REVISIÓN SISTEMÁTICA DE PRAGMÁTICA, AUTODETERMINACIÓN Y DISCAPACIDAD INTELECTUAL

El presente estudio tiene como objetivo revisar la literatura existente en los últimos cinco años centrada en el tema de pragmática, autodeterminación y discapacidad intelectual, con el propósito de profundizar acerca del concepto de autodeterminación y pragmática en relación con la discapacidad intelectual y explorar acerca de las carencias existentes dirigidas a futuras investigaciones. Para ello, se realizó una búsqueda bibliográfica en las bases de datos de Web of Science, Scopus y Dialnet, aplicando una serie de criterios de inclusión y de exclusión por el cual finalmente se obtuvieron 53 estudios relevantes para esta revisión. En cuanto a la pragmática se pone de manifiesto la posibilidad de detectar de forma precoz posibles alteraciones del neurodesarrollo además del impacto positivo de la participación de los progenitores en las intervenciones al igual que en autodeterminación. Las investigaciones recientes en el ámbito de las personas con DI en relación con la autodeterminación indican en primer lugar la importancia de las variables contextuales y personales, en segundo lugar el apoyo familiar, en tercer lugar al apoyo social, en cuarto lugar aspectos de salud tales como el deporte, en quinto lugar y más relevante la vida independiente (calidad de vida, autonomía personal y empleo), en sexto lugar investigaciones centradas en intervenciones y finalmente en instrumentos de medida. Aunque se observa que hay una carencia de investigaciones que relacionan directamente la pragmática con la autodeterminación en personas con discapacidad intelectual.<br /

Attenuation of neuropsychiatric symptoms and caregiver burden in Alzheimer's disease by motor intervention: a controlled trial

OBJECTIVE: To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden. DESIGN: This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms. SETTING: The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly. SUBJECTS: Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences). INTERVENTIONS: Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week. MAIN MEASURES: Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls). RESULTS: Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F: 11.12; p = 0.01; Cornell Depression scale: F: 11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01). CONCLUSIONS: Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study

Self-perception of knowledge and adherence reflecting the effectiveness of antiretroviral therapy

Objectives: To evaluate which indirect method for assessing adherence best reflects highly active antiretroviral therapy (HAART) effectiveness and the factors related to adherence. Method: This descriptive, cross-sectional study was performed in 2012 at a reference center of the state of Sao Paulo. Self-report (simplified medication adherence questionnaire [SMAQ]) and drug refill parameters were compared to the viral load (clinical parameter of the effectiveness of pharmacotherapy [EP]) to evaluate the EP. The "Cuestionario para la Evaluacion de la Adhesion al Tratamiento Antiretroviral" (CEAT-VIH) was used to evaluate factors related to adherence and the EP and, complementarily, patient self-perception of adherence was compared to the clinical parameter of the EP. Results: Seventy-five patients were interviewed, 60 of whom were considered as adherent from the clinical parameter of the EP and ten were considered as adherent from all parameters. Patient self-perception about adherence was the instrument that best reflected the EP when compared to the standardized self-report questionnaire (SMAQ) and drug refill parameter. The level of education and the level of knowledge on HAART were positively correlated to the EP. Forgetfulness, alcohol use, and lack of knowledge about the medications were the factors most frequently reported as a cause of nonadherence. Conclusion: A new parameter of patient self-perception of adherence, which is a noninvasive, inexpensive instrument, could be applied and assessed as easily as self-report (SMAQ) during monthly drug refill, since it allows monitoring adherence through pharmaceutical assistance. Therefore, patient adherence to HAART could be evaluated using self-perception (CEAT-VIH) and the viral load test.Program of Support to Scientific Development of the School of Pharmaceutical Sciences at the Universidade Estadual Paulista - UNESP [2010/21-I]FAPESP [2014/03468-6]Department of Drugs and Medications, School of Pharmaceutical Sciences of the UNESP – Univ Estadual Paulista, AraraquaraDepartment of Surgery and Anatomy, Americo Brasiliense State HospitalDepartment of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, BrazilDepartment of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, BrazilProgram of Support to Scientific Development of the School of Pharmaceutical Sciences at the Universidade Estadual Paulista - UNESP: 2010/21-IFAPESP: 2014/03468-6Web of Scienc

Effects of Sulpiride on True and False Memories of Thematically Related Pictures and Associated Words in Healthy Volunteers

Episodic memory, working memory, emotional memory, and attention are subject to dopaminergic modulation. However, the potential role of dopamine on the generation of false memories is unknown. This study defined the role of the dopamine D-2 receptor on true and false recognition memories. Twenty-four young, healthy volunteers ingested a single dose of placebo or 400 mg oral sulpiride, a dopamine D-2-receptor antagonist, just before starting the recognition memory task in a randomized, double-blind, and placebo-controlled trial. The sulpiride group presented more false recognitions during visual and verbal processing than the placebo group, although both groups had the same indices of true memory. These findings demonstrate that dopamine D-2 receptors blockade in healthy volunteers can specifically increase the rate of false recognitions. The findings fit well the two-process view of causes of false memories, the activation/monitoring failures model.Univ Fed Sao Paulo, Dept Psychobiol, Sao Paulo, BrazilAssociacao Fundo Incent Pesquisa, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Physiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, BrazilWeb of Scienc

Informal Trade of Psychoactive Herbal Products in the City of Diadema, SP, Brazil: Quality and Potential Risks

The present study aimed to assess the quality and risks involved in the consumption of psychoactive herbal products (PHs) that are available through informal commerce in the city of Diadema, SP, Brazil. Methods of ethnography were used to conduct the fieldwork during which four dealers were selected to record the collection, handling, packaging, types of PHs marketed, and their therapeutic purposes. in addition, lots of the PHs selected were purchased from the dealers and analyzed using microbiology and pharmacognosy techniques. 217 PHs were recorded and categorized into two main groups: stimulants (67%) and depressants (27%) of the central nervous system; sixteen of them were selected, and their 52 lots were acquired. the deficiencies observed in handling and packaging these lots by dealers were confirmed by microbiological analysis; 80.8% of them presented risk according to the indicators defined by the Brazilian Pharmacopoeia. the pharmacognostic analysis confirmed the authenticity of only 9 to 16 PHs analyzed. in addition, descriptions of contraindications, adverse reactions, and drug interactions were found in the literature for the PHs. the results of this study allow the observation of the priorities for the sanitary adequacy of the popular trade of herbs.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)AFIP-Associacao Fundo de Incentivo a PesquisaUniversidade Federal de São Paulo, Dept Med Prevent, BR-04038034 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ciencias Biol, Ctr Estudos Etnobot & Etnofarmacol, BR-09972270 Diadema, SP, BrazilUniv São Paulo, Dept Farm, BR-05508000 São Paulo, BrazilAdolfo Lutz Inst, Ctr Medicamentos Cosmet & Saneantes, BR-01246902 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, BR-04023062 São Paulo, BrazilUniv Bandeirante Anhanguera, BR-02071013 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ciencias Biol, BR-09972270 Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Med Prevent, BR-04038034 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ciencias Biol, Ctr Estudos Etnobot & Etnofarmacol, BR-09972270 Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ciencias Biol, BR-09972270 Diadema, SP, BrazilWeb of Scienc

ACCESO, SEGURIDAD Y USO DE MEDICAMENTO POR LA POBLACIÓN

O presente estudo teve por objetivo identificar as famílias que apresentem estoque e façam uso de medicamentos, bem como avaliar as condições de armazenamento, segurança e uso desses medicamentos. O estudo realizou-se em um município do estado de São Paulo; as entrevistas, em domicílios cadastrados em uma das dez unidades de Estratégia de Saúde da Família (ESF) de que o município dispõe, sendo a amostra definida por meio de sorteio aleatório estratificado (134 domicílios, IC 95%). A coleta de dados foi realizada por meio de entrevistas com um formulário semiestruturado, durante o primeiro semestre de 2011. Houve entrevistas em 118 (88,0%) domicílios, dos quais 112 (95,0%) possuíam medicamentos, que eram estocados em lugares inseguros ou inadequados em 75,4% deles; a automedicação sem prescrição médica era prática comum em 46 (47,4%) domicílios e falta de identificação e segurança nos medicamentos armazenados foi observada em 60 (53,6%) dos domicílios. A maioria possui estoque de medicamentos feito de forma inadequada ou insegura ou apresenta especialidades com falta de identificação e segurança, o que pode levar a intoxicações ou inefetividade terapêutica. A Assistência Farmacêutica no âmbito do SUS carece de serviços de assistência farmacêutica para os usuários de medicamentos, o que pode ser suprido pela presença do farmacêutico na ESF, essencial para a promoção do uso racional de medicamentos, já que, por meio da atenção farmacêutica pode identificar, corrigir e prevenir, possíveis problemas relacionados a medicamentos.The present study aims to identify families who have stock and are making use of medications, as well as assess the conditions of storage, security and use of these drugs. The study was conducted in a city of São Paulo, the interviews were conducted in households enrolled in one of ten units of the Estratégia de Saúde da Família (ESF) that the city provides and the sample was defined by means of stratified random sampling (134 1 Professora assistente doutora do Departamento de Fármacos e Medicamentos da Faculdade de Ciências Farmacêuticas – UNESP. 2 Aluno de graduação da Faculdade de Ciências Farmacêuticas – UNESP. 3 Professor Adjunto Doutor do Departamento de Psicobiologia da Universidade Federal de São Paulo. 4 Professor assistente doutor do Departamento de Ciências Biológicas da Faculdade de Ciências Farmacêuticas – UNESP. 7 MASTROIANNI, P. C.; ANDRADE, R. V.; GALDUROZ, J. C. F.; FARACHE FILHO, A. Acesso, segurança e uso de medicamentos por usuários. Rev. Ciênc. Ext. v.8, n.2, p.6-24, 2012. households, IC 95%). Data collection was conducted through interviews with a semistructured questionnaire during the first half of 2011. We interviewed 118 (88.0%) households, of which 112 (95.0%) had medications that were stored n insecure or inadequate places in 75.4% of households, non-prescription self-medication was a common practice in 46 (47 4%) households, and lack of identification and security of medications stored was observed in 60 (53.6%) households. Most households had stock of medicines, which were done improperly or unsecure, or have specialties with lack of identification and security, which can lead to poisoning or e ineffective therapy. The Pharmaceutical Assistance under SUS lacks social initiatives, with actions directed for medications users, which can be supplied by the presence of the pharmacist in the ESF, essential for the promotion of racional use of medicines, that, through the Pharmaceutical Care, can identify, correct and prevent possible problems related to drugs.El estudio tuvo como objetivo identificar las familias que estaban usando medicamentos y evaluar las condiciones de almacenamiento, seguridad y uso de medicamentos. En un municipio del estado de São Paulo con diez servicios de salud de la familia, fueron entrevistados moradores de casas registradas en uno de estos servicios. La amuestra fue definida por sorteo aleatorio (134 casa, IC95%). Se realizó la colecta en un formulario con preguntas abiertas y cerradas, durante el primer semestre de 2011. Se entrevistó 118 (88%) de las casas, de estas 112 (95%), tenían medicamentos y 75,4% el almacenamiento era en lugares inseguros o inadecuados. La automedicación era una práctica común en 46 (47,4%) de las casas. En 60 (53,6%) de las casas faltaba identificación y seguridad en los medicamentos almacenados. La mayoría de las casas tenían medicamentos y su almacenamiento era inadecuado o inseguro con falta de identificación, lo que puede llevar a intoxicaciones o inefectividad terapéutica. La atención farmacéutica en el sistema único de salud, en Brasil, carece de este servicio para promoción del uso seguro de medicamentos. La presencia del farmacéutico puede contribuir para el uso racional de medicamentos como identificar, corregir y prevenir posibles problemas relacionados a medicamentos

The low oxygen consumption is reflected on depression scores in elderly

The study aimed to investigate the effects of different types of exercise in indicative scores of depression in the elderly. Participated 168 elderly volunteers of both sexes, aged 60-75 years (65.66 ± 4.28 years), 40 women and 128 men. The volunteers were divided into seven distinct groups: a) Sedentary control (n = 40); b) Resisted control (n = 23); c) Walking (n = 23); d) Outdoor (n = 20); e) Cycle ergometer (n = 23); f) Resisted 50% of 1RM (n = 19); and g) Resisted 80% of 1RM (n = 20), and subjected to a protocol of six months of physical training three times a week. The group a remained without changing their routine activities during the study period and did not engage in any exercise program, as the group b appeared in the laboratory, but performed the exercises without charge. Before and immediately after the study period, the volunteers underwent an evaluation protocol for determination of oxygen consumption and responded to the Geriatric Depression Scale. The results revealed that the groups c and e, who exercised at intensities with predominant aerobic metabolism, showed reduction in depression scores, and other measures were not sufficient to promote reduction in this variable. The data suggest that exercise dominance in aerobic metabolism is more effective in reducing depression scores in elderly.O objetivo do estudo foi investigar os efeitos de diferentes tipos de exercício físico nos escores indicativos de depressão em idosos. Participaram 168 voluntários idosos, de ambos os sexos, com idades de 60 a 75 anos (65,66±4,28 anos), sendo 40 mulheres e 128 homens. Os voluntários foram alocados em sete grupos distintos: a) Controle sedentário (n=40); b) Controle resistido (n=23); c) Caminhada (n=23); d) Lazer (n= 20); e) Cicloergômetro (n=23); f) Resistido 50% de 1RM (n=19); e g) Resistido 80% de 1RM (n=20), sendo submetidos a um protocolo de seis meses de treinamento físico, três vezes por semana. O grupo a permaneceu sem alterar suas atividades de rotina durante o período de estudo e não se engajou em nenhum programa de exercício físico, já o grupo b compareceu no laboratório, mas realizou os exercícios sem carga. Antes e imediatamente após o período de estudo, os voluntários foram submetidos a um protocolo de avaliação para determinação do consumo de oxigênio e responderam à Escala Geriátrica de Depressão. Os resultados revelaram que os grupos c e e, que se exercitaram em intensidades com predomínio do metabolismo aeróbio, apresentaram redução nos escores de depressão, sendo que as demais intervenções não foram suficientes para promover redução nessa variável. Os dados sugerem que exercícios com predominância no metabolismo aeróbio são mais efetivos em promover reduções em escores de depressão de idosos.Centro de Estudos em Psicobiologia e ExercícioUniversidade Federal de São Paulo (UNIFESP) Departamento de BiociênciasUniversidade Federal do ABC Centro de Matemática, Computação e CogniçãoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsicobiologiaUNIFESP, Depto. de BiociênciasUNIFESP, EPM, Depto. de PsicobiologiaSciEL

A Yoga and Compassion Meditation Program Reduces Stress in Familial Caregivers of Alzheimer's Disease Patients

Familial caregivers of patients with Alzheimer's disease exhibit reduced quality of life and increased stress levels. the aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress, anxiety, depression, and salivary cortisol levels in familial caregivers. A total of 46 volunteers were randomly assigned to participate in a stress-reduction program for a 2-month period (yoga and compassion meditation program-YCMP group) (n = 25) or an untreated group for the same period of time (control group) (n = 21). the levels of stress, anxiety, depression, and morning salivary cortisol of the participants were measured before and after intervention. the groups were initially homogeneous; however, after intervention, the groups diverged significantly. the YCMP group exhibited a reduction of the stress (P < 0.05), anxiety (P < 0.000001), and depression (P < 0.00001) levels, as well as a reduction in the concentration of salivary cortisol (P < 0.05). Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress, anxiety, depression, and salivary cortisol in familial caregivers.Associacao Fundo de Incentivo a Pesquisa-AFIPUniversidade Federal de São Paulo UNIFESP, Dept Psychobiol, BR-04024002 São Paulo, BrazilInst Appana Mind Desenvolvimento Humano, Departiment Res, BR-05436020 São Paulo, BrazilHosp Israelita Albert Einstein, Inst Cerebro, BR-05601901 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Div Endocrinol, Dept Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psychobiol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Div Endocrinol, Dept Med, BR-04023062 São Paulo, BrazilWeb of Scienc

MELHORA DO EQUILÍBRIO DE IDOSAS HÍGIDAS APÓS TREINAMENTO COGNITIVO DA FUNÇÃO EXECUTIVA, ATENÇÃO E MEMÓRIA

O objetivo do presente trabalho foi verificar se o equilíbrio pode ser melhorado com o treinamento de funções cognitivas recrutadas para a marcha: função executiva, atenção e memória. Participaram do estudo 60 idosas com idade média 70,65 ± 5 anos, que foram randomicamente divididas em Grupo Controle (GC = 30) e Grupo Experimental (GE = 30). As avaliações foram realizadas com os testes de equilíbrio (TUG), força de membros inferiores (TSL), função executiva (Wisconsin), atenção e memória operacional (Dígito-WAIS), além dos testes de nível de atividade física (Baecke), rastreio cognitivo (MEEM), e sintomas depressivos (EDG) para caracterizar a amostra. O protocolo de treinamento cognitivo era composto por 24 sessões de treinamento de função executiva, resolução de problemas, atenção e memória. Os resultados mostraram que houve melhora do equilíbrio (p < 0,001) do grupo experimental, assim como da função executiva, atenção e memória (p < 0,001) e também da força de membros inferiores (p = 0,002). O treinamento cognitivo específico de funções executivas, atenção, memória operacional e resolução de problemas promove a melhora do equilíbrio de idosas.