Activity-Dependent Neurorehabilitation Beyond Physical Trainings: "Mental Exercise" Through Mirror Neuron Activation

The activity dependent brain repair mechanism has been widely adopted in many types of neurorehabilitation. The activity leads to target specific and non-specific beneficial effects in different brain regions, such as the releasing of neurotrophic factors, modulation of the cytokines and generation of new neurons in adult hood. However physical exercise program clinically are limited to some of the patients with preserved motor functions; while many patients suffered from paralysis cannot make such efforts. Here the authors proposed the employment of mirror neurons system in promoting brain rehabilitation by "observation based stimulation". Mirror neuron system has been considered as an important basis for action understanding and learning by mimicking others. During the action observation, mirror neuron system mediated the direct activation of the same group of motor neurons that are responsible for the observed action. The effect is clear, direct, specific and evolutionarily conserved. Moreover, recent evidences hinted for the beneficial effects on stroke patients after mirror neuron system activation therapy. Finally some music-relevant therapies were proposed to be related with mirror neuron system.

Is mental practice an effective adjunct therapeutic strategy for upper limb motor restoration after stroke? A systematic review and meta- analysis

Stroke is one of the most common conditions requiring rehabilitation, and its motor impairments are a major cause of permanent disability. Hemiparesis is observed by 80% of the patients after acute stroke. Neuroimaging studies showed that real and imagined movements have similarities regarding brain activation, supplying evidence that those similarities are based on the same process. Within this context, the combination of mental practice (MP) with physical and occupational therapy appears to be a natural complement based on neurorehabilitation concepts. Our study seeks to investigate if MP for stroke rehabilitation of upper limbs is an effective adjunct therapy. PubMed (Medline), ISI knowledge (Institute for Scientific Information) and SciELO (Scientific Electronic Library) were terminated on 20 February 2015. Data were collected on variables as follows: sample size, type of supervision, configuration of mental practice, setting the physical practice (intensity, number of sets and repetitions, duration of contractions, rest interval between sets, weekly and total duration), measures of sensorimotor deficits used in the main studies and significant results. Random effects models were used that take into account the variance within and between studies. Seven articles were selected. As there was no statistically significant difference between the two groups (MP vs control), showed a - 0.6 (95% CI: -1.27 to 0.04), for upper limb motor restoration after stroke. The present meta-analysis concluded that MP is not effective as adjunct therapeutic strategy for upper limb motor restoration after stroke.

From Mind to Body: Is Mental Practice Effective on Strength Gains? A Meta-Analysis

Mental practice is an internal reproduction of a motor act (whose intention is to promote learning and improving motor skills). Some studies have shown that other cognitive strategies also increase the strength and muscular resistance in healthy people by the enhancement of the performance during dynamic tasks. Mental training sessions may be primordial to improving muscle strength in different subjects. The aim of this study was to systematically review and meta-analiyze studies that assessed whether mental practice is effective in improving muscular strength. We conducted an electronic-computed search in Pub-Med/Medline and ISI Web of Knowledge, Scielo and manual searchs, searching papers written in English between 1991 and 2014. There were 44 studies in Pub-Med/Medline, 631 in ISI Web of Knowledge, 11 in Scielo and 3 in manual searchs databases. After exclusion of studies for duplicate, unrelated to the topic by title and summary, different samples and methodologies, a meta-analysis of 4 studies was carried out to identify the dose-response relationship. We did not find evidence that mental practice is effective in increasing strength in healthy individuals. There is no evidence that mental practice alone can be effective to induce strength gains or to optimize the training effects.

Effects of Exercise on Physical and Mental Health, and Cognitive and Brain Functions in Schizophrenia: Clinical and Experimental Evidence

Exercise promotes several health benefits, such as cardiovascular, musculoskeletal and cardiorespiratory improvements. It is believed that the practice of exercise in individuals with psychiatric disorders, e.g. schizophrenia, can cause significant changes. Schizophrenic patients have problematic lifestyle habits compared with general population; this may cause a high mortality rate, mainly caused by cardiovascular and metabolic diseases. Thus, the aim of this study is to investigate changes in physical and mental health, cognitive and brain functioning due to the practice of exercise in patients with schizophrenia. Although still little is known about the benefits of exercise on mental health, cognitive and brain functioning of schizophrenic patients, exercise training has been shown to be a beneficial intervention in the control and reduction of disease severity. Type of training, form of execution, duration and intensity need to be better studied as the effects on physical and mental health, cognition and brain activity depend exclusively of interconnected factors, such as the combination of exercise and medication. However, one should understand that exercise is not only an effective nondrug alternative, but also acts as a supporting linking up interventions to promote improvements in process performance optimization. In general, the positive effects on mental health, cognition and brain activity as a result of an exercise program are quite evident. Few studies have been published correlating effects of exercise in patients with schizophrenia, but there is increasing evidence that positive and negative symptoms can be improved. Therefore, it is important that further studies be undertaken to expand the knowledge of physical exercise on mental health in people with schizophrenia, as well as its dose-response and the most effective type of exercise.

Auto-determinação e inclusão social das pessoas com deficiência mental - uma intervenção centrada no sujeito

Dotar as pessoas com deficiência mental com competências para se autodeterminarem e terem a oportunidade de concretizar a sua plena inclusão social, é um desafio colocado à sociedade actual. Torna-se importante colocar em prática o que diferentes autores e organizações como a American Association of Mental Retardation defendem, criando condições para que os profissionais, famílias e comunidade possam ser os facilitadores deste processo. Neste sentido foi implementado no Centro de Reabilitação de Ponte de Lima um modelo de intervenção específico baseado na promoção e desenvolvimento da autonomia pessoal, social e de realização da pessoa com deficiência mental e criado um instrumento de observação e registo que reflecte essa forma de intervenção designado por Protocolo de Registo e Avaliação de Competências - PRAC. Neste estudo realizou-se uma análise ao instrumento em causa, pretendendo dar um contributo para a sua posterior validação. Nesse sentido, utilizou-se uma metodologia qualitativa e quantitativa para analisar se o instrumento pode ou não ser considerado representativo da capacidade de autodeterminação; se é estável quando utilizado por mais que um utilizador; se descrimina os indivíduos com maior ou menor autonomia e se os itens quando sujeitos à análise factorial, evidenciam os constructos teóricos previamente traçados. Muito embora o PRAC tenha sido pensado e estruturado para pessoas com deficiência mental, neste estudo foi utilizado por um grupo diversificado de profissionais oriundos de áreas distintas o que veio comprovar que o instrumento pode ser utilizado em diferentes contextos e com público-alvo mais alargado. Os resultados evidenciados são consistentes, permitindo respostas positivas às questões elaboradas, é de referir contudo que necessitam de um maior aprofundamento de forma a estabelecer outro tipo de generalizações.

O sentir do terapeuta ocupacional na relação terapêutica

A literatura específica e o percurso da terapia ocupacional ilustram a continua preocupação e a percepção da importância da relação terapeuta/cliente para o sucesso da ocupação terapêutica e consequentes resultados positivos da terapia. Isto não significa que exista um grande aprofundamento desta temática e consensos quanto aos factores e competências que a influenciam e lhe estão inerentes. Apesar de haver algumas referências de como o terapeuta deve estar, não tem sido abordado como o terapeuta sente e vive a relação terapêutica. O objectivo principal deste estudo é contribuir para a importância da postura técnica e simultaneamente subjectiva de cada terapeuta ocupacional, no contexto terapêutico. Pretende-se perceber a forma como o terapeuta ocupacional vivência alguns aspectos que o acompanham no processo terapêutico que é manifesto nas suas atitudes e se reflectem na qualidade da intervenção terapêutica e complementarmente na sua vivência pessoal. Usou-se a metodologia qualitativa, a entrevista semi-estruturada e a análise de conteúdo, por valorizar a subjectividade, indo ao encontro do objectivo definido. A amostra integrou vinte terapeutas ocupacionais, com mais de dez anos de experiência profissional e cinco da actual área de especialização profissional - Crianças e Jovens; Medicina Física e Reabilitação, Saúde Mental Adultos e outra de diversos (Toxicodependência, Geriatria e Comunidade). Concluímos que a relação terapêutica em terapia ocupacional é referida como sendo o primeiro passo no investimento terapêutico, para a maioria não é considerada um procedimento técnico, mas produto do bom senso, “dom” da pessoa / terapeuta e vivenciam as emoções e sentimentos do contexto terapêutico, solitariamente e ou com a família, alguns com colegas e poucos numa equipa organizada.

Profissionais de saúde mental enquanto agentes de estigmatização da doença mental

A doença mental continua imbuída de mitos, preconceitos e estereótipos, apesar da crescente aposta na investigação e na melhoria de tratamento nesta área da saúde. Como consequência, as pessoas com doença mental são discriminadas e estigmatizadas quer pelo público geral e pelos meios de comunicação, quer pelas próprias famílias e pelos profissionais de saúde mental que lhes prestam cuidados. Uma vez que os profissionais de saúde mental estabelecem uma ponte entre a doença e a saúde, espera-se que as suas atitudes e práticas contribuam para o recovery da pessoa com doença mental. No entanto, se os profissionais também apresentarem atitudes e crenças estigmatizantes face à doença mental, este processo reabilitativo pode ficar comprometido. Nesse sentido, e perante as lacunas de investigação nesta área, este trabalho tem como objectivo explorar e clarificar a presença ou ausência de atitudes estigmatizantes dos profissionais de saúde mental e, quando presentes, como se caracterizam. Para tal realizaramse 24 entrevistas de carácter qualitativo a profissionais de saúde mental que trabalham em três instituições na região do Porto, nomeadamente num serviço de psiquiatria de um hospital geral, num hospital especializado e em estruturas comunitárias. A análise do material discursivo recolhido junto de Assistentes Sociais, Enfermeiros, Médicos Psiquiatras, Psicólogos e Terapeutas Ocupacionais evidencia a presença de crenças e atitudes de carácter estigmatizante face à doença mental, independentemente da idade, formação ou local onde exercem funções, salvo escassos aspectos onde parece haver influência da idade e da profissão. Significa isto que é provável que as variações de atitudes dos profissionais sejam fundamentalmente consequência das suas características pessoais.

Avaliação da satisfação e importância atribuída aos serviços prestados na área da saúde mental

Com o objectivo de avaliar o grau de satisfação e importância atribuída aos serviços prestados na consulta na área da saúde mental e identificar as relações entre as variáveis demográficas e o grau de satisfação do utente foi realizado um estudo descritivo transversal, numa amostra de 305 utentes. Com a aplicação do questionário verificamos que a satisfação conjugada com a importância fornece-nos informação valiosa permitindo identificar pontos fortes, oportunidades ou necessidades de melhoria dos serviços. Neste estudo verificamos que os utentes encontram-se satisfeitos com os serviços prestados e consideram-nos importantes. Na análise bivariada, encontramos relação entre a satisfação e escolaridade.

Content adaptation for an adaptive hypermedia system

The aim of this paper is presenting the recommendation module of the Mathematics Collaborative Learning Platform (PCMAT). PCMAT is an Adaptive Educational Hypermedia System (AEHS), with a constructivist approach, which presents contents and activities adapted to the characteristics and learning style of students of mathematics in basic schools. The recommendation module is responsible for choosing different learning resources for the platform, based on the user's characteristics and performance. Since the main purpose of an adaptive system is to provide the user with content and interface adaptation, the recommendation module is integral to PCMAT’s adaptation model.

Lipid content of frozen fish: comparison of different extraction methods and variability during freezing storage

In this work, a microwave-assisted extraction (MAE) methodology was compared with several conventional extraction methods (Soxhlet, Bligh & Dyer, modified Bligh & Dyer, Folch, modified Folch, Hara & Radin, Roese-Gottlieb) for quantification of total lipid content of three fish species: horse mackerel (Trachurus trachurus), chub mackerel (Scomber japonicus), and sardine (Sardina pilchardus). The influence of species, extraction method and frozen storage time (varying from fresh to 9 months of freezing) on total lipid content was analysed in detail. The efficiencies of methods MAE, Bligh & Dyer, Folch, modified Folch and Hara & Radin were the highest and although they were not statistically different, differences existed in terms of variability, with MAE showing the highest repeatability (CV = 0.034). Roese-Gottlieb, Soxhlet, and modified Bligh & Dyer methods were very poor in terms of efficiency as well as repeatability (CV between 0.13 and 0.18).

Lipid content and fatty acid profile of Senegalese sole (Solea senegalensis Kaup, 1858) juveniles as affected by feed containing different amounts of plant protein sources

A growth trial with Senegalese Sole (Solea senegalensis Kaup, 1858) juveniles fed with diets containing increasing replacement levels of fishmeal by mixtures of plant protein sources was conducted over 12 weeks. Total fat contents of muscle, liver, viscera, skin, fins and head tissues were determined, as well as fatty acid profiles of muscle and liver (GC-FID analysis). Liver was the preferential local for fat deposition (5.5–10.8% of fat) followed by fins (3.4–6.7% fat). Increasing levels of plant protein in the diets seems to be related to increased levels of total lipids in the liver. Sole muscle is lean (2.4–4.0% fat), with total lipids being similar among treatments. Liver fatty acid profile varied significantly among treatments. Plant protein diets induced increased levels of C16:1 and C18:2 n -6 and a decrease in ARA and EPA levels. Muscle fatty acid profile also evidenced increasing levels of C18:2 n 6, while ARA and DHA remained similar among treatments. Substitution of fishmeal by plant protein is hence possible without major differences on the lipid content and fatty acid profile of the main edible portion of the fish – the muscle.

Salt content in bread and dough from northern Portugal: method development and comparison

In the initial stage of this work, two potentiometric methods were used to determine the salt (sodium chloride) content in bread and dough samples from several cities in the north of Portugal. A reference method (potentiometric precipitation titration) and a newly developed ion-selective chloride electrode (ISE) were applied. Both methods determine the sodium chloride content through the quantification of chloride. To evaluate the accuracy of the ISE, bread and respective dough samples were analyzed by both methods. Statistical analysis (0.05 significance level) indicated that the results of these methods did not differ significantly. Therefore the ISE is an adequate alternative for the determination of chloride in the analyzed samples. To compare the results of these chloride-based methods with a sodium-based method, sodium was quantified in the same samples by a reference method (atomic absorption spectrometry). Significant differences between the results were verified. In several cases the sodium chloride content exceeded the legal limit when the chloride-based methods were used, but when the sodium-based method was applied this was not the case. This could lead to the erroneous application of fines and therefore the authorities should supply additional information regarding the analytical procedure for this particular control.

Mental imagery in interpreting – a neurocognitive perspective

The paper discusses mental imagery as an important part of information processing performed during interpreting. Mental imagery is examined to see if visual processing used to remember the source text or to facilitate its understanding helps to ‗off-load‘ other cognitive (mainly linguistic) resources in interpreting. The discussion is based on a neurocognitively-oriented depictivist model by Kosslyn (1994). The overview of mental imagery processes and systems is followed by the discussion of imagery used in interpreting. First, imagery development in student interpreters is described on the basis of a note-taking course for would-be consecutive interpreters organized by the author at AMU. The initial part of the course devoted to imagery involves visualizations of geographical, descriptive and narrative texts. The description abounds in authentic examples and presents conclusions for interpreting trainers. Later, imagery as employed by professional interpreters is discussed on the basis of a qualitative survey. General implications of the use of mental imagery for cognitive processing limitations in interpreting are presented in the concluding section.

Comparing the content of instruments assessing environmental factors using the International Classification of Functioning, Disability and Health

Purpose: To describe and compare the content of instruments that assess environmental factors using the International Classification of Functioning, Disability and Health (ICF). Methods: A systematic search of PubMed, CINAHL and PEDro databases was conducted using a pre-determined search strategy. The identified instruments were screened independently by two investigators, and meaningful concepts were linked to the most precise ICF category according to published linking rules. Results: Six instruments were included, containing 526 meaningful concepts. Instruments had between 20% and 98% of items linked to categories in Chapter 1. The highest percentage of items from one instrument linked to categories in Chapters 2–5 varied between 9% and 50%. The presence or absence of environmental factors in a specific context is assessed in 3 instruments, while the other 3 assess the intensity of the impact of environmental factors. Discussion: Instruments differ in their content, type of assessment, and have several items linked to the same ICF category. Most instruments primarily assess products and technology (Chapter 1), highlighting the need to deepen the discussion on the theory that supports the measurement of environmental factors. This discussion should be thorough and lead to the development of methodologies and new tools that capture the underlying concepts of the ICF.