Habilidades perceptivas visuais e qualidade de escrita de escolares com dislexia

OBJECTIVE: This study aimed to characterize and compare the visual perceptual skills and writing quality of students with dyslexia, with good academic performance, and to relate the perceptual visual motor skills and the writing quality of students with dyslexia, with good academic performance. METHODS: 40 students participated in this study; 35 males and 5 females, from 8 to 11 years and 11 months, who attended from the 3rd to 5th grade level of public municipal schools of Marília-SP, divided into two groups: Group I (GI) comprised 20 students with interdisciplinar diagnoses of dyslexia, and Group II (GII) comprised 20 students with good academic performance. The Visual Perceptual Skills Test - TVPS-3 and the Disgraphy Scale were applied. RESULTS: The results obtained from this study showed that the students with dyslexia presented difficulties in visual skills concerning discrimination and memory. Besides discrimination and memory skills, it was observed inferior performance concerning the relation visual spacial skills and steady form, and inferior performance in all the visual skills, when compared to the chronological age. However, the group of students with good academic performance has also presented inferior performance concerning the relation visual spacial skills and steady form. CONCLUSIONS: The study mentions that maybe schools do not invest sufficiently in activities which envolve visual experiences necessary for the enhancement of reading and writing. Although statistically significant difference was not observed between the groups concerning disgraphy, it iwas possible to observe that a higher amount of students presented disgraphy.

Ocular pulse amplitude in healthy subjects as measured by dynamic contour tonometry

OBJECTIVES: To test whether dynamic contour tonometry yields ocular pulse amplitude (OPA) measurements that are independent of corneal thickness and curvature, and to assess variables of observer agreement. METHODS: In a multivariate cluster analysis on 223 eyes, the relationship between central corneal thickness, corneal curvature, axial length, anterior chamber depth, intraocular pressure, sex, age, and OPA measurements was assessed. Intraobserver and interobserver variabilities were calculated from repeated measurements obtained from 8 volunteers by 4 observers. RESULTS: The OPA readings were not affected by central corneal thickness (P = .08), corneal curvature (P = .47), anterior chamber depth (P = .80), age (P = .60), or sex (P = .73). There was a positive correlation between OPA and intraocular pressure (0.12 mm Hg/1 mm Hg of intraocular pressure; P<.001) and a negative correlation between OPA and axial length (0.27 mm Hg/1 mm of length; P<.001). Intraobserver and interobserver variabilities were 0.08 and 0.02 mm Hg, respectively, and the intraclass correlation coefficient was 0.89. CONCLUSIONS: The OPA readings obtained with dynamic contour tonometry in healthy subjects are not influenced by the structure of the anterior segment of the eye but are affected by intraocular pressure and axial length. We found a high amount of agreement within and between observers.

Clinical usefulness of gene-expression profile to rule out acute rejection after heart transplantation: CARGO II.

AIMS A non-invasive gene-expression profiling (GEP) test for rejection surveillance of heart transplant recipients originated in the USA. A European-based study, Cardiac Allograft Rejection Gene Expression Observational II Study (CARGO II), was conducted to further clinically validate the GEP test performance. METHODS AND RESULTS Blood samples for GEP testing (AlloMap(®), CareDx, Brisbane, CA, USA) were collected during post-transplant surveillance. The reference standard for rejection status was based on histopathology grading of tissue from endomyocardial biopsy. The area under the receiver operating characteristic curve (AUC-ROC), negative (NPVs), and positive predictive values (PPVs) for the GEP scores (range 0-39) were computed. Considering the GEP score of 34 as a cut-off (>6 months post-transplantation), 95.5% (381/399) of GEP tests were true negatives, 4.5% (18/399) were false negatives, 10.2% (6/59) were true positives, and 89.8% (53/59) were false positives. Based on 938 paired biopsies, the GEP test score AUC-ROC for distinguishing ≥3A rejection was 0.70 and 0.69 for ≥2-6 and >6 months post-transplantation, respectively. Depending on the chosen threshold score, the NPV and PPV range from 98.1 to 100% and 2.0 to 4.7%, respectively. CONCLUSION For ≥2-6 and >6 months post-transplantation, CARGO II GEP score performance (AUC-ROC = 0.70 and 0.69) is similar to the CARGO study results (AUC-ROC = 0.71 and 0.67). The low prevalence of ACR contributes to the high NPV and limited PPV of GEP testing. The choice of threshold score for practical use of GEP testing should consider overall clinical assessment of the patient's baseline risk for rejection.

Epidemiologic and methodological issues in serial measurements of blood pressure: The blood pressure study in Mexican children

The Blood Pressure Study in Mexican Children (BPSMC) is a short term longitudinal study of serial blood pressure collected in three observation periods by standardized examinations of 233 female children, 10 to 12 years of age, enrolled in public and private primary schools in Tlalpan, Mexico. Study objectives were: (1) to describe from baseline information the distribution and relationship of blood pressure to age and selected anthropometric factors, as well as to compare the BPSMC results with other blood pressure studies, (2) to examine the sources and amount of variation present in serial blood pressure of 123 children, and (3) to evaluate observer performance by means of intra- and inter-observer variability.^ Stepwise regression results from baseline revealed that of all anthropometric factors and age, weight was the best predictor for blood pressure.^ The results of serial blood pressure measurements show that, besides the known sources of blood pressure variability (subject, day, reading), the physiologic event of menarche has an important bearing upon the variability and characterization of blood pressure in young girls. The assessment of the effects of blood pressure variability and reliability upon the design and analysis of epidemiologic studies, became apparent among post-menarcheal girls; where blood pressure measurements taken from them have low reliability. Research is needed to propose alternatives for assessing blood pressure during puberty.^ Finally, observer performance of blood pressure and anthropometry were evaluated. Anthropometric measurements had reliabilities in excess of R = 0.96. Acceptable reliabilities (R = 0.88 to 0.95) were obtained for systolic and diastolic (phase 4 and 5) blood pressures. The BPSMC showed a 50 percent decrease in measurement error from the first to the third observation periods. ^

Ingesta energética y de macronutrientes en mujeres atletas

Objetivo: determinar la ingesta de macronutrientes adecuada para mejorar el estado nutricional de las mujeres atletas y su rendimiento deportivo. Métodos: se realizó una búsqueda en cuatro bases de datos: EBSCO, Proquest, Pubmed y OvidSP, empleando las palabras clave “protein intake” AND “athletes” y “endurance athletes” AND “nutrition”. Criterios de selección: artículos originales sobre el consumo de proteínas en atletas femeninas (Entre 2009 y 2014), en revistas científicas indexadas. Resultados: se identificaron 722 artículos, de los cuales solo el 1,4% fueron considerados como incluidos. El 100% eran ensayos clínicos finalizados y publicados en el extranjero, el 50% en EE. UU. El 20% eran estudios exclusivos de mujeres atletas y el 80% incluían hombres y mujeres en la muestra. En el 70% de los estudios las mujeres atletas presentaron déficits energéticos; en la ingesta proteica, el 70% cumplieron con las recomendaciones dietéticas; la ingesta de hidratos de carbono fue inadecuada en el 90% de los ensayos clínicos y, en el 50%, las mujeres presentaban una sobreingesta de grasas. Conclusiones: existe una deficiencia de información acerca de la nutrición en mujeres atletas en Europa y a nivel internacional. Las atletas femeninas consumen energía y macronutrientes en menor proporción que los atletas masculinos. No existe consenso en el rango de proteínas recomendado y se encuentran discrepancias en el consumo en función del tipo de ejercicio físico que se realice. Se recomienda llevar a cabo un acuerdo entre instituciones científicas de prestigio sobre la ingesta energética y de macronutrientes en el deporte, especialmente en la mujer.

The role of Community Health Workers. Historical perspective of facilitators and barriers. Case study in Vaupés, Colombia

Thesis (Master's)--University of Washington, 2016-06

A randomized controlled trial of intensive neurophysiology education in chronic low back pain

Objectives: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. Methods: This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal drawing-in task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. Results: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. Discussion: Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.

Bespoke Radiology e-Learning

Introduction: Foundation doctors are expected to assess and interpret plain x-ray studies of the chest/abdomen before a definitive report is issued by senior staff. The Royal College of Radiologists have published guidelines (RCR curriculum) on the scope of plain film findings medical students should be familiar with.1 Studies have shown that the x-ray interpretation without feedback does not significantly improve diagnostic ability. 2 Queen’s University, Belfast Trust Radiology and Experior Medical developed an online system to assess individual student ability to interpret X-ray findings. Over a series of assessments each student’s profile is built up, identifying strengths and weakness. The system can then create bespoke individual assessments re-evaluating previously identified weak areas and quantifying interpretative skill improvement. Aim: To determine how readily an online system is adopted by senior medical students, investigating if increasing exposure to x-ray interpretation combined with cyclical formative feedback enhances performance. Methods: The system was offered to all 270 final year medical students as an online resource. The system comprised a series of 20 weekly 30 minute assessments, containing normal and abnormal x-rays within the RCR curriculum. After each assessment students were given formative feedback, including their own result, annotated answers, peer group comparison and a breakdown of areas of strength and weakness. Focus groups of 4-5 students addressed student perspectives of the system, including ease of use, image resolution, system performance across different operating platforms, perceived value of formative feedback loops, breakdown of performance and the value of bespoke personalised assessments. Research Ethics Approval was granted for the study. Data analysis was via two-sided one-sample t-test; initial minimal recruitment was estimated as 60 students, to detect a mean 10% change in performance, with a standard deviation of 20%. Results and Discussion: Over 80% (n = XXX/270) of the student cohort engaged with the study. Student baseline average was 39%, increasing to 62% by the exit test. The steadily sustained improvement (57% relative performance in interpretative diagnostic accuracy) was despite increasing test difficulty. Student feedback via focus groups was universally positive throughout the examined domains. Conclusion: The online resource proved to be valuable, with high levels of student engagement, improving performance despite increasingly difficulty testing and positive learner experience with the system. References: 1. Undergraduate Radiology Curriculum, The Royal College of Ra, April 2012. Ref No. BFCR(12)4 The Royal College of Radiologists, April 2012 2. I Satia, S Bashagha, A Bibi, R Ahmed, S Mellor, F Zaman. Assessing the accuracy and certainty in interpretating chest x-rays in the medical division. Clin Med August 2013 Vol.13 no. 4 349-352

Internal Control application : Empirical evidence from Sweden

Aim The aim of this study is to explore based on internationally recognised frameworks: 1. how internal control structures are applied in Sweden among different sectors; 2. how organizational size and environment affect internal control structures; and 3. the impact of internal control structures on organizational performance. Methods A quantitative method was used in the data collection and analysis. The sample consisted of 1117 organizations operating in Sweden. A mean analysis was conducted to measure the level of internal control structures among different industries, organizational sizes, and different choices of listing in the stock exchange market. Person’s correlation analysis was then used to explore possible correlations between external environmental factors and internal control structures, and internal control structures and organizational performance. Lastly, a structural model was built to measure the impact of internal control structures on organizational performance. The measurements of internal control structures and organizational performance are based on COSO framework’s principles and objectives. Results This study gives an insight on how internal control structures are applied across industrial sectors in Sweden, with financial institutions and manufacturing organizations having notably higher levels of internal control structures. Additionally, it provides evidence of the impact external environmental factors have on internal control structures. Furthermore, it shows that organizations that are listed in the Swedish stock exchange market have an equivalent level of internal control structures to those registered in the American stock exchange market. In contrast, organisations that are not listed in the stock exchange market have a notably lower level of internal control structures. Lastly, it illustrates the positive impact the presence of internal control structures has on organizational performance. 3 | P a g e Conclusion The results highlight a crucial role the supervisory authority Finansinspektionen (FI) has in regulating the Swedish financial market. They also show that the stability of the Swedish business environment has had a positive impact on the level of internal control structures.

Os efeitos imediatos da aplicação de Kinesiotape no complexo articular do ombro no desempenho do nadador de competição

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia

Validation of dot blot hybridization and denaturing high performance liquid chromatography as reliable methods for TP53 codon 72 genotyping in molecular epidemiologic studies

Background: Mutations in TP53 are common events during carcinogenesis. In addition to gene mutations, several reports have focused on TP53 polymorphisms as risk factors for malignant disease. Many studies have highlighted that the status of the TP53 codon 72 polymorphism could influence cancer susceptibility. However, the results have been inconsistent and various methodological features can contribute to departures from Hardy-Weinberg equilibrium, a condition that may influence the disease risk estimates. The most widely accepted method of detecting genotyping error is to confirm genotypes by sequencing and/or via a separate method. Results: We developed two new genotyping methods for TP53 codon 72 polymorphism detection: Denaturing High Performance Liquid Chromatography (DHPLC) and Dot Blot hybridization. These methods were compared with Restriction Fragment Length Polymorphism (RFLP) using two different restriction enzymes. We observed high agreement among all methodologies assayed. Dot-blot hybridization and DHPLC results were more highly concordant with each other than when either of these methods was compared with RFLP. Conclusions: Although variations may occur, our results indicate that DHPLC and Dot Blot hybridization can be used as reliable screening methods for TP53 codon 72 polymorphism detection, especially in molecular epidemiologic studies, where high throughput methodologies are required.

Assessment of the Performance of Acoustic and Mass Balance Methods for Leak Detection in Pipelines for Transporting Liquids

On-line leak detection is a main concern for the safe operation of pipelines. Acoustic and mass balance are the most important and extensively applied technologies in field problems. The objective of this work is to compare these leak detection methods with respect to a given reference situation, i.e., the same pipeline and monitoring signals acquired at the inlet and outlet ends. Experimental tests were conducted in a 749 m long laboratory pipeline transporting water as the working fluid. The instrumentation included pressure transducers and electromagnetic flowmeters. Leaks were simulated by opening solenoid valves placed at known positions and previously calibrated to produce known average leak flow rates. Results have clearly shown the limitations and advantages of each method. It is also quite clear that acoustics and mass balance technologies are, in fact, complementary. In general, an acoustic leak detection system sends out an alarm more rapidly and locates the leak more precisely, provided that the rupture of the pipeline occurs abruptly enough. On the other hand, a mass balance leak detection method is capable of quantifying the leak flow rate very accurately and of detecting progressive leaks.

UV-Derivative Spectrophotometric and Stability-Indicating High-Performance Liquid Chromatographic Methods for Determination of Simvastatin in Tablets

A stability-indicating high-performance liquid chromatographic (HPLC) and a second-order derivative spectrophotometric (UVDS) analytical methods were validated and compared for determination of simvastatin in tablets. The HPLC method was performed with isocratic elution using a C18 column and a mobile phase composed of methanol:acetonitrile:water (60:20:20, v/v/v) at a flow rate of 1.0 ml/min. The detection was made at 239 nm. In UVDS method, methanol and water were used in first dilution and distilled water was used in consecutive dilutions and as background. The second-order derivative signal measurement was taken at 255 nm. Analytical curves showed correlation coefficients > 0.999 for both methods. The quantitation limits (QL) were 2.41 mu g/ml for HPLC and 0.45 mu g/ml for UVDS, respectively. Intra and inter-day relative standard deviations were < 2.0 %. Statistical analysis with t- and F-tests are not exceeding their critical values demonstrating that there is no significant difference between the two methods at 95 % confidence level.

Development and validation of high performance liquid chromatographic and UV-derivative spectrophotometric methods for the determination of sotalol hydrochloride in tablets

High performance liquid chromatographic (HPLC) and UV derivative spectrophotometric (UVDS) methods were developed and validated for the quantitative determination of sotalol hydrochloride in tablets. The HPLC method was performed on a C18 column with fluorescence detection. The excitation and emission wavelengths were 235 and 310nm, respectively. The mobile phase was composed of acetonitrile-water containing 0.1% trietylamine (7:93v/v) and pH adjusted to 4.6 with formic acid. The UVDS method was performed taking a signal at 239.1nm in the first derivative. The correlation coefficients (r) obtained were 0.9998 and 0.9997 for HPLC and UVDS methods, respectively. The proposed methods are simple and adaptable to routine analysis.

Diagnostic Performance of Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-MDCT: The CT Angiography and Perfusion Methods of the CORE320 Multicenter Multinational Diagnostic Study

OBJECTIVE. Coronary MDCT angiography has been shown to be an accurate noninvasive tool for the diagnosis of obstructive coronary artery disease (CAD). Its sensitivity and negative predictive value for diagnosing percentage of stenosis are unsurpassed compared with those of other noninvasive testing methods. However, in its current form, it provides no information regarding the physiologic impact of CAD and is a poor predictor of myocardial ischemia. CORE320 is a multicenter multinational diagnostic study with the primary objective to evaluate the diagnostic accuracy of 320-MDCT for detecting coronary artery luminal stenosis and corresponding myocardial perfusion deficits in patients with suspected CAD compared with the reference standard of conventional coronary angiography and SPECT myocardial perfusion imaging. CONCLUSION. We aim to describe the CT acquisition, reconstruction, and analysis methods of the CORE320 study.