Traducción, adaptación cultural y validación del ABILHAND-Kids para el portugués brasileño

This study aimed to translate, to adapt cross-culturally and to validate the ABILHAND-Kids for the Brazilian Portuguese. ABILHAND-Kids was translated to Brazilian Portuguese and translated back by two certified translators in each phase. After the expert committee approval, the pre-test version was applied in 40 parents of children with cerebral palsy in order to verify item comprehension. Twenty-one volunteers were enrolled in the psychometric properties analysis. Reproducibility was verified by interrater and intrarater reliability and the validity was tested by investigating Box and Block Test, Purdue Pegboard Test and grip strength correlations. ABILHAND-Kids showed strong intrarater (ICC=0.91) and interrater (ICC=0.97) reliability and high internal consistency (Cronbach’s alfa: 0.99). ABILHAND-Kids showed significant correlations with Box and Block Test (performed by dominant upper extremity), Purdue Pegboard Test and grip strength. The Brazilian Portuguese version of ABILHAND-Kids is a reliable tool to measure upper extremities function of children with cerebral palsy, based on the perception of their parents.El objectivo de este estudio fue traducir el ABILHAND-Kids para el portugués brasileño, adaptar culturalmente y verificar su validez y confiabilidad. El ABILHAND-Kids fue traducido para el portugués y la traducción reversa fue hecha por dos traductores independientes en cada fase. Después de aprobación del comité, la versión pré-prueba fue aplicada en 40 voluntarios con hijos presentando parálisis cerebral para verificar la comprehensión de los ítems. Participaron del análisis de las propriedades psicométricas 21 voluntarios. La reproducibilidad fue verificada por análisis de confiabilidad intra y interevaluador y validez por correlación con el Box and Block Test, el Purdue Pegboard Test y la fuerza de prensión manual. El ABILHAND-Kids demonstró alta confiabilidad intra (ICC=0,91) y interevaluadora (ICC=0,97), y alta consistencia interna (Alfa de Cronbach: 0.99). El ABILHAND-Kids presentó correlación significativa con el Box and Block Test (realizado por el miembro superior dominante), el Purdue Pegboard Test y la fuerza de prensión. La versión brasileña del ABILHANDKids es válida y confiable para evaluar la función de miembros superiores en niños con parálisis cerebral basado en la percepción de sus padres.O objetivo deste estudo foi traduzir o ABILHAND-Kids para o português brasileiro, adaptá-lo culturalmente e verificar sua validade e confiabilidade. O ABILHAND-Kids foi traduzido para o português e a tradução reversa foi feita por dois tradutores independentes em cada fase. Após a aprovação do comitê, a versão pré-teste foi aplicada em 40 voluntários com filhos com paralisia cerebral para verificar a compreensão dos itens. Participaram da análise das propriedades psicométricas 21 voluntários. A reprodutibilidade foi verificada por análise da confiabilidade intra e interavaliador e a validade pela correlação com o Box and Block Test, Purdue Pegboard Test e força de preensão manual. O ABILHAND-Kids demonstrou alta confiabilidade intra-avaliador (ICC=0,91) e interavaliador (ICC=0,97) e alta consistência interna (Alfa de Cronbach: 0,99). O ABILHAND-Kids apresentou correlação significativa com Box and Block Test (realizado pelo membro superior dominante), com o Purdue Pegboard Test and a força de preensão. A versão brasileira do ABILHANDkids é válida e confiável para avaliar a função de membros superiores em crianças com Paralisia Cerebral, com base na percepção de seus pais

Percepción subjetiva del esfuerzo en el liminar anaeróbico en pacientes con enfermedad arterial coronaria

The study aimed to identify and compare the ratings of perceived exertion (RPE) at the ventilatory anaerobic threshold (VAT) in healthy subjects and patients with coronary artery disease (CAD). A total of 30 male subjects took part in the study and were divided into three groups: a control group (CG) composed of 10 healthy participants; a group composed of 10 participants diagnosed with CAD beta-blocker user (G-DACb); and a group composed of 10 participants with CAD non-beta-blocker user (G-DAC). The participants performed a cardiopulmonary exercise test (CPET) with continuous type ramp protocol to determine the VAT, through the visual graphical analysis (loss of parallelism between the oxygen uptake and the carbon dioxide output). During CPET, before the end of each one-minute period, the subjects were asked to rate dyspnea (RPE-D) and leg fatigue (RPE-L) on the Borg CR-10 scale. After the VAT was determined, the score that the participants gave on the Borg CR10 scale was verified. CG participants showed higher workload, oxygen uptake, carbon dioxide output, ventilation and heart rate at the VAT compared to the G-DAC and G-DACb (pEl objetivo del estudio fue identificar y comparar la percepción subjetiva del esfuerzo (PSE) en el liminar anaeróbico ventilatorio (LAV) en sujetos sanos y con enfermedad arterial coronaria (EAC). Fueron estudiados 30 hombres siendo10 sanos que constituyeron el grupo control (GC) y 20 diagnosticados con EAC, de los cuales 10 utilizaban medicamento betabloqueante (G-DACb) y 10 no utilizaban (G-DAC). Los voluntarios fueron sometidos a una prueba de ejercicio cardiopulmonar (TECP) con protocolo continuo tipo rampa para la determinación del LAV, a través del análisis gráfico visual (pérdida del paralelismo entre el consumo de oxígeno y producción de dióxido de carbono). Durante la realización del TECP, se pidió a los voluntarios que informaran al final de cada minuto la percepción subjetiva del esfuerzo de los miembros inferiores (PSE-M) y la percepción subjetiva del esfuerzo respiratorio (PSE-R) a través de la escala de Borg CR-10. El GC presentó mayores valores de potencia, consumo de oxígeno, producción de dióxido de carbono, ventilación y frecuencia cardiaca en el LAV comparado con los grupos G-DAC y G-DACb (pO objetivo do estudo foi identificar e comparar a percepção subjetiva do esforço (PSE) no limiar anaeróbio ventilatório (LAV) em indivíduos saudáveis e com doença arterial coronariana (DAC). Foram estudados 30 homens, sendo 10 saudáveis que constituíram o grupo controle (GC) e 20 diagnosticados com DAC, dos quais 10 faziam uso de medicamento betabloqueador (G-DACb) e 10 não faziam uso (G-DAC). Os voluntários foram submetidos a um teste de exercício cardiopulmonar (TECP) com protocolo contínuo tipo rampa para determinação do LAV, através da análise visual gráfica (perda do paralelismo entre o consumo de oxigênio e a produção de dióxido de carbono). Durante a realização do TECP, foi solicitado aos voluntários que relatassem ao final de cada minuto a percepção subjetiva do esforço de membros inferiores (PSE-M) e a percepção subjetiva do esforço respiratório (PSE-R), através da escala CR-10 de Borg. O GC apresentou maiores valores de potência, consumo de oxigênio, produção de dióxido de carbono, ventilação e frequência cardíaca no LAV comparado aos grupos G-DAC e G-DACb (

Cardiovascular control in women with fibromyalgia syndrome: Do causal methods provide nonredundant information compared with more traditional approaches?

The cardiovascular autonomic control and the baroreflex sensitivity (BRS) have been widely studied in FMS patients through the computation of linear indices of spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities. However, there are many methodological difficulties regarding the quantification of BRS by the traditional indices especially in relation to the issue of causality. This difficulty has been directly tackled via a model-based approach describing the closed loop HP-SAP interactions and the exogenous influences of respiration. Therefore, we aimed to assess if the BRS assessed by the model-based causal closed-loop approach during supine and active standing in patients with FMS could provide complementary information to those obtained by traditional indices based on time and frequency domains. The findings of this study revealed that, although the traditional methods to quantify BRS did not show any significant differences between groups, the causality analysis applied to the HP, SAP and respiratory series, through the model based closed loop approach, detected lower BRS in supine position as well as a blunted response to the orthostatic stimulus in patients with FMS compared to healthy control subjects. Also, the strength of the causal relation from SAP to HP (i.e., along the cardiac baroreflex) increased during the active standing only in the control subjects. The model-based closed-loop approach proved to provide important complementary information about the cardiovascular autonomic control in patients with FMS

Justification of suicide terrorism and the gendered interpretation. Case study: Al-Qaeda & ISIS

Terrorism has been a controversial and focal point for discussion with many perspectives on the subject.The objective of this thesis is to present the justifications of suicide terrorism, focusing on Al-Qaeda and ISIS in Iraq with a comparative analysis. The gendered interpretation is also taken into account to present how this contradicts female participation in terrorism. The purpose of this thesis is to engage in terrorism studies from a different perspective and stress the inclusion of the role of women as this is often underestimated and hence used strategically by terrorist groups. In terms of justifications, this thesis investigates the strategic, social and individual logics set out by Pape (2005) in order to analyse the different reasons behind suicide terrorism and how terrorist organizations can justify their acts in relation to the broader goal. The gendered interpretation concept refers to the existence of masculine and feminine ideals that are connected to specific roles and activities in society. In this sense, prejudice based on gender is often the result and women’s capabilities to perform an attack are underestimated. The similarities and differences of Al-Qaeda and ISIS are teased out in terms of deployment of women and logics of suicide terrorism. The findings show that foreign presence in Iraq tend to drive both terrorist groups to their acts to free the territories. By connecting the Islamic ideology to the organizations, recruitment and support among the communities are facilitated. Individual motivations to participate in terrorism are mostly related to identity and religious attachments. By referring to terrorism as a masculine activity, women’s capabilities are underestimated based on their image and traditional feminine ideals. Hence, the dangers of a gendered interpretation are presented as this strategy can be used by terrorist organizations to conduct deadly attacks with many casualties by deploying women suicide bombers

Potential Soil Remineralizers from Silicate Rock Powders (SRP) as Alternative Sources of Nutrients for Agricultural Production (Amazon Region)

The demand for mineral fertilizers has increased over the years. In the states of Amazonas and Roraima, acquiring conventional fertilizers used in agriculture is challenging due to the distance from large production centers. In these regions, alternative fertilizers are needed to maintain food security. However, research in agrominerals of silicate rock powders (SRP) is still incipient. The objective of this research was to characterize three important Units of Agrogeological Interest in the Manaus/Boa Vista axis in the Amazon region of Brazil: (i) EBAM Quarry: quartz monzonites from the Água Branca suite, partially potassified, (ii) Granada Mining Quarry: basalts from the Apoteri formation, and (iii) Samauma Quarry: riolites from the Iricoumé Group. Samplings were carried out followed by chemical analyses for determining macro and micronutrients, in addition to potentially toxic elements; petrographic analyses were performed for mineralogical characterization as well as granulometric analyses of the powders collected in the quarries. The results showed that the EBAM quarry rock powder meets the standards established by Brazilian legislation. It also has low levels of potentially toxic elements and only 15% quartz, indicating good safety in the use of this SRP, in addition to the large supply of the material already crushed, for which there is still no market. At the Granada Mineração quarry, SRP also has the necessary characteristics to classify as a soil remineralizer, including K2O content above 1%. At Pedreira Samauma, although SRP does not qualify as an agromineral, it has more than 5% K2O and 77% aphanitic matrix, which could result in a more accessible release of abundant K and Si to the soil–plant system. Using laser granulometry analysis, it was possible to make some considerations about the effects of the crushing process in such different lithotypes and, finally, to characterize and classify the prospects of greatest interest for “rochagem” in the Amazon

Soluble interleukin-1 receptor type 2 plasma levels in Parkinson’s disease: relationship with cardiac autonomic profile before and after peripheral mechanical somatosensory stimulation

Introduction: Systemic inflammation promotes neurodegeneration in Parkinson’s disease (PD). Interleukin-1 receptor type 2 (sIL-1R2) plasma levels increase during inflammation. Data on sIL-1R2 in PD patients and its relationship with PD cardiac autonomic profile are limited, given the possible anti-inflammatory effect of vagal activation. Previously, automated mechanical peripheral somatosensory stimulation (AMPSS) enhanced cardiac vagal modulation. Objectives were to 1) evaluate sIL-1R2 plasma concentrations in PD patients and healthy controls and 2) investigate the correlations between sIL-1R2 and cardiac autonomic indices obtained by spectrum analysis of heart rate variability before and after AMPSS.Methods: sIL-1R2 plasma levels were assessed in 48 PD patients and 50 healthy controls. Electrocardiogram and beat-by-beat arterial pressure were recorded at baseline and after 5 AMPSS sessions in 16 PD patients.Results: PD patients had higher sIL-1R2 levels than controls. In the PD subgroup, an inverse correlation between sIL-1R2 and HFnu was found. There was a negative correlation between changes induced by AMPSS on HFnu and sIL-1R2.Discussion: Higher sIL-1R2 levels in PD patients reflect the inflammatory dysregulation associated with the disease. In PD patients, higher sIL-1R2 was associated with reduced cardiovagal tone. Increased cardiovagal modulation following AMPSS was associated with lower sIL-1R2 levels in Parkinson’s disease patients, suggesting inflammatory state improvement

Avaliação cardiorrespiratória e efeitos da hidroterapia em mulheres com síndrome fibromiálgica

Fibromyalgia syndrome (FMS) is a non-inflammatory chronic pain syndrome characterized by diffuse musculoskeletal pain. Advances have been made in underlying its etiology and pathophysiology and some evidence has suggested that autonomic dysfunction plays an important role in FMS. Thus, the present thesis consisted of three studies in order to elucidate unknown aspects regarding the autonomic cardiovascular control in women with FMS. The Study I, entitled "Respiratory sinus arrhythmia and its association with pain in women with fibromyalgia syndrome", aimed to evaluate the autonomic modulation of heart rate (HR) at rest and during the deep breathing test, as well as to evaluate possible associations between cardiac autonomic indices and the pain in women with FMS. The results suggest that women with FMS present compromised neurocardiac integrity, which is associated with the pain and the impact on quality of life. The Study II, entitled "Cardiovascular Control in women with fibromyalgia syndrome: the causal methods provide complementary information to traditional methods?", aimed to assess whether the baroreflex sensitivity assessed by the model-based causal closedloop approach based on spontaneous RR and systolic arterial pressure variabilities during supine and active standing in patients with FMS could provide complementary information to those obtained by traditional indices based on time and frequency domains. The model-based causal closed-loop method provided complementary information on the cardiovascular autonomic control, revealing reduced baroreflex sensitivity, a reduced strength of the baroreflex control as well as a blunted response to the orthostatic stimulus in FMS patients. The Study III, entitled "Effects of a hydrotherapy program on symbolic dynamics and complexity of heart rate variability and aerobic capacity in women with fibromyalgia syndrome", aimed to evaluate the effects of a hydrotherapy program on aerobic capacity and linear and non-linear dynamics of heart rate variability in women with FMS. A 16-week hydrotherapy program proved to be effective in improving symptoms, aerobic functional capacity and cardiac autonomic control in women with FMS. The improvement in non-linear dynamics of HR variability was associated with the improvement of pain and the impact of FMS on the quality of life.Financiadora de Estudos e ProjetosA síndrome fibromiálgica (SFM) é uma síndrome dolorosa crônica não inflamatória, caracterizada por dores musculoesqueléticas difusas. Avanços têm sido realizados para o entendimento da sua etiologia e fisiopatologia e algumas evidências têm sugerido que a disfunção autonômica exerce importante papel na SFM. Assim, a tese foi composta por três estudos com o intuito de elucidar aspectos ainda desconhecidos sobre o controle autonômico cardiovascular em mulheres com SFM. O Estudo I, intitulado Arritmia sinusal respiratória e sua associação com a dor em mulheres com síndrome fibromiálgica , teve como objetivo avaliar a modulação autonômica da frequência cardíaca (FC) em repouso e durante a manobra de acentuação da arritmia sinusal respiratória, bem como avaliar possíveis associações entre os índices autonômicos e a dor em mulheres com SFM. Os resultados sugerem que mulheres com SFM apresentam comprometimento da integridade neurocárdica, a qual está associada à dor e ao impacto na qualidade de vida. O Estudo II, intitulado Controle cardiovascular em mulheres com síndrome fibromiálgica: os métodos causais fornecem informações complementares aos métodos tradicionais? . Esse estudo objetivou avaliar se a aplicação do método model-based causal closed-loop na quantificação da sensibilidade barorreflexa, nas posturas supina e ortostática em mulheres com SFM, fornece informações complementares àquelas proporcionadas pelos índices tradicionais baseados nos domínios do tempo e da frequência. O método model-based causal closed-loop permitiu obter informações complementares, extremamente relevantes, sobre o controle autonômico cardiovascular, revelando comprometimento da função barorreflexa em pacientes com SFM, em relação ao grupo saudável, em repouso e frente ao estímulo ortostático. O Estudo III, intitulado Efeitos de um programa de hidroterapia nas dinâmicas simbólicas e de complexidade da variabilidade da frequência cardíaca e na capacidade aeróbia em mulheres com síndrome fibromiálgica teve como objetivo verificar a influência da hidroterapia sobre as variáveis cardiorrespiratória e sua relação com a dor e com a qualidade de vida em mulheres com SFM. Um programa de hidroterapia de 16 semanas mostrou ser efetivo em melhorar os sintomas, a capacidade funcional aeróbia e o controle autonômico cardíaco em mulheres com SFM. A melhora na dinâmica não linear da variabilidade da FC se associou com a melhora da dor e do impacto da SFM na qualidade de vida

Evaluation of maximal inspiratory and sniff nasal inspiratory pressures in pre- and postoperative myocardial revascularization

OBJECTIVE: The objective of this study was to evaluate and correlate inspiratory muscle strength using maximal inspiratory pressure (MIP) and sniff nasal inspiratory pressure (Pnsn) in patients with coronary artery disease in pre- and postoperative of myocardial revascularization surgery. METHODS: Thirty-eight men were studied, divided into a control group (CG) comprised of healthy individuals (n=18), age 55.52 ± 7.8 years and a myocardial revascularization group (MRG), comprised of patients with coronary artery disease submitted to myocardial revascularization (n=20), age 58.44 ± 9.3 years. All volunteers were submitted to MIP and Pnsn measurement, and the MRG was evaluated in the preoperative period and on the first postoperative day (PO1). RESULTS: MRG presented MIP (80.60 ± 26.60 cmH2O) and Pnsn (74.70 ± 31.80 cmH2O) values inferior to CG (MIP: 112.22 ± 32.00 cmH2O; Pnsn: 103.70 ± 34.10 cmH2O), and there was significant reduction of these values on PO1 (MIP: 40.05 ± 15.70 cmH2O; Pnsn: 40.05 ± 16.60 cmH2O). There was correlation and concordance between evaluation methods in both groups studied, as well as in pre- and postoperative MRG conditions. CONCLUSIONS: The results showed that the studied patients presented reduced MIP and Pnsn pre- and post-operative myocardial revascularization. Also, the Pnsn correlated with MIP and can be considered suitable for assessing inspiratory muscle strength in this population