Disease severity affects obstacle crossing in people with Parkinson's disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?

Background: Although the effect of symptomatic back pain on functional movement has been investigated, changes to spinal movement patterns in essentially pain-free people with a history of recurrent back pain are largely unreported. Reaching activities, important for everyday and occupational function, often present problems to such people, but have not been considered in this population. The purpose of this study was to compare the amplitude and timing of spinal and hip motions during two, seated reaching activities in people with and without a history of recurrent low back pain (RLBP).Methods: Spinal and hip motions during reaching downward and across the body, in both directions, were tracked using electromagnetic sensors. Analyses were conducted to explore the amplitudes, velocities and timings of 3D segmental movements and to compare controls with subjects with recurrent, but asymptomatic lumbar or lumbosacral pain.Findings: We detected significant differences in the amplitude and timing of movement in the lower thoracic region, with the RLBP group restricting movement and demonstrating compensatory increased motion at the hip. The lumbar region displayed no significant between-group differences. The order in which the spinal segments achieved peak velocity in cross-reaching was reversed in RLBP compared to controls, with lumbar motion leading in controls and lagging in RLBP.Interpretation: Subjects with a history of RLBP show a number of altered kinematic features during reaching activities which are not related to the presence or intensity of pain, but which suggest adaptive changes to movement control. (C) 2013 Elsevier Ltd. All rights reserved.

Systematic Screening of Plant Extracts from the Brazilian Pantanal with Antimicrobial Activity against Bacteria with Cariogenic Relevance

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Positive effects of auditory cue in locomotor pattern of people with Parkinson's disease (off and on medication)

Gait disorders are identified in people with Parkinson’s disease. The aim of this study was to investigate the effect of auditory cues and medication on kinematic, kinetic and EMG parameters, during different gait phases of people with PD and healthy elderly. Thirty subjects distributed in two groups (Group 1, PD patients off and on medication; Group 2, healthy elderly) participated in this study and were instructed to walk in two experimental conditions: non-cued and cued. Therefore, kinematic, kinetic and electromyography analyses were utilized to investigate the locomotor pattern. Changes in locomotor pattern (greater muscular activity) with auditory cue were observed for PD patients. Regarding the medication, locomotor parameter improvement was observed after levodopa intake in association with the auditory cue. These results confirm the hypothesis about the external cues therapy that could be used as a complement to drug therapy to achieve improvement in the locomotor pattern of PD patients.

Uma proposta de intervenção com atividade física individualizada na deficiência intelectual: um estudo de caso

The practice of regular physical activity has been considered a protective factor against the degenerative processes of the body, acting as a promoter of health, especially for risk groups such as obese and resistant groups exercise adherence as among the intellectually disabled (ID) . This study involved the administration of a training protocol and the physical parameters of longitudinal health in a subject about 43 years, intellectually deficient, hypertensive, obese and with a strong predisposition to develop diabetes and heart disease. The main objective of long-term program was to reduce body weight and normalize blood pressure (BP) after the student's physical activity and preferentially interfere with BP values at rest (ie before the daily schedule). The other objective was to improve general physical fitness. The protocol involved four meetings per week lasting one hour, in addition to participation in the program PROEFA (twice a week with sessions of one hour each), totaling 57 sessions spread over five months. The evaluation protocol included in each session the following tests: blood pressure measurements and heart rate, and amount of physical activity recorded via pedometer. Tests applied before and after the training included: anthropometric assessment, agility test, flexibility test, test drive through vertical and horizontal jumps and endurance to the test bench. The mass (kg) and BMI corresponded to the initial values of 127.7 kg and 42.05 kg m-2, and 5 months after 113.2 kg and 37.48 kg m-2, respectively. The waist-hip ratio was close to 1 after the intervention and this value corresponded to 0.98. For the test of agility (shuttle run) was not found improvement in performance. To test the values of the horizontal jump in pre-test were 52 cm and 56 cm post-test, vertical jump has been improved and...(Complete abstract click electronic access below)

Experiências inclusivas na educação de jovens e adultos em um município do interior paulista

Pós-graduação em Educação - FFC

Factors associated with breastfeeding in disabled and phenotipically normal children

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

LEISURE AND MENTAL HEALTH IN PEOPLE WITH HYPERTENSION: CONVERGENCE IN HEALTH EDUCATION

People with hypertension constantly deal with issues related to mental health due to the psychosocial determinants of this illness, and leisure is an important control strategy. The objective of this study was to promote health education to a group of hypertensive patients, through research-action, based on critical-social pedagogy, and taking into consideration the participants' perception of leisure. Educational activities were conducted and, following, an evaluation was performed regarding the subjects' opinion about the impact of leisure on their lives and mental health. The group perceived leisure as a coping strategy for loneliness and also as a late development of independence; it was also regarded as a means of socialization and as a promotion of mental health. These perceptions revealed two themes: aging, leisure, and chronic disease; and knowledge and leisure experiences. Educational actions, such as group dynamics and discussions, were planned considering these themes with the purpose of providing the necessary conditions for socializing and exchanging experiences.

PROFILE OF CAREGIVERS OF ELDERLY PEOPLE WITH ALZHEIMER DISEASE ASSOCIATED TO RESILIENCE

This exploratory and descriptive study described sociodemographic and health variables of caregivers of elderly people with Alzheimer's disease, associating care provided with resilience. Participants were 101 caregivers over 18 years old who accompanied older adults in a Primary Care Unit of a Brazilian public hospital in 2009. Questionnaires regarding the profile, the Beck Depression Inventory, and the Resilience Scale were used. Descriptive statistical analysis was performed. Most caregivers were female, without depression, aided by other people in providing care, and had a high degree of resilience. The variables degree of kinship, medical treatment, the use of medication, tiredness, prostration, discouragement, and caregivers' mental health had significant association with resilience. Physical health was significantly associated to experience in care, with 82 elderly people presenting acute cognitive damage. Older adults in the family context can benefit from a more resilient caregiver.

Religious/spiritual coping in people with chronic kidney disease undergoing hemodialysis

The objective of the present study is to investigate the use of religious/spiritual coping mechanisms in patients with chronic kidney disease undergoing hemodialysis, by means of interviews using a sociodemographic questionnaire and the religious/spiritual coping scale. Data analysis was performed using descriptive statistics and multiple linear regression. A total of 123 individuals were interviewed, 79.6% of whom presented a high score for religious/spiritual coping and none of whom presented low or irrelevant scores. The variables that affected the religious/spiritual coping behavior were: gender, age group, treatment time, family income, and religious practice. In conclusion, the participants used religious/spiritual coping mechanisms as a strategy to cope with the disease, particularly women with a higher family income who attend church every week.

Family health team knowledge concerning the health needs of people with tuberculosis

The purposes of the study were to get to know conceptions on tuberculosis and health needs and to describe the care provided to people with tuberculosis, according to health professionals' perspective. Qualitative study developed at family health units in Capao Redondo, Sao Paulo. The data were collected through open interviews in January 2010 and submitted to discourse analysis, resulting in three categories: meanings attributed to tuberculosis and health needs and care characteristics. The conceptions regarding the disease are supported by the multi-causal theory of the health-disease process. The care is characterized by interventions that go beyond the biological dimension. The precarious living conditions define the needs of most people with tuberculosis, and can be more important to the ill than the very diagnosis of the disease, influencing treatment adherence, and should gain relevance in care.

Muscle Atrophy and Functional Deficits of Knee Extensors and Flexors in People With Chronic Stroke

Background. Further clarification is needed with regard to the degree of atrophy in individual muscle groups and its possible relationship to joint torque deficit poststroke. Objective. The purpose of this study was to investigate quadriceps and hamstring muscle volume and strength deficits of the knee extensors and flexors in people with chronic hemiparesis compared with a control group. Design. This was a cross-sectional study. Methods. Thirteen individuals with hemiparesis due to chronic stroke (hemiparetic group) and 13 individuals who were healthy (control group) participated in this study. Motor function, quadriceps and hamstring muscle volume, and maximal concentric and eccentric contractions of the knee extensors and flexors were assessed. Results. Only the quadriceps muscle of the paretic limb showed reduced muscle volume (24%) compared with the contralateral (nonparetic) limb. There were no differences in muscle volume between the hemiparetic and control groups. The peak torque of the paretic-limb knee extensors and flexors was reduced in both contraction modes and velocities compared with the nonparetic limb (36%-67%) and with the control group (49%-75%). The nonparetic limb also showed decreased extensor and flexor peak torque compared with the control group (17%-23%). Power showed similar deficits in strength (12%-78%). There were significant correlations between motor function and strength deficits (.54-.67). Limitations. Magnetic resonance imaging coil length did not allow measurement of the proximal region of the thigh. Conclusions. There were different responses between quadriceps and hamstring muscle volumes in the paretic limb that had quadriceps muscle atrophy only. However, both paretic and nonparetic limbs showed knee extensor and flexor torque and power reduction.

Host immune response in immunodeficient mice against infection with Cryptosporidium parvum

Immunantwort von immundefizienten Mäusen gegenüber Infektionen mit Cryptosporidium parvum. Cryptosporidium parvum ist ein intrazellulärer, protozoischer Krankheitserreger, der im immunkompromittierten Wirt zu lebensbedrohender Enteritis führen kann. CD4+ T-Zellen und Interferon (IFN)-γ spielen wesentliche Rollen bei der Wirtsimmunantwort gegen die Infektion. Dennoch sind die Effektormechanismen, die zur Resistenz führen nur wenig verstanden. In dieser Studie wurde die Immunantwort von IFN-γ- und Interleukin (IL)-12-Defektmäusen parallel zu Wildtypmäusen analysiert. Die Ergebnisse identifizierten IFN-γ als Schlüsselzytokin bei der natürlichen und erworbenen Immunität während der Erst- und Folgeinfektion mit C. parvum. Tumornekrosefaktor (TNF)-α ist möglicherweise ein Induktor der frühen IFN-γ-Antwort in IL-12 Knockout-Mäusen. Weiterhin tragen offenbar sowohl Th1- als auch Th2-Zytokine zur Überwindung der Primärinfektion bei, die ersten mehr als die letztgenannten. Zytokingene waren am Ort der Infektion (Ileum) dramatisch verändert, nicht aber in den lokalen Lymphknoten und der Milz. Nach Folgeinfektion ergab sich in Abwesenheit von IFN-γ eine signifikante Erhöhung der Th2-Zytokine IL-5 and IL-13. Die Ergebnisse zeigten weiterhin, dass das Th1-Zytokin IL-18 zur Resistenz gegenüber C. parvum beiträgt, möglicherweise durch verschiedene Immunfunktionen, wie der Regulation von Serum-IFN-γ während der Infektion und/oder der Erhaltung der Homeostase der Th1/Th2-Zytokine durch Regulation der Th2-Zytokine. Weiterhin zeigten diese Untersuchungen den Transfer von Resistenz gegenüber C. parvum von infizierten auf naïve Mäuse mittels stimulierter intraepithelialer Lymphozyten und CD4+ T-Zellen. Diese Ergebnisse weisen auf die Gegenwart von C. parvum-spezifischen CD4+ T-Zellen in anderen lymphatischen Geweben neben der Darmmukosa hin. Eine Stimulation der Spendertiere durch Infektion war notwendig für eine übertragbare schützende Immunität. Dennoch konnte die übertragene Immunität nicht die Infektion der Empfängertiere vollständig verhindern; eine Verdopplung der Spenderzellen führte zu keinem besseren Ergebnis. Weiterhin ergab der Transfer von CD4+ und CD8+ T-Zellen (Pan-T-Zellen) keinen erhöhten Schutz der naiven Empfängertiere als der alleinige Transfer von CD4+ T-Zellen. Dies weist auf die fehlende Bedeutung der CD8+ T-Zellen beim Schutz vor C. parvum-Infektion hin.

Sensor-based evaluation of Circadian motor behavior in people with Dementia. Development and validation of analysis strategies

[ITA]La demenza consiste nel deterioramento, spesso progressivo, dello stato cognitivo di un individuo. Chi è affetto da demenza, presenta alterazioni a livello cognitivo, comportamentale e motorio, ad esempio compiendo gesti ossessivi, ripetitivi, senza uno scopo preciso. La condizione dei pazienti affetti da demenza è valutata clinicamente tramite apposite scale e le informazioni relative al comportamento vengono raccolte intervistando chi se ne occupa, come familiari, il personale infermieristico o il medico curante. Spesso queste valutazioni si rivelano inaccurate, possono essere fortemente influenzate da considerazioni soggettive, e sono dispendiose in termini di tempo. Si ha quindi l'esigenza di disporre di metodiche oggettive per valutare il comportamento motorio dei pazienti e le sue alterazioni patologiche; i sensori inerziali indossabili potrebbero costituire una valida soluzione, per questo scopo. L'obiettivo principale della presente attività di tesi è stato definire e implementare un software per una valutazione oggettiva, basata su sensori, del pattern motorio circadiano, in pazienti affetti da demenza ricoverati in un'unità di terapia a lungo termine, che potrebbe evidenziare differenze nei sintomi della malattia che interessano il comportamento motorio, come descritto in ambito clinico. Lo scopo secondario è stato quello di verificare i cambiamenti motori pre- e post-intervento in un sottogruppo di pazienti, a seguito della somministrazione di un programma sperimentale di intervento basato su esercizi fisici. --------------- [ENG]Dementia involves deterioration, often progressive, of a person's cognitive status. Those who suffer from dementia, present alterations in cognitive and motor behavior, for example performing obsessive and repetitive gestures, without a purpose. The condition of patients suffering from dementia is clinically assessed by means of specific scales and information relating to the behavior are collected by interviewing caregivers, such as the family, nurses, or the doctor. Often it turns out that these are inaccurate assessments that may be heavily influenced by subjective evaluations and are costly in terms of time. Therefore, there is the need for objective methods to assess the patients' motor behavior and the pathological changes; wearable inertial sensors may represent a viable option, so this aim. The main objective of this thesis project was to define and implement a software for a sensor-based assessment of the circadian motor pattern in patients suffering from dementia, hospitalized in a long-term care unit, which could highlight differences in the disease symptoms affecting the motor behavior, as described in the clinical setting. The secondary objective was to verify pre- and post-intervention changes in the motor patterns of a subgroup of patients, following the administration of an experimental program of intervention based on physical exercises.

Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial

the modern joint protection (JP) concept for people with rheumatoid arthritis (RA) is an active coping strategy to improve daily tasks and role performance by changing working methods and using assistive devices. Effective group JP education includes psycho-educational interventions. The Pictorial Representation of Illness and Self Measure (PRISM) is an interactive hands-on-tool, assessing (a) the individual's perceived burden of illness and (b) relevant individual resources. Both issues are important for intrinsic motivation to take action and change behaviour. This study compared individual conventional JP education (C-JP) with PRISM-based JP education (PRISM-JP).