scholarly journals Neurocognitive Impairment in Spanish-Speaking Latinos Living with Human Immunodeficiency Virus in the United States: Validation of Neuropsychological Tests Norms

2019 ◽  
Vol 34 (7) ◽  
pp. 1259-1259
Author(s):  
L Kamalyan ◽  
M A Hussain ◽  
M M Diaz ◽  
A Umlauf ◽  
D R Franklin ◽  
...  

Abstract Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Yet, most studies in this group have included English-speakers only. We investigated the rate and pattern of HIV-associated NCI in Spanish-speaking Latinos from the US-Mexico border region by utilizing newly developed norms for this group, and compared it to previously published norms for English-speaking non-Latino Whites and Blacks/African Americans. Participants and Method Participants included 153 HIV+ Spanish-speaking Latinos (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 27% female; 56% AIDS) living in the greater San Diego area. Participants completed comprehensive neuropsychological, neuromedical and psychiatric assessments in Spanish. The neuropsychological test battery employed in this study - and used extensively in prior studies of HIV- assesses seven ability domains. Raw test scores were converted to demographically-adjusted T-scores using regional norms for Spanish-speakers, and for non-Latino Whites and Blacks. NCI was defined per established criteria. Results Rate of global NCI was 39% using norms for Spanish-speaking Latinos, compared to 64% with White norms and 18% with Black norms. Using norms for Spanish speakers, domain specific NCI among those impaired was highest in executive function (68%), speed of information processing (65%), learning (51%), and working memory (50%). The pattern of HIV associated NCI varied when norms developed for non-Latino Whites and Blacks were used. Conclusions HIV+ Spanish speakers showed similar rates of global NCI to those in other HIV+ populations, when norms developed for this group were used. In contrast, use of non-Latino White and Black norms resulted in misclassification of impairment. The pattern of NCI differed based on the norms used. Present findings highlight the importance of utilizing norms developed for Spanish-speakers in the US in order to obtain more precise and valid depictions of cognition in this population.


2019 ◽  
Vol 34 (7) ◽  
pp. 1257-1257
Author(s):  
M A Hussain ◽  
L Kamalyan ◽  
M M Diaz ◽  
A Umlauf ◽  
D R Franklin ◽  
...  

Abstract Objective HIV-associated neurocognitive impairment (NCI) is prevalent and impactful. Yet, there is an absence of published studies that investigate its correlates among Spanish-speaking Latinos living in mainland US- a demographic that represents a large and vulnerable segment of the HIV+ population. The goal of the current study was to examine predictors of NCI among Spanish-speaking Latinos with HIV living in the United States. Participants and Method 153 Spanish-speaking Latinos living with HIV from the US-Mexico border region (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 73% female; 56% AIDS) completed comprehensive neuropsychological, neuromedical, and psychiatric evaluations in Spanish. Scores across 7 cognitive domains were converted to a Global Deficit Score (GDS) based on T-scores on individual tests using newly developed, region specific, and demographically-corrected norms for Spanish-speaking Latinos. NCI was determined using cutoff of GDS > 0.5 (39.2% of sample). Examined predictors included HIV disease characteristics (e.g., AIDS status, current CD4 count, duration of antiretroviral therapy (ART) exposure) and psychiatric comorbidities. Results A multivariable logistic regression - including predictors that were associated with NCI in univariable analyses - showed a significant interaction between lifetime history of substance use disorder (LT SUD) and duration of ART exposure, after accounting for AIDS status (LR Chi2 = 3.99, p = 0.046). Stratified analyses showed that among participants who did not have LT SUD, longer ART exposure was associated with decreased NCI (p = 0.01), while rates of NCI among those with LT SUD were not influenced by months of ART exposure (p = 0.91). Conclusions Present findings showed that HIV disease burden and psychiatric characteristics might interact to impact NCI among Spanish-speaking Latinos. Considering these influences may help in the provision of comprehensive care to Spanish-speaking, Latino minority groups that suffer from NCI and HIV.





2019 ◽  
Vol 34 (7) ◽  
pp. 1274-1274
Author(s):  
T Scott ◽  
A Morlett Paredes ◽  
M Taylor ◽  
A Umlauf ◽  
L Artiola i Fortuny ◽  
...  

Abstract Objective Adaptations of the Wechsler Adult Intelligence Scale, Revised (WAIS-R) and accompanying norms exist for a limited number of Spanish-speaking populations, but none are available for US-dwelling Spanish speakers of Mexican origin, who make up the largest proportion of Latinas/os in the US. As part of a larger test adaptation and norming effort for Spanish-speakers from the US-Mexico border region, we generated and investigated demographically adjusted interpretive norms for selected WAIS-R subtests. Participants and Method Participants included 183 community-dwelling, primarily Spanish-speaking individuals, aged 20 to 55 (education range: 0-20 years; 58% female), who were residing in the US-Mexico border region. Participants completed the WAIS-R Spanish version (Block Design, Arithmetic, and Vocabulary subtests) as part of a larger neuropsychological battery. Demographically adjusted T-scores were calculated for these subtests using fractional polynomial equations, which controlled for age, education, and sex. We examined rates of neurocognitive impairment (T < 40) in our sample derived from the present demographically adjusted Spanish speaking norms and from the existing WAIS-R demographically adjusted norms for English-speaking Non-Latina/o White and Black adults. Results Based on the normalized distribution of T-scores, the newly developed regional Spanish-speaker norms yielded subtest rates of impaired performance between 13-16% (i.e., within the expected -1 SD). By comparison, the proportion of impaired subtest performances was between 4-6% when applying the existing English-speaking norms to our sample. Conclusions Regional normative data will improve interpretation of test performance on selected WAIS-R subtests for Spanish-speakers living in the US and will facilitate a more valid analysis of neuropsychological profile patterns in this population. Cross-validation with Spanish-speakers in other regions and/or with other national origins is needed.



2019 ◽  
Vol 34 (7) ◽  
pp. 1265-1265
Author(s):  
A Morlett Paredes ◽  
J Carrasco ◽  
M Cherner ◽  
A Umlauf ◽  
M Rivera Mindt ◽  
...  

Abstract Objective To provide norms applicable to Spanish-speakers living in the US- Mexico border region for the Halstead Category Test, a test of executive function. Participants and Method Healthy Spanish-speakers (n = 252) were recruited from the US–Mexico border regions (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.3, range 0-20; 58% female). Participants completed the Category Test as part of a larger neuropsychological test battery. Relationships between demographic variables and raw error scores were assessed using Spearman and Wilcoxon Rank-sum tests. Demographically corrected T-scores for the Category Test were normed using fractional polynomial equations accounting for age, education, and sex. For comparison, T-scores were also computed for the Spanish-speaking normative sample using published norms for English-speaking non-Hispanic Whites and African Americans, which were also adjusted for age, education and sex. Impairment rates based on -1SD (T < 40) were calculated using both, published and current, norms. Results Older age was significantly associated with higher number of errors (Spearman ρ = 0.32, p < .001) and higher education was associated with lower number of errors (Spearman ρ = -0.52, p < .001), with no other significant demographic effects. Applying non-Hispanic norms resulted in overestimation of impairment rates in the Spanish-speaking sample (impairment rate: 48% with White norms and 27% with African American norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using African American norms were comparable to those based on the newly developed norms. Conclusions The present study is the first to develop norms for the Category test in a sample of Spanish-speakers in the US-Mexico border region. These norms will provide tools for the assessment of executive function in this population. Research concerning generalizability of norms to other Spanish-speaking populations is needed.



2019 ◽  
Vol 34 (7) ◽  
pp. 1256-1256
Author(s):  
A Heaton ◽  
A Gooding ◽  
M Cherner ◽  
A Umlauf ◽  
D Franklin ◽  
...  

Abstract Objective We developed demographically-corrected norms for US-dwelling, Spanish-speaking Hispanics on two widely used tests of motor skills - the Grooved Pegboard Test (Pegs) and Finger Tapping Test (Tapping). We then examined the effects of applying established norms for non-Hispanic Caucasians (NH Whites) and non-Hispanic African Americans (NH Blacks) on motor test results from our Hispanic population. Participants and Method 254 participants living in the US-Mexico border region of San Diego, CA and Tucson, AZ completed Pegs, and a subset (n = 183) completed Tapping. Age ranged from 19-60 and education from 0-20 years, with 59% women. Raw test scores were converted to demographically-corrected T-scores with a fractional polynomial procedure and compared to a fitted curve for the original data. Results Findings included significant main effects of education on both tests (p < .001), and of age for Pegs (p < .001). There was a significant interaction of sex and age on Tapping, such that older age was associated with lower scores in men only (p = .02). The resulting normative T-scores were confirmed to be free from demographic influences. Using a T < 40 cut point, rates of impairment in the Spanish speaking normative sample for dominant (D) and nondominant (ND) hands, respectively, were 17% and 14% for Pegs, and 12% and 10% for Tapping. Applying existing norms for NH Whites and NH Blacks to the raw scores of Spanish speakers generally yielded lower impairment rates on all measures, with one exception, Pegs ND, for which NH White norms overestimated impairment (23%). Conclusions Normative standards from other groups are not a good fit for interpreting motor test performance in this Hispanic population, which in the current instance would have generally underdiagnosed fine motor impairment. These findings underscore the importance of appropriate, population-specific normative data- even for tests of motor ability.



Author(s):  
Donna M. Kabalen de Bichara

Hundreds of 19th-century newspapers and magazines published in the region of the US–Mexico border are housed in archival collections in Mexico and the United States, and they provide access to historical, cultural, and ideological perspectives involving two world spheres that are intimately connected. Archival collections in the following databases provide access to periodicals published in the United States as well as in Mexico: the Newspaper and Periodicals Collection at the National Autonomous University of Mexico; the Readex Collection of Hispanic American Newspapers, 1808–1980; the Nettie Lee Benson Library’s microfilmed collection of 19th-century independent newspapers; the digital collection of periodicals and magazines from the Capilla Alfonsina Biblioteca Universitaria and the Biblioteca Universitaria Raúl Rangel Frias, at the Universidad Autónoma de Nuevo León; and the EBSCO Arte Público Hispanic Historical Collections, Series 1 and 2. These collections house digitized and microfilmed newspapers that include those published in the US states of California, Arizona, Nevada, New Mexico, and Texas, as well as Mexican states such as Baja California, Sonora, Chihuahua, Coahuila, Nuevo León, and Tamaulipas. The region includes areas that share not only a physical border but also a cultural memory based on the effects of historical collisions that have contributed to the formation of new meanings regarding these world spheres that can be understood as two intersecting semiotic systems that exist as a continuum. The intersection of these spaces represents the transnational aspect of periodical print culture of the late 19th century that communicates worldviews that are semiotically and ideologically heterogeneous. Indeed, cultural spaces that exist in the borderland (or that symbolic space that forms a border or frontier in a cultural sense), are semiotic realities that unfold in unpredictable and indeterminate ways as a result of historical processes. Periodical print culture produced in the border region provides access to diverse social, cultural, political, and religious perspectives. Furthermore, the history of print culture involves a process of communication of both social and cultural history. As objects of study, borderland newspapers ultimately provide the basis for understanding the circulation of ideas.



2011 ◽  
Vol 13 (2) ◽  
pp. 60 ◽  
Author(s):  
Brenda Fuentes ◽  
Francisco Soto Mas ◽  
Erika Mein ◽  
Holly E. Jacobson

Among Hispanic immigrants in the United States (US), learning English is considered necessary for economic and social achievement. Asa consequence, there is a high demand for English as a Second Language (ESL) classes. Despite the recognized benefits of ESL programs,both at the individual and social levels, more research is needed to identify education strategies that effectively promote all aspects of learningEnglish as a second language. This article describes an ESL curriculum that incorporates a theory-based pedagogical approach specificallydesigned for immigrant Hispanic adults on the US-Mexico border region. The article also describes the implementation of the curriculum aswell as the results of the evaluation, which was conducted using both quantitative and qualitative methods. Quantitative results indicate thatthe participants significantly improved their English proficiency (L2). Qualitative results suggest that participants were positively impactedby both the content and pedagogical approaches used by the curriculum. Their experience with the ESL class was positive in general. It canbe concluded that the curriculum achieved its objective. This approach could serve as a model for second language teaching for adults



2019 ◽  
Vol 34 (6) ◽  
pp. 857-857
Author(s):  
P Suarez ◽  
M Diaz-Santos ◽  
M Marquine ◽  
A Umlauf ◽  
D Franklin ◽  
...  

Abstract Objective Despite the wide use of the Trail Making Test when assessing Spanish-speakers in the United States (US), there is a lack of normative data to interpret level of performance in this population. Here we describe the generation of regional norms for the Trail Making Test for native Spanish-speakers residing in the Southwest Mexico-Border Region of US. Method Participants were 252 healthy native Spanish speakers, 58% women, between the ages of 19 and 60, and ranging in education from 0-20 years, recruited in San Diego, CA and Tucson, AZ. All received instructions translated into Spanish. Demographic effects on test performance were examined univariably. T-scores were calculated using fractional polynomial equations to account for linear and any non-linear effects of age, education, and sex. Results Older age and lower education were associated with worse scores on both Trails A and Trails B. The newly derived T-Scores showed no association with demographic variables and displayed the expected 16% rates of impairment using a -1 SD cutpoint based on a normal distribution. By comparison, published norms for English-speaking non-Hispanic whites yielded impairment rates of 28% for Trails A and 35% for Trails B while norms for African Americans resulted in 18 % impairment for Trails A and 20% impairment for Trails B. Conclusions Demographically adjusted regional norms improve the utility and diagnostic accuracy of the TMT for use with native Spanish speakers in the US-Mexico Border region.



2020 ◽  
Vol 10 (2) ◽  
pp. 21-40
Author(s):  
James Gerber

English abstract: US cities and towns on the border with Mexico tend to have below-average incomes, while Mexican border cities and towns tend to be above the average of Mexico. Social scientists have not explained these differences from national averages in a convincing way. Nor have they described the characteristics of border cities and towns in ways that differentiate them from cities and towns in the interiors of their respective nation. The key to both puzzles is the fact that the institutional environment in the US–Mexico border region is binational in origin. Mexican institutions create externalities in the United States and vice versa. Recognition of this fact is a first step in dealing with the international public goods and common pool resources of the border region.Spanish abstract: Ciudades y pueblos a ambos lados de la frontera México–EE. UU. comparten características que las hacen diferentes de las comunidades en el interior de sus respectivas naciones. Por ejemplo, las diferencias de ingresos transfronterizos son más pequeñas que las diferencias nacionales y cada lado está fuertemente influenciado por políticas y eventos que se originan en el otro lado. Hay tres razones principales para estos efectos: proximidad, redes y externalidades. Este ensayo utiliza la perspectiva de economía institucional para argumentar que el ambiente institucional de las ciudades y pueblos fronterizos es binacional. El reconocimiento de este hecho es un primer paso en la gestión de los bienes públicos internacionales y los recursos comunes de la región fronteriza.French abstract: Villes et villages des deux côtés de la frontière américano-mexicaine partagent des caractéristiques qui les différencient des communautés à l’intérieur de leurs nations respectives. Par exemple, les écarts de revenu de part et d’autre de la frontière sont plus réduits que les différences nationales, et chaque côté est fortement influencé par les politiques et les événements qui proviennent de l’autre côté. Trois raisons principales expliquent ces effets : la proximité, les réseaux et les externalités. Cet essai utilise la perspective de l’économie institutionnelle et soutient que l’environnement institutionnel des villes frontalières est binational. Cette reconnaissance est une première étape pour la gestion des biens publics internationaux et des ressources communes de la région frontalière.



Cancer ◽  
2008 ◽  
Vol 113 (S10) ◽  
pp. 2964-2973 ◽  
Author(s):  
Steven S. Coughlin ◽  
Thomas B. Richards ◽  
Kiumarss Nasseri ◽  
Nancy S. Weiss ◽  
Charles L. Wiggins ◽  
...  


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