OBJECTIVE: To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS: The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS: The mean age of the sample was 47.3 years(sd=16.8) and the mean education was 9.7 years(sd=5; range: 1 - 17). A total of 32.4% of the sample showed literacy/numeracy deficits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; p

OBJECTIVE: To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS: The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS: The mean age of the sample was 47.3 years(sd=16.8) and the mean education was 9.7 years(sd=5; range: 1 - 17). A total of 32.4% of the sample showed literacy/numeracy deficits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; p<0.01) and a negative correlation between age and the scores (r=-0.259; p<0.01). The correlation between the scores and age was not significant when the effects of education were held constant (rp=-0.031, p=0.584). A significant association (B=3.877, Beta =0.733; p<0.001) was found between schooling and scores. Age was not a significant predictor in this model (B=-0.035, Beta=-0.22; p=0.584). CONCLUSIONS: The short version of the Test of Functional Health Literacy in Adults was a suitable tool to assess health literacy in the study population. The high number of individuals classified as functional illiterates in this test highlights the importance of special assistance to help them properly understand directions for healthcare.

Abstract Although dyslexia is a common consequence of brain damage there are few studies about the rehabilitation of this disorder. Cognitive Neuropsychology models of reading have been used to describe several syndromes of acquired dyslexia. Phonological dyslexia is a reading disorder characterized by a dysfunctional grapheme-to-phoneme conversion procedure, which affects the ability to read low frequency words and nonwords. Lexical reading is preserved and patients can read frequent words (regular and irregular). Objective: Verify the application of the cognitive model in the characterization of the reading disorder of a patient with acquired dyslexia and in the devising and implementation of a rehabilitation plan. Methods: This study presents OCS, a 57-year-old patient who suffered from acquired phonological dyslexia after a left temporo-parietooccipital ischemic stroke. A rehabilitation program based on the principles of Cognitive Neuropsychology was devised non-words and low frequency words with controlled lengths were used and the patient was stimulated to read them aloud in a 22-session treatment. Results: The post-test evaluation showed quantitative and qualitative improvements Significant improvements were verified in the total number of correct responses including self-correction attempts (p<0.01) and in the reading of trisyllabic and polysyllabic non-words of simple syllabic structure (p=0.0007 and p=0.02 respectively). Conclusions: The use of the cognitive model to devise a rehabilitation program was successful and we observed significant improvement of reading skills in a short period of treatment. The achievements over this period provided the patient with functional reading performance.

ABSTRACT This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. Methods: A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. Results: Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. Conclusion: Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.

OBJETIVO: Tradução e adaptação da escala Cornell de depressão em demência e verificação da confiabilidade entre e intra-examinadores da versão na língua portuguesa. MÉTODO: A versão original da Escala Cornell foi traduzida para o português por firma especializada em tradução de textos médicos e retrotraduzida para o inglês por outros dois tradutores independentes. As divergências de tradução foram identificadas e discutidas, chegando-se à versão que foi submetida à pré-teste para adaptação sócio-cultural. Após esta adaptação, obteve-se a versão final que foi administrada a amostra de 29 pacientes com doença de Alzheimer provável e aos seus cuidadores. RESULTADOS: A versão final da escala mostrou-se de fácil aplicação e obteve boa confiabilidade intra-examinador (Kappa=0,77; p<0,001) e entre-examinadores (Kappa=0,76; p<0,001). CONCLUSÃO: A versão brasileira da Escala Cornell é um instrumento que pode ser utilizado para avaliação e acompanhamento de depressão em pacientes com demência.

This article aims to present the word visual recognition and lexical access in reading by both describing the steps of this process and integrating it into the knowledge resulting from the studies of Cognitive Psychology (models explaining the word reading processing) as well as from Psycholinguistics (evaluating the linguistics variables which affect lexical processing) focusing on the results obtained by the eye-tracking technology. The steps of the visual information recognition (orthographic processing), and the access to the phonological, morphological, and semantic levels of the word processing, are synthesized and discussed. This synthesis, comprising examples and graphic schemata, is intended to facilitate the access of this information to educators working with literacy. It also shows the skilled readers' cognitive processes to recognize and pronounce the words individually. It starts by outlining the work of the eyes during the reading process, focusing on the words of a sentence, and their relation to eye movements covering the written material, besides specifying how eye-trackers register the oculomotor movements. Next, it describes the sublexical and lexical processes of word processing, presenting two theoretical models (Dual Route Cascade and Iterative Model of the perceptual process) until the word is integrated into the sentence and the discourse.

Electrophysiological studies have increased in the field of Neuroscience of Language as they allow for detailed analyses of the temporal course of language processing. In figurative language research, the most employed technique is Event Related Potentials (ERPs). The N400 is the most studied ERP component and is usually described as a marker of difficulty or effort in semantic processing. However, many controversial results about N400 have been found. Two main reasons can be raised for these results: (1) methodological difficulties in controlling psycholinguistic variables that are known to affect language processing and (2) different interpretations regarding what the N400 indexes. In this systematic review our main goals are: (1) providing a general panorama of studies on the N400 component applied to metaphoric and idiomatic language and (2) discussing the different views adopted by researchers regarding functional N400 theories and how ERP studies of figurative processing fit into each of those theories. We found two main interpretations about the process which is indexed by the N400: N400 as a marker of lexical access or as a marker of semantic integration. We also found that this dichotomy has an impact on the choice of models to explain the results about figurative language processing.

RESUMO Objetivo Avaliar e caracterizar o comportamento oculomotor durante a leitura de pseudopalavras e palavras do português brasileiro caracterizadas quanto à frequência, extensão e regularidade e verificar sua relação com o desempenho em testes neuropsicológicos. Método 21 alunos universitários com média de idade de 20,9 anos realizaram a Tarefa de Leitura de Palavras e Pseudopalavras (TLPP) da Bateria Anele, além de testes de fluência verbal e de memória operacional fonológica. Foram estudados os padrões de duração da primeira fixação do olhar no estímulo, duração total das fixações no estímulo e a taxa de refixações (taxa de retornos ao estímulo). Resultados A duração da primeira fixação e a duração total das fixações foram significativamente menores para palavras em relação às pseudopalavras, bem como a duração total das fixações foi menor para palavras frequentes e curtas. Também foram encontradas interações significativas entre o desempenho na fluência verbal e a duração da primeira fixação. Conclusão Nossos resultados demonstram a aplicabilidade do rastreador ocular para avaliar a leitura no nível da palavra no Português Brasileiro. O rastreador ocular pode ser um instrumento adicional na investigação de transtornos de leitura do desenvolvimento e adquiridos, podendo auxiliar na detecção de dificuldades de leitura a partir da análise de diferenças do comportamento oculomotor entre leitores fluentes e não-fluentes.

The history of Brazilian neuropsychology is traced at different neuropsycholinguistic stages with a focus on the importance of sociocultural factors. We first focus on language disorders, the sequelae of injuries in the left hemisphere, and neuropsychology restricted to the medical field in Europe, the United States, and Brazil. In the middle of the last century, attention to the interdisciplinary importance of studies on the right hemisphere began. Studies consequently emerged on the individual variability of brain function with both biological and cultural origins. Based on this approach, Brazilian studies on aphasic children and illiterate aphasic persons were disseminated internationally. In the 1970s, cognitive neuropsychology began in England, highlighting dysfunctions in reading and writing processes. The characteristics of writing systems within each language became relevant for the manifestations of acquired dyslexia. Brazilian studies showed deficits in Portuguese and Japanese writing caused by brain lesions. During this scientific journey, scientific societies and postgraduate programs in Brazil were created to facilitate exchanges and communication among young researchers. By the end of the last century and in the early 2000s, the growth of the neuropsychology of aging raised awareness of the complexity of sociocultural factors, not only on language research but also according to the level of education, frequency of reading and writing habits, school type, and interactions among these factors and biological factors, especially between the level of education and age. From this historical standpoint, we outline future directions and perspectives in the field of Brazilian neuropsychology.

Abstract The Mini-Mental State Examination (MMSE) is a widely used screening test for cognitive impairment, but is heavily biased by education. Educational level has frequently been ranked using years of schooling, which may not be a good indirect measure of educational level because there is great heterogeneity in standards of schooling among populations and across regions of the same country. S-TOFHLA is a measure of health literacy with some results indicating that it is a good measure for literacy level. Objective: To evaluate the correlations between years of schooling and scores on the S-TOFHLA and the MMSE. Methods: Healthy subjects without cognitive impairment were submitted to the S-TOFHLA and the MMSE. Correlations and regression analysis were performed to determine possible associations among variables. Results: Both years of schooling and S-TOFHLA scores were strongly correlated with MMSE scores, but the strongest association was reached by the S-TOFHLA (r=0.702, p<0.01), where the S-TOFHLA was the best predictor of MMSE scores (R2=0.494, p<0.001). Conclusions: A stronger association between S-TOFHLA scores and MMSE performance was found than between years of education and MMSE scores. This finding justifies further studies incorporating years of schooling together with S-TOFHLA score, to evaluate cognitive performance.