Survey sampling and administration

Measuring the impact of digital technologies and devices – particularly the use of the internet – on children’s lives through reliable statistical data is essential to the design of effective public policies to promote children’s rights in the digital age and to protect them online. Policy-makers need high-quality data to underpin evidence-based policy decisions. Although it is clear that reliable statistics are needed for effective policies, and that the impact of evidencebased policies can only be measured by good statistics, most countries lack systematic and comparable statistics on the online risks and opportunities experienced by children. This Methodological Guide provides a framework for the production of high-quality, reliable statistics to measure access to and use of the internet and digital devices by children. Although this framework is aligned with the good practice of official statistics agencies, it does not replace theoretical and practical guidance or informed expertise on survey methodologies. The proposed framework provides practical guidance for activities related to administering the Global Kids Online (GKO) survey in the field, from planning to implementation

Photoperiodic modulation of circadian functions in Antarctic krill Euphausia superba Dana, 1850 (Euphausiacea)

An endogenous circadian clock influences metabolic output rhythms in the Antarctic krill (Euphausia superba Dana, 1850), a key species in the Southern Ocean ecosystem. Seasonal changes in photoperiod in Antarctica, ranging from midnight sun (24 h light) during mid-summer to very short days (3\u20134 h light) during mid-winter, represent a challenge for the synchronization of the krill circadian clock. We analyzed clock gene activity and clock output functions in krill exposed to different light conditions during a long-term photoperiodic simulation in the laboratory. In simulated early-autumn (light/dark or LD 16:8) and late-winter (LD 8:16) conditions, the circadian clock of krill was functional and the metabolic output was synchronized to the light/dark cycle, the clock genes Esper and Esclk peaked in antiphase around simulated dusk/dawn and most metabolic-related genes showed upregulation around simulated dusk. In contrast, in simulated mid-summer (light/light or LL) and mid-winter (LD 3:21) conditions, the synchronization of the circadian clock and the metabolic output appeared to be weaker, with clock gene expression becoming arrhythmic and upregulation of metabolic genes occurring at different times during the day. Early-autumn and late-winter photoperiodic cues in the laboratory thus seem to be sufficient to entrain the krill clock and promote metabolic synchronization, whereas midwinter and mid-summer photoperiodic cues seem to be insufficient for krill entrainment. Krill in the field may overcome the seasonal lack of overt photoperiodic cycle occurring during midsummer and mid-winter by using alternative light-related Zeitgebers (i.e., varying light intensity rather than the presence or absence of light) to promote basic homeostatic rhythms over 24 h

Relationship between the work developed in maximal and submaximal exercise capacity tests and the degree of airflow obstruction in individuals with Chronic Obstructive Pulmonary Disease

Este estudio tuvo como objetivo investigar la relación de labor desarrollada en dos tests de capacidad de ejercicio, un máximo y otro submáximo, con el grado de obstrucción del flujo aéreo en individuos con Enfermedad Pulmonar Obstructiva Crónica (EPOC). Los 53 individuos con EPOC (29 hombres, 70±9Años, 65±14kg, volumen espiratorio forzado en el primer segundo [VEF1] 38 [31-54]% previsto) tuvieron evaluadas su función pulmonar, a través de espirometría, y capacidad máxima de ejercicio en por el Incremental Shuttle Walking Test (ISWT), y submáxima, por el test de caminata de seis minutos (TC6min). El trabajo desarrollado en los tests fue calculado por el producto de la distancia recorrida con el peso corporal del individuo (P). Para evaluar la contribución del peso en el rendimiento de los tests, los individuos fueron separados en dos grupos : de alto peso (n=32) y bajo peso (n=21). Se observó una correlación del VEF1 con la distancia recorrida en el ISWT y con el ISWT*P (r=0,43 y r=0,49, respectivamente; PObjetivou-se investigar a relação do trabalho desenvolvido em dois testes de capacidade de exercício, um máximo e outro submáximo, com o grau de obstrução ao fluxo aéreo em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC). 53 indivíduos com DPOC (29 homens, 70±9 anos, 65±14 kg, volume expiratório forçado no primeiro segundo [VEF1] 38[31-54]% previsto) tiveram avaliadas sua função pulmonar, por meio de espirometria, e capacidade de exercício máxima, pelo Incremental Shuttle Walking Test (ISWT), e submáxima, pelo teste de caminhada de seis minutos (TC6min). O trabalho desenvolvido nos testes foi calculado pelo produto da distância percorrida com o peso corporal do indivíduo (P). Para avaliar a contribuição do peso no desempenho dos testes, os indivíduos foram separados em dois grupos: maior peso (n=32), e menor peso (n=21). Observou-se correlação do VEF1 com a distância percorrida no ISWT e com o ISWT*P (r=0,43 e r=0,49, respectivamente; pThe aim of this study was to investigate the relationship between the work in two exercise capacity tests, a maximum and a submaximal exercise, and the level of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD). Fifty-three subjects with COPD (29 men, 70±9 years old, 65±14 kg, forced expiratory volume in the first second [FEV1] 38[31-54]% predicted) had their lung function assessed by spirometry, and maximal and submaximal exercise capacity were evaluated by the Incremental Shuttle Walking test (ISWT) and the 6-Minute Walk Test (6MWT), respectively. The work in the tests was calculated by multiplying the covered distance and the individual's body weight (W). To evaluate the contribution of weight on the developed work, subjects were separated into two groups: higher weight (n=32), and lower weight (n=21). FEV1 correlated with the distance on the ISWT and with the ISWT*W (r=0.43 and r=0.49, respectively;

Does the wearing time of motion sensor interfere with the choice of physical activity in daily life outcomes of COPD patients?

Este estudo analisa a atividade física na vida diária (AFVD) de pacientes com doença pulmonar obstrutiva crônica (DPOC), quantificada em três diferentes períodos de uso diário do sensor de movimento: 8 horas, 12 horas e período de tempo acordado, a fim de identificar se os desfechos de AFVD diferem entre si. Trata-se de um estudo transversal com 45 pacientes (66±8 anos) classificados com DPOC de moderada a grave. A AFVD foi avaliada utilizando-se o monitor de atividade física SenseWear Armband (SAB) durante 7 dias consecutivos, 24 horas por dia. Compararam-se os resultados de AFVD fornecidos pelo monitor nos três períodos de avaliação dentro das 24 horas de uso. Os desfechos de sedentarismo e de atividade física (número de passos e gasto energético total) foram diferentes nos três períodos de utilização do SAB, com maiores valores na avaliação por período de tempo acordado. Quanto aos desfechos de atividade física estratificados por idade - 3 ou 2 equivalentes metabólicos (MET) -, os resultados foram similares na avaliação por 12 horas e por período de tempo acordado. Concluiu-se, afinal, que o uso do monitor de atividade física durante o tempo acordado é o desfecho mais indicado para monitoração acurada e completa de sedentarismo e atividade física em pacientes com DPOC.Este estudio analiza la actividad física en la vida diaria (AFVD) de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), cuantificada en tres distintos períodos de uso diario del sensor de movimiento: 8 horas, 12 horas y el período de tiempo despierto, con la finalidad de identificar si los resultados de AFVD difieren entre sí. Se trata de un estudio transversal con 45 pacientes (66±8 años) clasificados con EPOC de moderada a grave. La AFVD ha sido evaluada con la utilización del monitor de actividad física SenseWear Armband® (SAB) durante 7 días consecutivos, las 24 horas del día. Se han comparado los resultados de AFVD suministrados por el monitor en los tres períodos de evaluación dentro de las 24 horas de uso. Los resultados de sedentarismo y de actividad física (el número de pasos y de gasto energético total) han sido distintos en los tres períodos de utilización del SAB, con valores más grandes en la evaluación por período de tiempo despierto. Cuanto a los resultados de la actividad física estratificadas por edad - 3 o 2 equivalentes metabólicos (METs) -, los resultados han sido similares en la evaluación por 12 horas y por el período de tiempo despierto. Se ha concluido, por fin, que el uso del monitor de la actividad física durante el tiempo despierto es el resultado más indicado para el monitoreo preciso y completo de sedentarismo y de la actividad física en pacientes con EPOC.This study analyzes physical activity in the daily lives (PADL) of patients with chronic obstructive pulmonary disease (COPD), measured in three different periods of daily use of motor sensor: 8 hours, 12 hours, and awake time, in order to identify if the PADL outcomes are different among each other. It is a transversal study with 45 patients (66±8 years) classified as having moderate to severe COPD. The PADL was assessed using the physical activity monitor SenseWear Armband (SAB) for 7 consecutive days, 24 hours a day. The PADL results provided by the monitor in the three evaluation periods within 24 hours of use were compared. The sedentary and physical activity outcomes (number of steps and total energy expenditure) were different in the three periods using the SAB, having higher values in the assessment per awake time. Regarding the physical activity outcomes divided into age groups - 3 or 2 metabolic equivalents (METs) -, the outcomes were similar to the evaluation for 12 hours and per awake time. It was concluded, thus, that the use of physical activity monitor during the awake time is the most indicated outcome for accurate and complete monitoring of sedentarism and physical activity in COPD patients

A core syllabus for post-graduate training in respiratory physiotherapy

Physiotherapy contributes significantly to improving quality of life for patients with respiratory disease. Physiotherapists specialised in dealing with respiratory pathology and its associated problems are not only central in the delivery of pulmonary rehabilitation but also provide strategies and techniques for exercise testing, airway clearance, breathlessness management, mobility and function improvement and pain management. Published evidence-based recommendations have paved the way for standardised practice while also unravelling the extended scope of responsibilities of the respiratory physiotherapist. The breakdown of traditional roles and allocation of new responsibilities is not confined to the respiratory physiotherapist within healthcare systems. Team-based healthcare and interprofessional treatment of patients is prevalent in the provision of care across the globe. New methods of healthcare delivery indicate that tasks are entrusted to those deemed competent to perform them. It has therefore been necessary to train allied health professionals to take over parts of clinical care

Cardiology referral during the COVID-19 pandemic

OBJECTIVES: This study presents the cardiology referral model adopted at the University of Sa˜o Paulo-Hospital das Clı´nicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19. METHODS: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19. RESULTS: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with inhospital mortality. CONCLUSIONS: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pandemic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease

Cutoff points for the 1-RM test and their association with mortality in COPD

Introduction: There is no available cutoff for the 1-repetition maximum (1RM) test of knee extensor muscles associated with prognosis in patients with chronic obstructive pulmonary disease (COPD). Aims: To determine 1RM cutoffs for the knee extensors and to verify their association with mortality in COPD. Methods: In a preliminary analysis of a multicenter study, 170 patients performed the 1RM test of knee extensors (52%♂; 66±8yrs; FEV1 46±15%pred). Cutoffs for 1RM and 1RM/Body Weight ratio (1RM/BW) were identified by ROC curve analysis in a subgroup of patients (n=114; 68 from Brazil; 46 from Portugal). They were classified as either normal (≥80%pred) or low (<80%pred) strength by their maximum voluntary isometric contraction of knee extensors. Vital status was retrospectively ascertained for four years in the remaining sample (n=56). Results: The best discriminative cutoffs (1RM♀: 22kg; 1RM♂: 34kg; 1RM/BW♀: 25%; 1RM/BW♂: 48%) were tested in Kaplan-Meier analysis (Figure 1). Respectively, 40% and 41% of patients classified as ‘low strength’ according to 1RM and 1RM/BW cut-offs died in 4 years, in comparison to 0% and 20% in those with normal strength (P>0.05). Cox regression adjusted for confounders was not statistically significant. Conclusion: New gender-based knee extensors 1RM cutoffs adjusted or not for body weight were provided, although they were not yet statistically associated with mortality in this preliminary analysis.publishe

Effectiveness and safety of iodopovidone in an experimental pleurodesis model

OBJECTIVES: Chemical pleurodesis is an important therapeutic tool to control recurrent malignant pleural effusion. Among the various sclerosing agents, iodopovidone is considered effective and safe. However, in a recent study, ocular changes were described after iodopovidone was used in recurrent pneumothorax. The aim of the study was to evaluate the efficacy and morbidity of iodopovidone pleurodesis in an experimental model. METHODS: New Zealand rabbits were submitted to intrapleural injection of iodopovidone at concentrations of 2%, 4% and 10%. Biochemical (lactic dehydrogenase, proteins, triiodothyronine, free thyroxine, urea and creatinine) and immunological (Interleukin-8 [IL-8], VEGF and TGFβ) parameters were measured in the pleural fluid and blood. After 1, 3, 7, 14 and 28 days, groups of animals were euthanized, and macro- (pleura) and microscopic (pleura and retina) analyses were performed. RESULTS: An early pleural inflammatory response with low systemic repercussion was observed without corresponding changes in thyroid or renal function. The higher concentrations (4% and 10%) correlated with greater initial exudation, and maximum pleural thickening was observed after 28 days. No changes were observed in the retinal pigment epithelium of the rabbits. CONCLUSION: Iodopovidone is considered to be an effective and safe sclerosing agent in this animal model. However, its efficacy, tolerance and safety in humans should be further evaluated

Differences in Respiratory Muscle Responses to Hyperpnea or Loaded Breathing in COPD

Introduction We aimed to compare acute mechanical and metabolic responses of the diaphragm and rib cage inspiratory muscles during two different types of respiratory loading in patients with COPD. Methods In 16 patients (age:65±13, 56% male, FEV1:60±6%pred, Pimax:82±5%pred) assessments of respiratory muscle electromyography (EMG), esophageal (Pes) and gastric (Pga) pressures, breathing pattern, and noninvasive assessments of systemic (VO2, cardiac output, oxygen delivery and extraction) and respiratory muscle hemodynamic and oxygenation responses (blood flow index [BFI], oxygen delivery index, deoxyhemoglobin concentration [HHb] and tissues oxygen saturation [StiO2]), were performed during hyperpnea and loaded breathing. Results During hyperpnea, breathing frequency, minute ventilation, esophageal and diaphragm pressure-time product (PTP)/min, cardiac output and VO2 were higher than during loaded breathing (P0.05). SCA-BFI and oxygen delivery index were lower, and SCA-HHb was higher during loaded breathing compared to hyperpnea. Furthermore, SCA and intercostal muscle StiO2 were lower during loaded breathing compared to hyperpnea (P<0.05). Conclusion Greater inspiratory muscle effort during loaded breathing evoked larger ribcage and neck muscle activation compared to hyperpnea. In addition, lower SCA and intercostal muscle StiO2 during loaded breathing compared to hyperpnea indicates a mismatch between inspiratory muscle oxygen delivery and utilization induced by the former condition