Clinical 3-D Gait Assessment of Patients with Polyneuropathy Associated with Hereditary Transthyretin Amyloidosis

Hereditary amyloidosis associated with transthyretin V30M (ATTRv V30M) is a rare and inherited multisystemic disease, with a variable presentation and a challenging diagnosis, follow-up and treatment. This condition entails a definitive and progressive motor impairment that compromises walking ability from near onset. The detection of the latter is key for the disease's diagnosis. The aim of this work is to perform quantitative 3-D gait analysis in ATTRv V30M patients, at different disease stages, and explore the potential of the obtained gait information for supporting early diagnosis and/or stage distinction during follow-up. Sixty-six subjects (25 healthy controls, 14 asymptomatic ATTRv V30M carriers, and 27 symptomatic patients) were included in this case-control study. All subjects were asked to walk back and forth for 2 min, in front of a Kinect v2 camera prepared for body motion tracking. We then used our own software to extract gait-related parameters from the camera's 3-D body data. For each parameter, the main subject groups and symptomatic patient subgroups were statistically compared. Most of the explored gait parameters can potentially be used to distinguish between the considered group pairs. Despite of statistically significant differences being found, most of them were undetected to the naked eye. Our Kinect camera-based system is easy to use in clinical settings and provides quantitative gait information that can be useful for supporting clinical assessment during ATTRv V30M onset detection and follow-up, as well as developing more objective and fine-grained rating scales to further support the clinical decisions.This work was supported by the National funding agency, FCT—Fundação para a Ciência e a Tecnologia, in the context of the projects (UIDB/50014/2020; UIDB/00127/2020) and scholarship (SFRH/DB/110438/2015). This work was also supported by the Porto University Hospital Center (CHUP) in the context of the scholarship (BI.02/2018/UCA/CHP) as part of the research project [2014/167(119-DEFI/149-CES)]info:eu-repo/semantics/publishedVersio

Validation of a Single RGB-D Camera for Gait Assessment of Polyneuropathy Patients

Motion analysis systems based on a single markerless RGB-D camera are more suitable for clinical practice than multi-camera marker-based reference systems. Nevertheless, the validity of RGB-D cameras for motor function assessment in some diseases affecting gait, such as Transthyretin Familial Amyloid Polyneuropathy (TTR-FAP), is yet to be investigated. In this study, the agreement between the Kinect v2 and a reference system for obtaining spatiotemporal and kinematic gait parameters was evaluated in the context of TTR-FAP. 3-D body joint data provided by both systems were acquired from ten TTR-FAP symptomatic patients, while performing ten gait trials. For each gait cycle, we computed several spatiotemporal and kinematic gait parameters. We then determined, for each parameter, the Bland Altman's bias and 95% limits of agreement, as well as the Pearson's and concordance correlation coefficients, between systems. The obtained results show that an affordable, portable and non-invasive system based on an RGB-D camera can accurately obtain most of the studied gait parameters (excellent or good agreement for eleven spatiotemporal and one kinematic). This system can bring more objectivity to motor function assessment of polyneuropathy patients, potentially contributing to an improvement of TTR-FAP treatment and understanding, with great benefits to the patients' quality of life.This research was funded by ERDF – European Regional Development Fund through the Operational Program for Competitiveness and Internationalization - COMPETE 2020, and by national funds through the Porto Hospital Center (CHP) in the context of the scholarship BI.02/2018/UCA/CHP, and through the Portuguese Foundation for Science and Technology (FCT), in the context of scholarship SFRH/BD/110438/2015, and projects UID/CEC/00127/2019, UID/CEC/00127/2013, Incentivo/EEI/UI0127/2014, FCOMP-01-0124-FEDER-028943 and FCOMP-01-0124-FEDER-029673. It was also partially funded by NORTE2020 Integrated Project NanoSTIMA “NORTE-01-0145-FEDER-000016”, and POCI-01-0145-FEDER-028618 (PTDC/CCI-COM/28618/2017) - PERFECT, under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fundinfo:eu-repo/semantics/publishedVersio

Community health agents and the complexities of the working with patients using medicines

The community health agents are an important element in the management of medication information in primary healthcare setting, improving healthcare team interaction with the community. The aim of this study was to reveal how the use of medicines is present in the routine of agentes and understand the relationships established between agents, users and healthcare team. This is a quantitative and qualitative study, using participant observation, semi-structured interview and focus group. This study was conducted at three basic health units in a municipality of Minas Gerais, Brazil, between March, 2013 and February, 2015. The results show that agents constantly relate with patients who experience drug therapy problems and have doubts about the indication, effects, adverse drug reactions, among other. They perform some interventions directly with the patient, but usually they prefer to refer cases to the healthcare team. Some agents said recognizing the pharmacist as a reference on medicines, but the demand for this professional was low by the subjects of this study. We emphasize the importance of the agents training on medication use to instrumentalize them to recognize problematic situations, to develop interventions with the support of the healthcare team and to follow up patients using medicines.Os agentes comunitários de saúde representam importante elemento na gestão de informações sobre o uso de medicamentos na atenção primária, melhorando a interação da equipe de saúde com a comunidade. O objetivo do estudo foi revelar como o uso de medicamentos está presente na rotina deles e compreender as relações que se estabelecem entre agentes, usuários e equipe. Tratou-se de um estudo qualiquantitativo, com utilização de observação participante, entrevista semiestruturada e grupo focal. Foi desenvolvido em três unidades básicas de saúde em um município de Minas Gerais no período de março de 2013 a fevereiro de 2015. Os resultados revelaram que os agentes se relacionam constantemente com usuários que vivenciam problemas com o uso de medicamentos e apresentam dúvidas sobre suas indicações, efeitos esperados, reações adversas, entre outras. Eles realizam algumas intervenções diretamente com o usuário, porém preferem encaminhar os casos à equipe de saúde. Alguns agentes referiram-se ao farmacêutico como profissional de referência no tocante ao uso de medicamentos, mas a procura por esse profissional mostrou-se baixa pelos sujeitos do estudo. Ressalta-se a importância da formação do agente sobre utilização de medicamentos para instrumentalizá-los no reconhecimento de situações inadequadas, no desenvolvimento de intervenções com a equipe de saúde e no acompanhamento dos usuários

Dinâmica comportamental dos consumidores de café: um fator gerador de ações mercadológicas

Aiming to identify how marketing tools influence the coffee consumer’s purchasing behavior, a piece of marketing research with exploratory and descriptive analyses, of qualitative nature was accomplished. The survey was used, with structured questionnaires applied to 800 consumers (São Paulo, Belo Horizonte and Rio de Janeiro) in hypermarkets from July to December 2001. The questionnaires were tabulated and analyzed by utilizing the SSPS software (v.10) with descriptive and multivariate statistic analyses. The sample consisted mostly of consumers of the female gender, married, aged between 20 and 40 years, belonging, in general, to the social class B, senior high school educated. Among the marketing tools, it was found that the features related to the produce (flavor, smell and quality) have greater perception and influence on the consumer’s behavior. Price also plays an important role, as part of the sample belongs to social class C. It was verified that the consumer would not regard as relevant tools such as advertisement and package, proving themselves faithful to the brand. The consumer proved indifferent to the appeals and advertising announcements which, in general, are not very attractive.marketing, consumer’s behavior, coffee.,

Clinical outcomes of medication therapy management services in primary health care

This study evaluates whether the integration of pharmacists into health-care teams through the delivery of pharmaceutical care-based medication therapy management (MTM) services can improve the clinical outcomes of patients with chronic health conditions in the primary health-care setting. A retrospective descriptive study of 92 outpatients assisted by MTM pharmacists in primary health-care units was carried out over 28 months (median follow-up: 05 months). Patients were followed up by MTM pharmacists, with a total of 359 encounters and a ratio of 3.9 encounters per patient. The prevalence of hypertension, diabetes mellitus and dyslipidaemia was 29.5%, 22.0% and 19.4%, respectively. There was a high prevalence of drug-related problems with a ratio of 3.4 per patient. Pharmacists performed a total of 307 interventions to prevent or resolve drug-related problems. With regard to control of the most prevalent chronic medical conditions, a high percentage of patients reached their therapy goals by the last encounter with the pharmacist: 90.0% for hypertension, 72.3% for diabetes mellitus and 90.3% for dyslipidaemia. MTM services provided by pharmacists resolved drug therapy problems and improved patients' clinical outcomes. This study provides evidence for health-care managers of the need to expand the clinical role of pharmacists within the Brazilian public health-care system

Percepção de estudantes de graduação sobre a aprendizagem em disciplina adaptada para o ensino remoto emergencial

O objetivo deste artigo foi descrever as adaptações realizadas em uma disciplina introdutória do curso de Farmácia adaptada para o ensino remoto emergencial, bem como as percepções dos estudantes acerca dessa experiência educacional. Trata-se de um estudo qualitativo com análise temática de dados obtidos pela técnica de grupo focal. O contexto pandêmico exigiu que professores e estudantes buscassem novas formas de ensino e aprendizagem e a utilização de metodologias ativas nessa conjuntura permitiu a interação e criação de vínculos entre discentes e docentes, mesmo em ambiente virtual de aprendizagem. A percepção dos estudantes sobre o aprendizado na disciplina aponta que os objetivos propostos foram alcançados, embora a sobrecarga de atividades tenha sido apontada por eles como um aspecto negativo da experiência. A investigação realizada mostrou uma percepção positiva dos alunos sobre a experiência educacional, mesmo diante dos desafios da pandemia de covid-19. Os resultados obtidos evidenciam a necessidade de formação docente em métodos de ensino e aprendizagem e avaliação on-line, que poderão se tornar uma nova realidade na educação superior em tempos pós-pandemia

AVALIAÇÃO DA SATISFAÇÃO NO ENSINO REMOTO EMERGENCIAL SOB A PERSPECTIVA DISCENTE

Due to the SARS-CoV-2 pandemic, the Federal University of Minas Gerais (UFMG) established Emergency Remote Education (ERE) in July 2020, with the purpose of continuing the first semester of classes at the institution.  Considering the adaptive period, the goal was to evaluate the satisfaction of the students studying Pharmacy with ERE, focusing on the learning process.  Data collection was carried out through a virtual platform, with a questionnaire addressing sociodemographic data, lifestyle habits and the teaching-learning process. Data were analyzed using simple linear regression and the CART technique. The profile of the responding students was mainly characterized by women and students from the undergraduate professional cycle (above the 5th period). The average general satisfaction  with the teaching of students was 3.12 (on a scale that ranged from 1 to 5), showing an inverse correlation with learning in the professional cycle of the course (p<0.000).  Only 3.1% of students who indicated “none or little learning” rated having maximum satisfaction with the ERE. There was low satisfaction with the quality of practical classes (3.06), revealing the limitation of the ERE for the development of courses with content as practical as that of Pharmacy Finally, great satisfaction is observed for factors related to the didactics and methodology of the professor, showing their engagement and dedication with the ERE, despite the difficulties for its establishment.Debido a la pandemia del SARS-CoV-2, la Universidad Federal de Minas Gerais (UFMG) estableció la Enseñanza Remota de Emergencia (ERE), en julio de 2020, con el objetivo de continuar el primer semestre de clases. Teniendo en cuenta el periodo de adaptación, el objetivo fue evaluar la satisfacción de los estudiantes del curso de Farmacia con la ERE, enfocándose en el proceso de aprendizaje. Se realizó la recolección de datos a través de una plataforma virtual, con cuestionario acerca de datos sociodemográficos, hábitos de vida y el proceso de enseñanza-aprendizaje. Los datos fueron analizados por medio de regresión lineal simple y la técnica CART. El perfil de los estudiantes que respondieron se caracterizó principalmente por mujeres y estudiantes del ciclo profesional del curso de grado (después del quinto período). El promedio de satisfacción global con la docencia de los estudiantes fue de 3,12 (en una escala que osciló de 1 a 5), mostrando correlación inversa con el aprendizaje en el ciclo profesional del curso (p<0,000). Solo el 3,1% de los estudiantes que indicaron “poco o ningún aprendizaje" evaluaron tener la máxima satisfacción con el ERE. Hubo baja satisfacción con la calidad de las clases prácticas (3.06), revelando la limitación del ERE para el desarrollo de cursos con contenido tan práctico como el de Farmacia. Finalmente, se retrata una satisfacción por encima de la media por factores relacionados con la didáctica y metodologías del profesor, mostrando la dedicación de los profesores para adaptarse incluso con los obstáculos del ERE.Devido à pandemia do SARS-CoV-2, a Universidade Federal de Minas Gerais (UFMG) estabeleceu o Ensino Remoto Emergencial (ERE), em julho de 2020, com o objetivo de dar continuidade ao primeiro semestre letivo de aulas na instituição. Considerando o período adaptativo, objetivou-se avaliar a satisfação dos discentes do curso de Farmácia com o ERE, focando no processo de aprendizagem. Realizou-se coleta de dados por meio de plataforma virtual, com questionário sobre dados sociodemográficos, hábitos de vida e processo de ensino-aprendizagem. Os dados foram analisados por meio de regressão linear simples e da técnica CART. O perfil dos alunos respondentes foi caracterizado majoritariamente por mulheres e estudantes do ciclo profissionalizante da graduação (acima do 5º período). A média de satisfação geral com o ensino dos discentes foi de 3,12 (em uma escala que variou de 1 a 5), apresentando correlação inversa ao aprendizado no ciclo profissionalizante do curso (p<0,000). Apenas 3,1% dos alunos que indicaram “nenhum ou pouco aprendizado” atribuíram satisfação máxima com o ERE. Observou-se menor satisfação com a qualidade das aulas práticas (3,06), revelando a limitação do ERE para o desenvolvimento de cursos com conteúdos tão práticos como o de Farmácia. Por fim, é retratada uma satisfação acima da média para fatores relacionados à didática e metodologias dos docentes, mostrando o compromisso e dedicação dos professores ao ERE, apesar das dificuldades para o seu estabelecimento

Abstenção eleitoral e legitimidade democrática

Cet projet cherche une réponse à la question «quel est la relation entre l’abstention électorale et la légitimité de la démocratie?» D’abord, nous irons poser quelques hypothèses pour lesquelles nous chercherons des bonnes conclusions.This project tries to provide for an answer to the matter of the electoral abstention and its effects on the legitimacy of democracy as a regime. Firstly, we will approach some hypothesis so we can arrive to a satisfactory conclusionEste projeto procura responder à questão «o que está a abstenção eleitoral a fazer à legitimidade da democracia?» Iremos primeiro explorar algumas hipóteses para que possamos chegar a uma conclusão verosímil