Efectos de un programa de restricciones ambientales en el aprendizaje de la digitación en la flauta en secundaria: una aproximación desde el aprendizaje motor

Functional patterns were observed as a result of the acquisition of bimanual finger movements through playing the recorder under auditory and visual informational constraints. These patterns may improve important variables related to synchronization, accuracy and loss of rhythm among others. 147 students of third grade of secondary school participated in 5 variations of a flute learning program during 12 practice sessions. The results show a resistance to deterioration in the retention test in important instrumental variables compared to other groups, such as the note error in the group in which total restrictions were applied. The partial restrictions (EG3) also obtained a positive significance level compared to the other groups in synchronization as well.Los efectos de los patrones funcionales surgidos durante la adquisición bimanual de los movimientos de los dedos tocando flauta dulce bajo restricciones informacionales auditivas y visuales en la tarea instrumental, pueden contribuir a mejorar variables importantes relacionadas con la sincronización, precisión de la ejecución, pérdida de ritmo, entre otras variables. 147 alumnos de 3º curso de educación secundaria se sometieron a 5 variaciones de un programa de aprendizaje de flauta durante 12 sesiones de práctica. Los resultados muestran una resistencia al deterioro frente al resto de grupos en la prueba de retención, en variables importantes instrumentales como es el error de nota al grupo al que se aplicaron restricciones totales (GE1), aunque uno de los grupos sometido a restricciones parciales (GE3) también obtuvo mejoras estadísticamente significativas respecto al resto de grupos en otra variable importante como es la sincronización

The Effects of an Environmental Constraints Program on the Flute Fingering Learning in Secondary School: An Approach from Motor Learning

Los efectos de los patrones funcionales surgidos durante la adquisición bimanual de los movimientos de los dedos tocando flauta dulce bajo restricciones informacionales auditivas y visuales en la tarea instrumental, pueden contribuir a mejorar variables importantes relacionadas con la sincronización, precisión de la ejecución, pérdida de ritmo, entre otras variables. 147 alumnos de 3º curso de educación secundaria se sometieron a 5 variaciones de un programa de aprendizaje de flauta durante 12 sesiones de práctica. Los resultados muestran una resistencia al deterioro frente al resto de grupos en la prueba de retención, en variables importantes instrumentales como es el error de nota al grupo al que se aplicaron restricciones totales (GE1), aunque uno de los grupos sometido a restricciones parciales (GE3) también obtuvo mejoras estadísticamente significativas respecto al resto de grupos en otra variable importante como es la sincronización.Functional patterns were observed as a result of the acquisition of bimanual finger movements through playing the recorder under auditory and visual informational constraints. These patterns may improve important variables related to synchronization, accuracy and loss of rhythm among others. 147 students of third grade of secondary school participated in 5 variations of a flute learning program during 12 practice sessions. The results show a resistance to deterioration in the retention test in important instrumental variables compared to other groups, such as the note error in the group in which total restrictions were applied. The partial restrictions (EG3) also obtained a positive significance level compared to the other groups in synchronization as well

Efectos de las limitaciones informacionales en el aprendizaje de la flauta dulce. Una perspectiva desde el aprendizaje motor

Es sabido que unas de las mayores preocupaciones de los investigadores en la adquisición de las habilidades motoras es comprender el proceso o mecanismo por el cual los individuos adquieren y modifican sus movimientos para alcanzar el objetivo de la tarea con un alto grado de eficacia y eficiencia. En el ámbito de la adquisición motriz musical no iba a ser menos, por tanto nos proponemos conocer cómo podemos mejorar dichos procesos en el ámbito de la enseñanza musical dentro de la enseñanza secundaria obligatoria (ESO). Utilizando las restricciones en el aprendizaje de una tarea musical a flauta dulce, que dentro de la teoría de los sistemas dinámicos (TSD) —teoría que centra su objeto de estudio en las relaciones entre el ejecutante y el entorno o medio que le rodea—, la adquisición de una habilidad motora se entiende como un comportamiento que surge de la interrelación entre la práctica y un conjunto de restricciones (constraints en la literatura inglesa) (Angulo-Barroso, Faciabén y Mauerberg-Decastro, 2011), categorizados en condicionantes del organismo, del entorno y de la tarea (Haken, Kelso y Bunz, 1985; Newell, 1986, 1996; Handford, Davids, Bennett y Button, 1997), destacando esta última por ser la utilizada en la presente investigación (ver Araújo, 2006).Tesis Univ. Granada.Programa Oficial de Doctorado en Ciencias de la Educación (B22/56/1

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic