O uso da CIF através do trabalho interdisciplinar no AVC pediátrico: relato de caso

The International Classification of Functionality, Disability, and Health (ICF) was proposed by the World Health Organization (WHO) as a conceptual framework for interdisciplinary health care, involving (a) body structure and function, (b) activities and participation (c) and contextual fac­tors. This paper aims to discuss the use of ICF model in the context of inter­disciplinary assessment of a stroke in an adolescent. The methods of this stu­dy consist of qualitative assessments, neuropsychological tests, interviews and clinical scales used to assess the adolescent. The results showed that the adolescent functionality profile was comprised by right hemiparesis, postural instability, Broca’s aphasia, constructional apraxia (body structure and functions), motivational and learning difficulties, limitations in mobili­ty, communication, self care and domestic life (activities and participation). Four environmental factors were considered as barriers (e310, e320, e360, e385) and six as facilitators (e315, e340, e355, e410, e5801, e165) towards the participant’s functionality. It was found that ICF can be used in the clinical practice and rehabilitation planning. Key words: ICF, pediatric stroke, interdisciplinary work.A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) foi proposta pela Organização Mundial de Saúde (OMS) como referencial interdisciplinar em saúde, abrangendo: (a) estrutura e função do corpo, (b) atividades e participação e (c) fatores contextuais. O objeti­vo deste estudo foi aplicar a CIF por meio da avaliação interdisciplinar em um adolescente de 14 anos do sexo masculino que apresentou um episódio de Acidente Vascular Cerebral (AVC) aos 10 anos. Realizaram-se avaliações qualitativas, testes neuropsicológicos, escalas clínicas e entrevistas. Os resul­tados mostraram que o perfil funcional do adolescente foi hemiparesia di­reita, instabilidade postural, afasia de Broca, apraxia construtiva (estrutura e função do corpo), dificuldades de aprendizagem e motivacionais, limitações na comunicação, mobilidade, cuidado pessoal, vida doméstica e comunitá­ria (atividades e participação). Foram registrados quatro barreiras (apoio da família imediata, amigos, professora, serviços de educação) e seis facilitado­res (família ampliada, cuidadora, profissionais da saúde, atitudes da família imediata, serviços de saúde e situação econômica). Constatou-se que a CIF tem potencial para utilização na prática interdisciplinar e planejamento da reabilitação. Palavras-chave: CIF, AVC pediátrico, interdisciplinaridade

Prevalencia de deficiencias motoras y su relación con el gasto federal con prótesis, órtesis y otros equipos en los estados brasileños en 2010

The objective of this study was to know the prevalence of full motor difficulty (MD) (walking or climbing stairs) and according to degrees (mild, moderate, severe) in the Brazilian states and in the country; present the federal expenditures on prostheses, orthotics and materials (OPM) related to such difficulty; and verify the correlation between the prevalence of disabilities and public expenditures on OPM. Population data was used from every major city in Brazil, obtained from the IBGE website, and OPM expenditures related to MD, extracted from the DATASUS website in 2010. Data was analyzed through the prevalence of MD and OPM expenditures related to MD. We used the Stata 11 software for the implementation of the Spearman correlation test with a significance level of 5%. The prevalence of MD in Brazil in the year of 2010 was 6.91%; ranging from 8.63% (state of Alagoas) to 5.28% (state of Tocantins). The expenditures on OPM varied according to the state, and these expenditures were proportional to the prevalence of MD in the cities of the states of Acre and Piauí (orthotics); Pernambuco (prostheses), and Acre and Maranhão (equipment). The correlation between the amount spent and the prevalence of MD was inverse in the cities of the states of Espírito Santo, Minas Gerais, Paraná, Rio Grande do Sul, Santa Catarina and São Paulo (orthotics); Espírito Santo, Minas Gerais, Paraná, Rio Grande do Sul, Santa Catarina and São Paulo (prostheses); and Espírito Santo, Minas Gerais, Rio Grande do Sul and São Paulo (equipment).O objetivo deste estudo foi conhecer a prevalência de dificuldade motora (DM) (caminhar ou subir degraus) total e segundo graus (leve, moderada, grave) nos estados brasileiros e no país; apresentar os gastos federais com próteses, órteses e equipamentos (OPM) relacionados a essa dificuldade; e verificar a existência de correlação entre as prevalências de DM e gasto público com as OPM. Foram usados dados populacionais de todas as cidades do Brasil, obtidos a partir do site do IBGE, e gastos com OPM relacionados à DM, extraídos do site do DATASUS, de 2010. Os dados foram analisados por meio de prevalências de DM e gastos com OPM relacionados à DM. Utilizou-se o programa Stata 11 para execução do teste de correlação de Spearman com nível de significância de 5%. A prevalência de DM no Brasil no ano de 2010 foi de 6,91%, variando de 8,63% (AL) a 5,28% (TO). Os gastos com OPM variaram segundo os estados e foram proporcionais à prevalência de DM nas cidades dos estados do AC e PI (órteses), PB (próteses), e AC e MA (equipamentos). A correlação entre valor investido e prevalência de DM foi inversa nas cidades dos estados de ES, MG, PR, RS, SC e SP (órteses); ES, MG, PR, RS, SC e SP (próteses); e ES, MG, RS e SP (equipamentos)

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Avaliação da funcionalidade em crianças com disfunções neurológicas usando a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) como referência

Exportado OPUSMade available in DSpace on 2019-08-12T11:35:00Z (GMT). No. of bitstreams: 1 tese_peterson_andrade_pp.neuroci_ncias_ufmg.pdf: 1897848 bytes, checksum: 6b208522eee4deb6e6c61f8b8e2bf547 (MD5) Previous issue date: 12Introdução: A operacionalização da perspectiva biopsicossocial preconizada pela OMS apresenta dificuldades teóricas e metodológicas devido a complexidade da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). A paralisia cerebral (PC) pode desencadear deficiências nas estruturas e funções do corpo, limitações nas atividades e restrição de participação. Os fatores contextuais atuam como barreiras ou facilitadores para o desempenho e capacidade de crianças com PC. Desta forma, o modelo multidimensional da CIF pode ser usado para a investigação da funcionalidade desta condição. Considerando a CIF, algumas questões desafiam a operacionalização da perspectiva biopsicossocial: 1) Quais categorias da CIF devem compor uma avaliação abrangente da PC por uma equipe de reabilitação? 2) Quais itens são documentados nos prontuários? 3) Os profissionais conhecem o modelo da CIF? 4) Os conceitos da CIF são de fácil operacionalização? 5) Qual é o perfil funcional e contextual de crianças com disfunções neurológicas? Diante destas questões, o objetivo geral da presente tese foi aplicar o modelo da CIF com diferentes finalidades com a proposta de iniciar um debate sobre o uso desta classificação para avaliação e reabilitação de crianças com disfunções neurológicas. Métodos: Foram desenvolvidos cinco estudos (dois estudos empíricos, um estudo de análise de prontuários de um Núcleo de Reabilitação, um painel de experts e uma revisão crítica da literatura) com o objetivo de responder às questões da tese. Resultados: Um conjunto de categorias da CIF relevantes para a avaliação da PC foi levantado através da percepção dos profissionais envolvidos com a reabilitação da PC e através da análise de prontuários. Deficiências nas funções do corpo, limitações nas atividades e influência dos fatores ambientais na funcionalidade dos casos de PC foram avaliados pelos estudos empíricos desenvolvidos. Questões relacionadas com o construto de capacidade da CIF foram levantadas e discutidas em um estudo de revisão com o objetivo de iniciar um debate sobre os métodos aplicados para investigação do componente de atividade e participação. Considerações Finais: A operacionalização da perspectiva biopsicossocial exige a articulação de diferentes métodos teóricos e empíricos. A PC apresenta-se com um quadro funcional heterogêneo, pois existem diferentes comprometimentos nas funções cognitivas e motoras. Os fatores ambientais devem ser considerados nas avaliações das equipes de reabilitação, pois atuam como facilitadores ou barreiras para a funcionalidade dos casos. Avanços conceituais e metodológicos são necessários para a efetivação da proposta da OMS.Introduction: The operationalization of the biopsychosocial approach recommended by WHO presents theoretical and methodological difficulties due to the complexity of the International Classification of Functioning, Disability and Health (ICF). Cerebral palsy (CP) can trigger impairments in structures and body functions, limitations in activities and participation restrictions. Contextual factors may influence as barriers or facilitators to the performance and capacity of children with CP. Thus, the multidimensional model of the ICF can be used to investigate the functioning of this disease. Considering the ICF, some issues may arise for the operationalization of the biopsychosocial perspective: 1) What categories of ICF should comprise a CP assessment by a rehabilitation team? 2) What items are documented in the records? 3) Do the professionals know the ICF model? 4) Are the concepts of the ICF easily managed? 5) What is the functional and contextual profile of children with neurological disorders? Given these issues, the goal of this thesis was to apply the ICF model with different purposes with the aim to initiate a debate on the use of this classification by health professionals in children with neurological disorders. Methods: Five studies were developed (two empirical studies, a records analysis of a Rehabilitation Center, a panel of experts and a literature review). Results: An ICF code sets for the evaluation of CP has been raised through the perceptions of professionals involved with the rehabilitation of the CP and through analysis of medical records. Impairments in the body functions, limitations in activities and influence of environmental factors on the functioning of CP were observed by empirical study. Issues related to the capacity of the ICF construct were performed in order to start a discussion about the methods used to investigate the activity and participation component. Final Considerations: The operationalization of the biopsychosocial approach requires the articulation of different theoretical and empirical methods. The CP is presented with a heterogeneous functional profile, since there are different impairments in cognitive and motor functions. Environmental factors should be considered in the evaluations of the rehabilitation team, because they act as facilitators or barriers to the functioning of the cases. Conceptual and methodological advances are needed to accomplish the WHO purpos

Avaliação da funcionalidade em crianças e adolescentes com acidente vascular cerebral e paralisia cerebral: Um estudo exploratório

Exportado OPUSMade available in DSpace on 2019-08-11T04:19:03Z (GMT). No. of bitstreams: 1 peterson_marco_de_oliveira_andrade.pdf: 404966 bytes, checksum: 27a51e8a457549c6f8594f9de47f5d8c (MD5) Previous issue date: 28O acidente vascular cerebral (AVC) e a paralisia cerebral (PC) promovem deficiências nas estruturas e funções do corpo, limitações nas atividades e restrição na participação. Os fatores ambientais podem influenciar a funcionalidade das crianças ou adolescentes com AVC e PC positivamente (facilitadores) ou negativamente (barreiras). Objetivos: 1) desenvolver uma checklist e dar início ao processo de validação, a partir de uma perspectiva biopsicossocial, de um sistema de avaliação da funcionalidade de crianças e adolescentes com PC e AVC, usandoa Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) como referência; 2) realizar uma primeira avaliação da aplicabilidade da checklist; 3) Comparar o perfil de funcionalidade entre crianças ou adolescentes com diagnóstico de PC, AVC e controles. Métodos: O processo para desenvolver uma checklist de avaliação envolveu três etapas: 1) revisão da literatura sobre a utilização da CIF emcasos de AVC e PC; 2) conexão dos core sets da CIF para o AVC com o Estatuto da Criança e do Adolescente; 3) seleção das categorias a partir dos resultados da etapa 1 e 2 pelos pesquisadores do estudo. Em seguida a checklist elaborada foi utilizada para avaliar a funcionalidade de controles e crianças ou adolescentes com diagnóstico de AVC e PC. Resultados: Foram selecionadas 58 categorias de segundo e terceiro nível da CIF (18 de estruturas e funções do corpo; 15 de atividade e participação; 25 de fatores ambientais). A avaliação com os controles(N=34), casos de AVC (N=16) e casos de PC (N=29) em crianças e adolescentes, entre 5 e 19 anos, permitiu verificar a aplicabilidade da checklist elaborada e identificar diferenças significativas entre os três grupos em relação às deficiências (funções mentais, sensoriais, da voz e da fala e dos sistemas cardiovascular, hematológico, neuromusculoesquelético e geniturinário) e limitações nas atividades(aprendizagem e aplicação do conhecimento, tarefas e demandas gerais, comunicação, mobilidade, cuidado pessoal, vida doméstica, áreas principais da vida e vida comunitária, social e cívica). Considerações Finais: A checklist elaborada favorece a operacionalização da proposta biopsicossocial e permite registrarinformações sobre a funcionalidade e fatores contextuais relacionados com crianças e adolescentes com diagnóstico de AVC e PC. Estudos são necessários para validar a checklist desenvolvida e para elaborar instrumentos de avaliação conforme a terminologia e processo de funcionalidade e de incapacidade da CIF.Stroke and cerebral palsy may cause impairment in body structures and body functions, activities limitations and participation restrictions. Environmental factors may influence the functionality of cerebral palsy children and stroke children. This influence may occur in a positive way (facilitators) or a negative way (barriers). Objectives: 1) to develop and start a validation process of a functioning assessment system (checklist) for cerebral palsy children and stroke children, from a biopsychosocial perspective, using the International Classification of Functioning,Disability and Health (ICF) as reference; 2) to perform an initial assessment of the checklist applicability, 3) to compare the functionality profile among children or adolescents diagnosed with cerebral palsy, stroke and controls. Methods: The process to develop an assessment checklist was done in three stages: 1) literature review on the use of ICF in cases of stroke and cerebral palsy; 2) connection of ICF core sets for stroke and the Brazilian Child and Adolescent Statute; 3) categoriesselection from the results of stages 1 and 2, done by the researchers. Then, the elaborated checklist was used to evaluate the functionality of controls and children or adolescents diagnosed with stroke and cerebral palsy. Results: 58 categories were selected for the second and third level of ICF (18 of body functions and structures, 15 of activity and participation, 25 of environmental factors). The assessment with control children (N = 34), stroke children (N = 16) and cerebral palsy children (N = 29), from 5 to 19 years old, shown the applicability of the developed checklist andidentified significant differences between the three groups, regarding impairment (mental functions, sensory functions, voice and speech functions, functions of the cardiovascular and haematological systems, neuromusculoskeletal functions and genitourinary functions) and activities limitations (learning and applying knowledge, general tasks and demands, communication, mobility, self care, domestic life, majorareas life and community, social and civic life). Considerations: The developed checklist makes feasible the biopsychosocial proposal and allows information registration about the functioning and contextual factors, related with children and adolescents diagnosed with stroke and cerebral palsy. Studies are needed to validate the developed checklist and to develop assessment tools, according to the ICF the terminology and process of functioning and disability