Efeitos da equoterapia no equilíbrio, espasticidade e simetria corporal de crianças com paralisia cerebral: revisão sistemática

Introdução: A Paralisia Cerebral (P.C.) caracteriza-se por um conjunto de desordens de tônus, posturais e de movimento não progressivas, decorrentes de lesões cerebrais que ocorrem no cérebro ainda em desenvolvimento no período fetal, perinatal ou pós-natal. Uma das abordagens terapêuticas para os indivíduos com P.C. é a terapia assistida por cavalos, comumente conhecida como Equoterapia. Objetivo: Analisar os efeitos terapêuticos da Equoterapia no equilíbrio postural, espasticidade e simetria corporal de crianças com P.C. Métodos: Trata-se de um estudo de revisão sistemática, conduzido conforme a metodologia PRISMA. Artigos classificados como ensaios clínicos controlados foram pesquisados nas bases de dados PEDro, PubMed, LILACS, MEDLINE e CENTRAL. Os artigos foram avaliados quanto à sua qualidade metodológica através da escala PEDro. Resultados: Oito artigos foram incluídos para análise com amostra total de 310 crianças com paralisia cerebral que foram submetidas ou não a um protocolo de Equoterapia. O escore médio geral, resultante da avaliação da qualidade dos estudos, foi de 5,75. Todos os oito estudos analisados apresentaram resultados benéficos advindos das sessões terapêuticas de Equoterapia no tratamento das crianças com paralisia cerebral, para pelo menos uma das variáveis avaliadas. Conclusão: A Equoterapia pode resultar em efeitos positivos e relevantes na melhoria do equilíbrio postural, simetria corporal e redução na espasticidade de crianças com paralisia cerebral sendo, portanto, considerada uma abordagem eficaz no tratamento destes pacientes

VALIDAÇÃO DE INSTRUMENTO PARA MENSURAR A ADESÃO AO TRATAMENTO FARMACOLÓGICO EM PACIENTES PSIQUIÁTRICOS

Objective: To validate the Scale of Assessment of Adherence to Pharmacological Treatment in Patients with Psychiatric Disorders (VERUM), developed to specifically assess the elements that influence adherence to pharmacological treatment in patients with Mental Disorders, as to its reproducibility, reliability and validity. Methods: Statistical techniques were used to test the reproducibility of the scale (H coefficient), internal consistency through Cronbach's Alpha and Mcdonald's Omega Coefficient, and validity of the instrument through comparison with the MARS Scale and Exploratory Factor Analysis. Results: Cronbach's alpha (0.81) and Mcdonald's Omega (0.826) indicated that VERUM has good internal consistency and Spearman's Correlation (-0.69) showed that there is correlation between MARS and VERUM items. Exploratory Factor Analysis grouped the VERUM Scale items into three dimensions that influence study group adherence: secondary gain, inner world, and relationships with the outer world. Conclusion: Results of the statistical analyses showed that the VERUM Scale is a valid and reliable tool to assess adherence to pharmacological treatment in psychiatric patients. The dimensions of adherence are organized into factors that go beyond those recognized in the literature.    Objetivo: Validar la Escala de Evaluación de la Adherencia al Tratamiento Farmacológico en Pacientes con Trastornos Psiquiátricos (VERUM), desarrollada para evaluar específicamente los elementos que influyen en la adherencia al tratamiento farmacológico en pacientes con trastornos mentales, en términos de su reproducibilidad, fiabilidad y validez. Métodos: Se utilizaron técnicas estadísticas para comprobar la reproducibilidad de la escala (coeficiente H), la consistencia interna mediante el Alfa de Cronbach y el Coeficiente Omega de Mcdonald, y la validez del instrumento mediante la comparación con la Escala MARS y el Análisis Factorial Exploratorio. Resultados: El Alfa de Cronbach (0,81) y el Omega de Mcdonald (0,826) indicaron que VERUM tiene una buena consistencia interna y la Correlación de Spearman (-0,69) mostró que existe una correlación entre los ítems de MARS y VERUM. El Análisis Factorial Exploratorio agrupó los ítems de la Escala VERUM en tres dimensiones que influyen en la adherencia del grupo de estudio: ganancia secundaria, mundo interior y relaciones con el mundo exterior. Conclusiones: Los resultados de los análisis estadísticos mostraron que la Escala VERUM es una herramienta válida y fiable para evaluar la adherencia al tratamiento farmacológico en pacientes psiquiátricos. Las dimensiones de la adherencia se organizan en factores que van más allá de los reconocidos en la literatura.  Objetivo: Validar a Escala de Avaliação da Adesão ao Tratamento Farmacológico em Pacientes Portadores de Transtornos Psiquiátricos (VERUM), desenvolvida para avaliar especificamente os elementos que influenciam a adesão ao tratamento farmacológico em pacientes com Transtornos Mentais, quanto à sua reprodutibilidade, confiabilidade e validade. Métodos: Foram utilizadas técnicas estatísticas para testar a reprodutibilidade da escala (coeficiente H), consistência interna por meio do Alfa de Cronbach e Coeficiente Ômega de Mcdonald, e validade do instrumento através de comparação com a Escala MARS e Análise Fatorial Exploratória. Resultados: Alfa de Cronbach (0,81) e Ômega de Mcdonald (0,826) indicaram que VERUM possui boa consistência interna e a Correlação de Spearman (-0,69) mostrou que há correlação entre os itens de MARS e VERUM. A Análise Fatorial Exploratória agrupou os itens da Escala VERUM em três dimensões que influenciam a adesão do grupo de estudo: ganho secundário, mundo interior e relações com o mundo exterior. Conclusões: Resultados das análises estatísticas mostraram que a Escala VERUM é uma ferramenta válida e confiável para avaliar a adesão ao tratamento farmacológico em pacientes psiquiátricos. As dimensões de adesão organizam-se em fatores que vão além dos reconhecidos na literatura.  Objetivo: Validar a Escala de Avaliação da Adesão ao Tratamento Farmacológico em Pacientes Portadores de Transtornos Psiquiátricos (VERUM), desenvolvida para avaliar especificamente os elementos que influenciam a adesão ao tratamento farmacológico em pacientes com Transtornos Mentais, quanto à sua reprodutibilidade, confiabilidade e validade. Métodos: Foram utilizadas técnicas estatísticas para testar a reprodutibilidade da escala (coeficiente H), consistência interna por meio do Alfa de Cronbach e Coeficiente Ômega de Mcdonald, e validade do instrumento através de comparação com a Escala MARS e Análise Fatorial Exploratória. Resultados: Alfa de Cronbach (0,81) e Ômega de Mcdonald (0,826) indicaram que VERUM possui boa consistência interna e a Correlação de Spearman (-0,69) mostrou que há correlação entre os itens de MARS e VERUM. A Análise Fatorial Exploratória agrupou os itens da Escala VERUM em três dimensões que influenciam a adesão do grupo de estudo: ganho secundário, mundo interior e relações com o mundo exterior. Conclusões: Resultados das análises estatísticas mostraram que a Escala VERUM é uma ferramenta válida e confiável para avaliar a adesão ao tratamento farmacológico em pacientes psiquiátricos. As dimensões de adesão organizam-se em fatores que vão além dos reconhecidos na literatura.

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

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

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

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio