include objective physical activity level, physical fitness, mental well-being, academic achievement, health-related quality of life, perception of environmental urban features, physical activity barriers, and adherence to active transportation. It is expected that the results of the MOV-ES Project will transcend the physical health of schoolchildren and will have an impact on the school community, especially by decongesting the school environment.

Interpreting reliable change on the Spanish-language NIH toolbox cognition battery

This study applied a reliable change methodology to the test-retest data from the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) normative sample. Participants included Spanish-speaking adults (n = 48; 54.2% women, 100% Latinx) evaluated twice within one to two weeks on the Spanish-language NIHTB-CB, consisting of two crystallized and five fluid cognitive tests. Test-retest means, standard deviations, and intraclass correlations were used to calculate upper and lower bounds of 70, 80, and 90% confidence intervals (CIs) around change scores, with these bounds used as cutoffs for inferring reliable change. Cutoffs were calculated for raw scores, age-adjusted standard scores (SS; M = 100, SD = 15), and demographic-adjusted T-scores (T; M = 50, SD = 10), adjusting for age, gender, and education. Test-retest change scores on the Spanish-language NIHTB-CB exceeding the following cutoffs indicate reliable change based on an 80% CI (i.e., values exceeding these cutoffs indicate greater decline or greater improvement than 90% of the sample): Dimensional Change Card Sort (SS ≥ 15/T ≥ 11), Flanker (SS ≥ 13/T ≥ 10), List Sorting (SS ≥ 13/T ≥ 9), Picture Sequence Memory (SS ≥ 14/T ≥ 9), Pattern Comparison (SS ≥ 14/T ≥ 10), Picture Vocabulary (SS ≥ 8/T ≥ 6), Oral Reading (SS ≥ 7/T ≥ 5), Fluid Cognition Composite (SS ≥ 12/T ≥ 9), Crystallized Cognition Composite (SS ≥ 6/T ≥ 5), and Total Cognition Composite (SS ≥ 8/T ≥ 7). These cutoffs are one of few resources to interpret cognitive change at retest among Spanish-speaking patients and participants.

Mental Health Trajectories of Latinx Female Caregivers and Young Children During COVID-19: A Longitudinal Analysis

Studies of the impact of COVID-19 on mental health symptoms suggest that there may be a unique impact of COVID-19 on minoritized individuals, young children (children five and younger), and their caregivers. Longitudinal studies with representative samples including minoritized populations are needed to accurately reflect the experience of families during COVID-19. The current study used a longitudinal design to assess trajectories of mental health among Latinx female caregivers and their young children over time, beginning prior to the onset of the COVID-19 pandemic and over the course of 12 months. In fall of 2019, Latinx female caregivers (N = 213; 93.0% biological mother) of young children (M _age  = 5.38, SD = 0.34) reported on their own and their child's (52.6% female) mental health symptoms, as well as parenting stress, at three time points through Fall of 2020. Growth curve models showed that self-report of caregiver global mental health worsened over time, though caregiver depression and parenting stress did not change significantly, nor did caregiver-report of their children's mental health. Results suggest that while female caregiver well-being was adversely affected by COVID-19, caregivers showed resilience in the face of this pandemic, which in turn may have buffered the impact of the pandemic on Latinx child mental health. Methodological and contextual implications of these results are considered.

Integrating Technology in Neuropsychological Assessment

Abstract. Although neuropsychological assessments include some measures that are administered, scored, or interpreted using new technologies, most researchers in this area advocate that more technology should be integrated. The current situation in neuropsychological assessment may be conceptualized as triggering a crisis leading to a paradigm shift, as there is some resistance to adopting more technology. In this paper, the context of the present crisis in neuropsychological assessment, the main obstacles, and new developments will be discussed. An example of a new computerized assessment tool, the NIH Toolbox, is highlighted. Also addressed are potential issues: in the assessment with tablets illustrating it with the older adult population and how to ensure the compatibility of data collected through these devices within the framework of the European General Data Protection Regulation (GDPR). Recommendations for research, test development, and clinical practice are also provided.

Algorithms for Operationalizing Mild Cognitive Impairment Using the Spanish-Language NIH Toolbox Cognition Battery

OBJECTIVE

Neuropsychologists would benefit from flexible methods for operationalizing psychometric cognitive impairment in Spanish-speaking examinees that vary in association with intelligence, education, and sociocultural characteristics. The current study combined low and high score base rates (BRs) for the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) to identify score combinations that are uncommon within different stratifications of the normative sample and may indicate cognitive impairment.

METHOD

The Spanish-language NIHTB-CB normative sample included 250 healthy Latinx adults with complete data on two crystallized and five fluid cognitive tests (M = 38.8 ± 13.7 years old, 72.0% women). Test performances were converted into age-adjusted and demographically adjusted normed scores, adjusting for age, gender, and education. The frequencies at which participants obtained one or more low scores or few to no high scores on fluid cognitive tests were combined into algorithms that occurred at BRs approximately 1 SD (~16%) or 1.5 SDs (~7%) below the mean.

RESULTS

Algorithms are provided for age-adjusted and demographically adjusted scores, with BRs stratified by crystallized ability, education, and sociocultural characteristics. Using demographically adjusted norms, the BR of obtaining any one of the following, 5 scores <50th, 4+ scores ≤25th, 3+ scores ≤16th, or 2+ scores ≤9th percentile, approximates 1 SD below the mean in participants born (BR = 16.2%) or educated abroad (BR = 18.6%), who are monolingual Spanish speakers (BR = 16.4%) or who reside in low-income households (BR = 13.6%).

CONCLUSIONS

These algorithms offer a flexible approach to operationalizing psychometric cognitive impairment, through which different definitions can be applied to different examinees based on varying crystallized ability, education, and sociocultural characteristics.

International consensus statement on allergy and rhinology: Olfaction

BACKGROUND

The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O).

METHODS

Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus.

RESULTS

The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies.

CONCLUSION

This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.

Assessing Cognitive Decline in High-Functioning Spanish-Speaking Patients: High Score Base Rates on the Spanish-Language NIH Toolbox Cognition Battery

OBJECTIVE

Prior research has focused on the normal frequency of obtaining low scores on a neuropsychological test battery, but few studies have examined the normal frequency of obtaining high scores. This study involved the preparation of high score multivariate base rates for the Spanish-language National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB).

METHOD

Participants included 250 healthy Latinx adults (age range: 19-80) from the Spanish-language NIHTB-CB normative sample who completed the full battery (two crystallized and four fluid cognition tests). Multivariate base rates, stratified by education, crystallized ability, and sociocultural characteristics, quantified the frequency at which participants obtained one or more "high" fluid test scores (i.e., ≥50th, ≥63rd, ≥75th, ≥84th, ≥91st, ≥95th, and ≥ 98th percentile).

RESULTS

It was common for participants to obtain one or more high scores (i.e., 50.8% obtained one or more scores ≥84th percentile) and uncommon for participants to obtain "no" high scores, especially when using non-conventional thresholds for defining a high score (i.e., 10.8% obtained no scores ≥50th percentile). High scores were more commonly obtained by participants with greater education and higher crystallized ability, who were bilingual, born and educated within the United States, and from higher income households.

CONCLUSIONS

This study demonstrated that participants administered multiple neuropsychological tests commonly obtain high scores, and that the frequency of high scores varies by education, crystallized ability, and sociocultural characteristics. The absence of high scores may be indicative of cognitive impairment among examinees who are higher functioning, have greater education, and have specific sociocultural characteristics (e.g., bilingualism, higher socioeconomic status).

Parental perceived immigration threat and children's mental health, self-regulation and executive functioning in pre-Kindergarten

Many children in immigrant households endure unique stressors shaped by national, state, and local immigration policies and enforcement activity in the United States. Qualitative studies find that during times of heightened immigration enforcement, children as young as 3 years of age show signs of behavioral distress related to national anti-immigrant sentiment and the possibility of losing a parent. Using multiple sources of data from 168 racially and ethnically diverse families of children in pre-Kindergarten, the present study examined variability in perceived levels of immigration enforcement threat by parental immigrant status and ethnicity. This study examined associations between immigration enforcement threat and child mental health, self-regulation, and executive functioning and whether parent immigrant status or child gender moderates these associations. We found substantial variability in perceived immigration threat, with immigrant parents and Latinx parents reporting significantly greater levels of immigration threat compared to nonimmigrant parents and non-Latinx parents. Immigration enforcement threat was associated with greater child separation anxiety and overanxious behaviors, and lower self-regulation among boys and girls and among children of immigrant and U.S.-born parents. In contrast to our hypothesis, immigration enforcement threat was associated with higher self-regulation according to independent assessor ratings. Educators and healthcare providers working with young children from immigrant and Latinx households should be aware of the disproportionate stress experienced by immigrant and Latinx families due to a xenophobic sociopolitical climate marked by heightened immigration enforcement threat and racist, anti-immigrant rhetoric. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cognitive and socio-emotional correlates of psychological well-being and mental health in Guatemalan adults

BACKGROUND

Little is known about associations of psychological and mental well-being with cognitive and socioemotional factors in low and middle-income countries, particularly among vulnerable populations born in adverse environments that may restrict developmental potential. This study aimed to examine the cognitive and socioemotional correlates of psychological well-being and mental health in a cohort of Guatemalan adults born in contexts of poverty and malnutrition.

METHODS

From Dec 2017 to Apr 2019, data were collected from 704 women and 564 men ages 40-57 years living in four rural villages in eastern Guatemala and Guatemala City. We measured latent domains of psychological well-being, spirituality and religion, emotional support, and executive function using Confirmatory Factor Analysis (CFA). Under a Structural Equation Modeling framework, we examined intercorrelations among latent domains and observed measures of intelligence and mental health.

RESULTS

CFA supported the construct validity of factor structures in this population. Correlations of psychological well-being with spirituality and religion were moderate in women (r = 0.68, p < 0.001) and men (r = 0.70, p < 0.001). Executive function was weakly correlated with psychological well-being in men (r = 0.23, p < 0.001) and showed no association in women. Correlations of psychological well-being with emotional support and IQ were weak in women (r = 0.34, and r = 0.15, respectively; p < 0.001 for both) and men (r = 0.35, and r = 0.25, respectively; p < 0.001 for both). Mental health and IQ were weakly correlated in men (r = 0.09, p < 0.05) and showed no association in women. Mental health showed weak correlations with emotional support (r = 0.18, p < 0.001 in women; r = 0.09, p < 0.05 in men), psychological well-being (r = 0.32 and r = 0.35, in women and men respectively; p < 0.001 for both) and showed no association with executive function in both sexes.

CONCLUSIONS

Of all examined factors, spirituality and religion made the greatest contribution to psychological well-being. These findings support the notion that in populations experiencing difficult circumstances, religion can perhaps make a greater contribution to well-being and aid coping. More research is needed to examine mediators of this association.

Pedagogical Proposal of Tele-Exercise Based on "Square Stepping Exercise" in Preschoolers: Study Protocol

Early childhood education aims to achieve the motor, cognitive, emotional, and social development of preschoolers by providing them with a variety of learning opportunities. The square-stepping exercise (SSE) is a balance and lower limb strength training programme used to prevent falls and stimulate cognitive function in older adults. This project aims to propose an SSE tele-exercise (Tele-SSE) protocol to evaluate its effects on the motor and cognitive development of children aged between 3 and 6 years. A randomized controlled trial with experimental (Tele-SSE) and control (general education) groups will be carried out. The application of Tele-SSE will be performed for 9 months (three times per week) and one additional follow-up after the intervention at the beginning of the next academic year. One-hundred and two preschoolers will be recruited and randomly distributed into the two groups: experimental (n = 51) and control (n = 51). Although the main outcome will be balance due to the nature of the SSE, outcomes will include physical and motor (body mass index, waist circumference, handgrip and lower-limb strength, speed-agility, and cardiorespiratory fitness) and cognitive (executive functions and attention, episodic memory, and language assessment, using the Fitness Assessment in the Preschool Battery (PREFIT) and The National Institutes of Health Toolbox—Early Childhood Cognition Battery. This project aims to improve cognitive and motor skills in preschoolers aged between 3 and 6 years old, based on a 9-month Tele-SSE intervention. If this intervention proves to be effective, it could be implemented in those centres, entities and associations specializing in early childhood education.

A Multivariate Interpretation of the Spanish-Language NIH Toolbox Cognition Battery: The Normal Frequency of Low Scores

OBJECTIVE

The current study involved the preparation of multivariate base rates for the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) based on the U.S. normative sample, quantifying the normal frequency of low scores among healthy adults.

METHOD

Participants included 250 healthy Latinx adults (M = 38.8 ± 13.7 years old, range: 19-80; 72.0% women; education: M = 11.5 ± 3.9 years) who completed the full Spanish-language NIHTB-CB, including two tests of crystallized cognition and five tests of fluid cognition. Multivariate base rates quantified the frequency at which participants obtained 1 or more fluid scores ≤25th, ≤16th, ≤9th, ≤5th, and ≤2nd percentile, per age-adjusted or demographically adjusted (age, gender, education) normed scores.

RESULTS

A substantial minority of participants had 1 or more low scores (e.g., 40.4% had 1 or more age-adjusted score ≤16th percentile). The frequencies of low scores increased with fewer years of education and lower crystallized cognitive ability. Higher frequencies of low scores were observed among participants who were born and educated abroad, versus within the USA; monolingual Spanish speakers, versus bilingual Spanish/English speakers; and from households below the national median income, versus households above the national median.

CONCLUSION

Low scores were common and related to crystallized ability, education, and sociocultural variables. Although using demographically adjusted scores reduced group differences related to sociocultural variables, group differences were not eliminated, indicating that age, gender, and education score adjustments do not fully explain the associations between sociocultural variables and test performances. These stratified base rates may be useful when working with Spanish-speaking patients with diverse sociocultural characteristics.