“Its Hand around My Throat”. The Social Rendering of Borrelia

This paper builds on biomedical and anthropological discourses of microbial agency to explore the important opportunities this discourse offers medicine, politics, anthropology, and patients. “Borrelia burgdorferi”, often termed “the Great Imitator”, is an ideal candidate for this discussion as it reveals how difficult it is to speak about Lyme disease without engaging with microbial agency. Based on 12-months research with Lyme disease patients and clinicians in Scotland, this paper offers a social rendering of the bacteria that reveals epistemologies of illness not available in medical accounts: the impact of social and psychological symptoms such as body dysmorphia, depression, shame, post-traumatic stress disorder, and suicide-related deaths on patients’ illness narratives. Divorcing agency from the bacteria silences these important patient narratives with the consequence of a limited medical and social understanding of the signification of Lyme disease and the holistic methods needed for treatment. This paper furthermore argues that the inclusion of patient worldings of Borrelia acting in the medical renderings offers a democratic determination of what the illness is. Finally, building on Giraldo Herrera and Cadena, I argue for a decolonization of Borrelia, exploring how the pluriverse both takes the epistemologies of patients seriously and reveals medical equivocation

Peak expiratory flow mediates the relationship between handgrip strength and timed up and go performance in elderly women, but not men

OBJECTIVE: The aim of the present study was to verify if there is sex difference in the associations among handgrip strength, peak expiratory flow (PEF) and timed up and go (TUG) test results. METHODS: The sample included 288 consecutive elderly men (n=93) and women (n=195). Functional capacity was measured using the TUG test, and muscle strength was measured based on handgrip. Moreover, as a measure of current health status, PEF was evaluated. Linear regression procedures were performed to analyze the relationships between handgrip and both PEF and TUG test results, with adjustment for confounders, and to identify the possible mediating role of PEF in the association between handgrip strength and TUG test results. RESULTS: In men, handgrip strength was associated with both PEF and TUG performance (p<0.01). After adjustment for PEF, the relationship between handgrip strength and TUG performance remained significant. In women, handgrip strength was also associated with both PEF and TUG performance (p<0.01). However, after adjustment for PEF, the relationship between handgrip strength and TUG performance was no longer significant. CONCLUSION: Mobility in the elderly is sex dependent. In particular, PEF mediates the relationship between handgrip strength and TUG performance in women, but not in men

Biosocial fragiities: life with chronic Lyme disease in Scotland

This thesis explores patient experiences in the controversy of chronic Lyme disease in Scotland, and the importance of social relationships between patients, doctors, advocates, and researchers as these groups navigate the controversy. Chronic Lyme disease is a contested illness; its existence is disputed by biomedical guidelines and NHS Scotland. Patients and doctors seeking to legitimise chronic Lyme organise under the banner of “Lyme-literacy” and argue for medical research on diagnostic tools, long-term antibiotic treatment, and bacterial persistence. This thesis also introduces the concept “biosocial fragilities” which I define as the fragilities inherent to the labour of producing biosocial spaces. Where biosociality and biosolidarity explore the empowerment, joy, and kinship of this labour, biosocial fragilities explores what it means when this labour is carried out by chronically-ill persons; the irony of biosociality and biosolidarity being dependent on vulnerable peoples’ health; and the ways in which this makes biosociality fragile. Biosocial fragilities furthermore explores how and why the biosociality and biosolidarity produced by advocates does not always extend to them, thereby placing them in a further fragility. This thesis offers new perspectives to the medical anthropological literature on biosociality and biosolidarity in the form of biosocial fragilities. Ethnographic fieldwork was conducted over a period of 12 months across multiple sites in Scotland and online. I offer an in-depth account of what living with chronic Lyme disease is like, paying particular attention to people’s dual identities as patients and as advocates. By centering the patient experience, I describe the fragility and limits of advocacy work and the tension between biomedical and Lyme-literate knowledge. Furthermore, I describe clinical scientists, infectious disease researchers, epidemiologists, and advocates researching and treating chronic Lyme, their common goal of understanding what chronic Lyme is, and unpack why, despite this shared goal, they do not feel heard by one another. By attending public health meetings, Parliamentary hearings, conferences, and patient advocacy gatherings, I trace how chronic Lyme disease is understood and how the meaning given to it challenges whether diagnostic tools are efficient or in fact inefficient; whether medical knowledge and guidelines are outdated; if healthcare should include long-term antibiotics; the role of private economies in healthcare; what constitutes healed and what constitutes ongoing illness; and who the expert is, the patient or the doctor. Patients and advocates dismantle biomedical hierarchies that determine who may call themselves a Lyme-literate expert; Lyme-literate medics engage with their patients in experiments with long-term antibiotics. Within this community, Lyme-literate medicine is described as pioneer work. However, to the biomedical community, it is considered non-medical and unethical. How patients, doctors, advocates and researchers approach this question reveals the tension between contested illness and biomedical knowledge, and patients’ ideas of responsibility, care, power, and expertise. Three themes can be found throughout this thesis. One is patient experiences of living with a contested illness. The second is the experience of biomedical doctors and Lyme-literate doctors researching Lyme disease, tick-borne diseases, and chronic Lyme disease. The third is advocates’ experiences with political campaigns and the patient community. The overall analytical argument of my thesis uses these themes to undercut the idea of binary medical camps standing in opposition to one another, to instead demonstrate the people who move between them, how they seek collaborations with one another, and how alliances change. Furthermore, as my fieldwork year took place in 2019 to 2020, the COVID-19 pandemic makes an appearance throughout the thesis, demonstrating how one disease can overshadow another, the impact of the pandemic on existing disease research, and offers notes of comparison between the socio-political consequences of the two. My work thereby highlights crip emotional intelligence for how it prepared chronic Lyme patients for the COVID-19 pandemic, and suggests it as an important guide for learning from people living with contested illness and navigating ongoing anxieties of infectious diseases

Predictors of walking capacity in peripheral arterial disease patients

OBJECTIVE: To estimate walking capacity in intermittent claudication patients through a prediction model based on clinical characteristics and the walking impairment questionnaire. METHODS: The sample included 133 intermittent claudication patients of both genders aged between 30 and 80 years. Data regarding clinical characteristics, the walking impairment questionnaire and treadmill walking test performance were obtained. Multiple regression modeling was conducted to predict claudication onset distance and total walking distance using clinical characteristics (age, height, mass, body mass index, ankle brachial index lower, gender, history of smoking and co-morbid conditions) and walking impairment questionnaire responses. Comparisons of claudication onset distance and total walking distance measured during treadmill tests and estimated by a regression equation were performed using paired t-tests. RESULTS: Co-morbid conditions (diabetes and coronary artery disease) and questions related to difficulty in walking short distances (walking indoors - such as around your house and walking 5 blocks) and at low speed (walking 1 block at average speed - usual pace) resulted in the development of new prediction models high significant for claudication onset distance and total walking distance (p0.05) were observed. CONCLUSION: The current study demonstrated that walking capacity can be adequately estimated based on co-morbid conditions and responses to the walking impairment questionnaire

STUDI POTENSI Pteris vitata, Amaranthus spinosus, Ipomoea reptanspoir SEBAGAI FITOREMEDIATOR TANAH TERCEMAR MERKURI (Hg)

Kerusakan lingkungan dan menurunnya kualitas hidup organisme akibat pencemaran logam merkuri (Hg) telah terjadi, dimana merkuri bereaksi dengan metana hasil dekomposisi senyawa organik membentuk metil merkuri yang bersifat toksik. Dewasa ini, beberapa penelitian pada kasus pencemaran merkuri diarahkan pada upaya remediasi lingkungan. Salah satu metode remediasi adalah menggunakan tanaman sebagai bioremediator yang mampu menyerap merkuri di lingkungan tanah dan perairan. Bioremediasi dengan pola fitoremediasi sangat ditentukan oleh jenis tumbuhan, iklim, dan kondisi tailing dimana semua tumbuhan memiliki kemampuan menyerap logam tetapi dalam jumlah bervariasi. Upaya remediasi lingkungan secara bioremediator menggunakan Tanaman Paku Pakis (Pteris vitata), Bayam Duri (Amaranthus spinosus), dan Kangkung Darat (Ipomoea reptanspoir) diharapkan mampu mengakumulasi merkuri dalam konsentrasi tinggi (hiperakumulator) sehingga dapat memulihkan tanah yang tercemar memalui penyerapan dan mengakumulasi merkuri di dalam jaringannya. Potensi tanaman sebagai fitoremediator merkuri dilakukan melalui pendekatan Bio-Concentration Factor (BCF) dan Translocation Factor (TF) yang didahului dengan analisis secara Mercury Analyser. Dari hasil didapatkan bahwa konsentrasi merkuri (Hg) pada tanah, pada akar, dan pada daun tanaman Pteris vitata masing-masing 1,46 mg.Kg-1; 0,41 mg.Kg-1; dan 0,08 mg.Kg-1, tanaman Amaranthus spinosus masing-masing 1,28 mg.Kg-1; 0,25 mg.Kg-1; dan 0,02 mg.Kg-1, dan tanaman Ipomoea reptanspoir masing-masing 1,92 mg.Kg-1; 1,06 mg.Kg-1; dan 0,12 mg.Kg-1. Nilai Bio-Concentration Factor (BCF) untuk masing-masing tanaman 0,28; 0,19; dan 0,55 dan Translocation Factor (TF) masing-masing 0,19; 0,08; dan 0,11. Hasil didapatkan bahwa ketiga tanaman hiperakumulator tidak efektif sebagai fitoremediator merkuri., walaupun efisiensi penyerapan masing-masing tanaman 33,56%, 21.09%, dan 61,46%

O exercício físico e o bem estar dos idosos - Barreiras e benefícios percebidos: Um estudo realizado num Centro de Convivência em Juiz de Fora, Brasil

Considerando o crescimento da população idosa a nível mundial e em atenção à tendência dos estudos dos aspectos positivos da vida humana, a presente pesquisa buscou investigar o bem estar subjetivo, os níveis de prática de exercícios físicos, os prós e os contras, assim como as barreiras e benefícios para essa prática.Participaram da pesquisa 101 idosos frequentadores de um centro de convivência na cidade de Juiz de Fora, Minas Gerais, Brasil (76,2% mulheres e 23,8% homens, com média de idades entre 75 e 76 anos). Para a coleta de dados utilizou-se um questionário com questões referentes à prática de exercícios físicos, às barreiras e benefícios relacionados a essa prática e incluindo as versões traduzidas e adaptadas da Satisfaction With Life Scale, da Positive and Negative Affect Schedule, da Decision Balance Scale for Exercise e do Stages of Exercise Change.Os resultados da pesquisa indicaram uma maior presença de mulheres em centros de convivência e uma maioria de praticantes de exercícios físicos, tanto na instituição pesquisada quanto fora dela. O bem estar subjetivo não apresentou diferenças significativas entre as variáveis analisadas, porém, observou-se a tendência de mulheres praticantes de exercícios físicos alcançarem valores maiores nessa avaliação. O benefício mais relatado acerca da prática de exercícios físicos foi a diminuição da dor e a barreira mais mencionada foi a falta de motivação. Com relação à avaliação do balanço decisional os indivíduos praticantes apresentaram médias maiores nos prós. Confirma-se assim que os exercícios físicos são de grande importância para a promoção da saúde dos idosos devendo ser incentivado em todas as idades para ajudar no envelhecimento com cada vez mais qualidade e menos limitações. Neste aspecto, considera-se a importância dos centros de convivência para idosos incorporarem exercícios físicos em suas atividades, assim como a divulgação dos benefícios que tais práticas promovem.Considering the growth of the elderly population worldwide and in the light of the trend of studies about the positive aspects of human life, the present research aimed to investigate the subjective well-being, the levels of physical exercise, the pros and cons, as well as the barriers and benefits to this practice.A total of 101 elderly, members of a community center in the city of Juiz de Fora, Minas Gerais, Brazil (76.2% women and 23.8% men, mean age 75-76 years) participated in the study. To collect data, a questionnaire was used with questions related to the practice of physical exercises, the barriers and benefits related to this practice and including the translated and adapted versions of the Satisfaction With Life Scale, of the Positive and Negative Affect Schedule, of Decision Balance Scale for Exercise and the Stages of Exercise Change.The results of the research indicated a greater presence of women in community centers and a majority of physical exercise practitioners, both in the research institution and outside. The subjective well-being did not present significant differences between the analyzed variables, however, it was observed the tendency of physically active women reach higher values in this evaluation. The most reported benefit of physical exercise was pain reduction and the most mentioned barrier was lack of motivation. With regard to the evaluation of the decisional balance, physically active individuals presented higher averages in the pros. It is thus confirmed that physical exercises exert great importance for the promotion of the health of the elderly and should be encouraged at all ages to help with aging with increasing quality and less limitations. In this aspect, it is considered the importance of the community center for the elderly to incorporate physical exercises in their activities, as well as the divulgation of the benefits that these practices promote

Remote ischemic preconditioning in patients with intermittent claudication

OBJECTIVE: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A showed a significant increase in the initial claudication distance in the second test compared to the first test. CONCLUSION: RIPC increased the initial claudication distance in patients with intermittent claudication; however, RIPC did not affect the total walking distance of the patients

Variation of the muscular balance during a season in under-20 soccer players

O objetivo deste estudo foi analisar o equilíbrio muscular dos flexores e extensores (RFE) de joelho ao longo de uma temporada de treinamento em jogadores de futebol categoria sub-20. Fizeram parte da amostra 15 sujeitos pertencentes à equipe sub-20 da Associação Atlética Ponte Preta de Campinas. Os atletas participaram de um macrociclo de preparação (MP) de 29 semanas, composto por período preparatório e competitivo que foram divididos em quatro mesociclos: etapa geral (M1), etapa especial (M2), etapa pré-competitiva (M3) e etapa competitiva (M4). A RFE de ambos os membros foi determinada em dinamômetro isocinético utilizando o pico de torque (PT) obtido em três séries consecutivas de cinco repetições com velocidade de 60º/s. Avaliação isocinética foi realizada em quatro momentos ao longo do MP, sempre ao final de cada mesociclo (M1, M2, M3 e M4). Para análise estatística, foi empregado teste Friedman de medidas repetidas, seguida do teste de Wilcoxon e teste U de Mann-Whitney, com nível de significância de p<0,05. O PT nos músculos flexores de joelho, em ambos os membros, no M2 e M3 foram superiores aos observados em M1 e M4. O PT dos extensores de joelho em M1 foi significantemente inferior aos demais momentos do estudo (M2, M3 e M4), em ambos os membros. A RFE, em ambos os membros, foi inferior em M1 quando comparado a M2 e M3. A comparação da RFE entre os membros não revelou diferenças significantes em nenhum dos momentos do estudo (M1, M2, M3 e M4). Os resultados encontrados na presente investigação indicaram existência de alterações na magnitude da RFE, porém dentro da normalidade, e, manutenção da proporcionalidade entre os membros ao longo do MP. Esses resultados sugerem que não existem períodos sensíveis para a ocorrência de lesões em virtude de desequilíbrios musculares ao longo do MP em jogadores de futebol da categoria sub-20.The objective of the present study was to evaluate the muscular balance of knee flexors and extensors (RFE) in under-20 soccer players during a training season. 15 under-20 subjects from the Ponte Preta Athletic Association of Campinas participated in a 29 week macrocycle preparation (MP), composed of preparatory and competitive periods which were divided into four mesocycles: general stage (M1), special stage (M2), pre-competitive stage (M3) and competitive stage (M4). RFE of both members was determined with the torque peak (TP) obtained in isokinetic dynamometer in three consecutive sets of five repetitions of 60 degrees/s. Isokinetic evaluation was accomplished in four stages along the MP at the end of each mesocycle (M1, M2, M3, and M4). Statistic analysis was performed using the Friedman test with repeated measures, followed by Wilcoxon test and Mann-Whitney U test, with significance level of p<0.05. TP of knee flexors muscles in both members were greater in M2 and M3 than in M1 and M4. TP of knee extensors in M1 was significantly inferior than the other stages of the study (M2, M3, and M4), in both members. RFE, in both members, was inferior in M1 when compared to M2 and M3. RFE comparison among members did not reveal significant differences in any moment of the study (M1, M2, M3, and M4). The results indicated the existence of alterations in the size of RFE; within normality though, and maintenance of the proportionality among members along the MP. These results suggest that there are not sensitive periods to the occurrence of injuries due to muscular imbalances along MP in under-20 soccer players

Effects of Isometric Handgrip Training in Patients With Peripheral Artery Disease: A Randomized Controlled Trial

BackgroundMeta‐analyses have shown that isometric handgrip training (IHT) can reduce brachial systolic and diastolic blood pressure (BP) by >6/4 mm Hg, respectively. However, whether IHT promotes these effects among patients with peripheral artery disease, who exhibit severe impairment in cardiovascular function, is currently unknown. This study aimed to evaluate the effects of IHT on the cardiovascular function of patients with peripheral artery disease. Methods and ResultsA randomized controlled trial with peripheral artery disease patients assigned to either the IHT or control group was conducted. The IHT group performed 3 sessions per week, for 8 weeks, of unilateral handgrip exercises, consisting of 4 sets of isometric contractions for 2 minutes at 30% of maximum voluntary contraction and a 4‐minute interval between sets. The control group received a compression ball in order to minimize the placebo effects, representing sham training. The primary outcome was brachial BP. The secondary outcomes were central BP, arterial stiffness parameters, cardiac autonomic modulation, and vascular function. The IHT program reduced diastolic BP (75 [10] mm Hg preintervention versus 72 [11] mm Hg postintervention), with no change in the control group (74 [11] mm Hg preintervention versus 74 [11] mm Hg postintervention), with this between‐group difference being significant (P=0.04). Flow‐mediated dilation improved in the IHT group (6.0% [5.7] preintervention versus 9.7% [5.5] postintervention), with no change in the control group (7.6% [5.5] preintervention versus 7.4% [5.1] postintervention), with this between‐group difference being significant (P=0.04). There was no change in other measured variables over the intervention period. ConclusionsIHT reduced brachial diastolic BP and improved local vascular function in patients with peripheral artery disease

O processo de elaboração de um glossário bilíngue de colocações da área médica: contribuições para tradutores e professores de língua inglesa

O objetivo deste estudo é apresentar o processo de elaboração de um glossário bilíngue (português-inglês) de colocações da área Médica, enfatizando a importância do conhecimento da terminologia adequada para o trabalho de tradução, revisão e ensino de língua inglesa. O estudo encontrou suporte teórico e metodológico na Linguística de&nbsp;Corpus, cujos principais pressupostos são a abordagem empírica na análise de dados e a visão probabilística da linguagem. Além disso, permite a investigação de grandes quantidades de dados por meio de ferramentas computacionais, por exemplo o&nbsp;WordSmith Tools. Para a execução do trabalho, foram compilados dois&nbsp;corpora, um em português e outro em inglês, com aproximadamente 85 mil palavras cada. Os resultados da pesquisa mostraram que o uso de&nbsp;corpus&nbsp;na tarefa de versão é muito relevante, principalmente quando se trata de colocações de uma área de especialidade. Concluímos que apesar de não ser uma tarefa simples e requerer muito cuidado e dedicação em todas as etapas, a elaboração de glossários é extremamente útil para aqueles que trabalham com a língua inglesa