Prevalence of diabetic foot and its risk factors in the state of espirito santo, brazil

Introdução: O Pé Diabético (PD) é a principal causa de amputações não traumáticas nos países ocidentais, causando morte ou incapacidade física e mental, má qualidade de vida e alto custo para a sociedade. Objetivo: Analisar a prevalência de DF e fatores de risco relacionados na população diabética residente no Estado do Espírito Santo, Brasil. Métodos: Estudo transversal, descritivo, com delineamento de série temporal, utilizando dados secundários de morbidade de indivíduos com DF residentes no Estado do Espírito Santo, cadastrados e acompanhados pelo Sistema de Cadastro e Acompanhamento de Hipertensos e Diabéticos. Resultados: Dos 64.196 diabéticos, 3,9% tinham DM tipo 1, 10,9% DM tipo 2 e 85,2% eram hipertensos. A prevalência de DF foi de 2,9% no DM tipo 1, 3,3% no DM tipo 2 e 4,5% no DM com hipertensão. Maiores taxas de DF foram observadas no sexo masculino, com idade acima de 60 anos no DM tipo 1 e tipo 2, e até 19 anos no DM com hipertensão, tabagismo, sedentarismo, Infarto Agudo do Miocárdio (IAM), AVC e Doença Renal Crônica (DRC) ). Nos indivíduos com excesso de peso, a prevalência de DF foi maior apenas no DM tipo 1. Houve associação significativa em todas as variáveis exceto sobrepeso em ambos os tipos de DM, sedentarismo e acidente vascular cerebral no DM tipo 1. Conclusão: Os achados mostraram importantes prevalências de DF, com maior concentração em homens com mais de 60 anos, sobre tabagismo, sedentarismo, IAM, AVC e DRC, com associação estatística significativa nas variáveis analisadas, com exceção do excesso de peso em ambos os tipos de DM, como bem como sedentarismo e acidente vascular cerebral no DM tipo 1.

Introduction: Diabetic Foot (DF) is the leading cause of non-traumatic amputations in Western countries, causing death or physical and mental disability, poor quality of life and high cost to society. Objetive: To analyze the prevalence of DF and related risk factors in the diabetic population residing in Espírito Santo State, Brazil. Methods: Cross-sectional, descriptive study with time series design, using secondary data on morbidity of individuals with DF living in the State of Espírito Santo, registered and followed by the Hypertensive and Diabetic Registration and Monitoring System. Results: From 64,196 diabetic patients, 3.9% had Type 1 DM, 10.9% Type 2 DM and 85.2% had hypertension. The prevalence of DF was 2.9% in type 1 DM, 3.3% in type 2 DM and 4.5% in DM with hypertension. Higher rates of DF were observed in males, aged over 60 years in type 1 and type 2 DM, and up to 19 years in DM with hypertension, smoking, sedentary lifestyle, Acute Myocardial Infarction (AMI), stroke and Cronic Kidney disease (CKD). In overweight individuals, the prevalence of DF was higher only in type 1 DM. There was a significant association in all variables except overweight in both types of DM, sedentary lifestyle and stroke in type 1 DM. Conclusion: Findings showed important prevalence of DF, with higher concentration in men older than 60 years, on smoking, sedentary lifestyle, AMI, stroke and CKD, with significant statistical association in the analized variables, except for overweight in both types of DM, as well as sedentary lifestyle and stroke in type 1 DM.

Instruments for augmentative and alternative communication for children with autism spectrum disorder: a systematic review

New technologies designed to improve the communication of autistic children can also help to promote interaction processes and cognitive and social development. The aim of this study was to analyze the instruments used to improve the communication skills of children with autism spectrum disorder. We searched the PubMed and Web of Science databases using the descriptors "autism", "Asperger", "education", "children" and "assistive technology" and selected articles that met the following inclusion criteria: (i) original research; (ii) written in English; (iii) based on participants with a primary diagnosis of autism spectrum disorder; and (iv) tested an instrument designed to promote communication in children with autism spectrum disorder. Our search retrieved 811 articles, of which 34 met the inclusion criteria. Data on 26 instruments were extracted, and the measurement properties of the instruments were combined with information about their outcomes and presentation. The most commonly used interventions were the Treatment and Education of Autistic and Related Communication Handicapped Children program and the Picture Exchange Communication System. The Treatment and Education of Autistic and Related Communication Handicapped Children program was shown to produce improvements in the communication skills, socialization and self-care skills of children with autism spectrum disorder. The Picture Exchange Communication System produced inconsistent results. The results of the identified studies confirm the significant importance of these instruments in improving the communicative process of autistic children.

Motor learning through virtual reality in elderly - a systematic review / Aprendizado motor através de realidade virtual em idosos

INTRODUCTION: Decline in physical function is a common feature of older age and has important outcomes in terms of physical health as it relates to quality of life. Our capacity for motor learning allows us to flexibly adapt movements to an ever-changing environment. The term Virtual Reality refers to a wide variety of methods used to simulate an alternative or virtual world. OBJECTIVE: To analyze the results shown in previous studies on motor learning with Virtual Reality use in elderly participants. METHOD: To select the articles, three steps were followed. A systematic literature review was performed without time limitation. The research was carried out using PubMed, BVS and Web of science; considering the keywords, we included articles that showed the following three terms: elderly, virtual reality and motor learning. RESULTS: The initial search yielded 49 articles. After duplicates were removed, two of the authors independently evaluated the title and abstract of each article against the study inclusion criteria. From these, 45 articles were excluded based on title and abstract. Finally, four articles met the inclusion criteria. CONCLUSION: Although few studies were conducted on motor learning in elderly people through virtual reality and, even fewer were of good quality, it was shown that elderly people, with or without a specific disease, can benefit from interventions based on virtual reality to improve motor learning skills.

INTRODUÇÃO: O Declínio da função física é uma característica comum de idade avançada e tem consequências importantes em termos de saúde física e qualidade de vida. Nossa capacidade de aprendizagem motora nos permite adaptar movimentos a um ambiente em constante mudança. A expressão Realidade Virtual refere-se a uma ampla variedade de métodos usados para simular uma alternativa ao mundo virtual. OBJETIVO: Analisar os resultados apresentados em estudos anteriores sobre aprendizagem motora com o uso de Realidade Virtual em participantes idosos. MÉTODO: Para selecionar os artigos, três etapas foram seguidas. Uma revisão sistemática da literatura foi realizada sem limitação de tempo. A pesquisa foi realizada utilizando PubMed, BVS e Web os Science; considerando-se as palavras-chave, incluímos artigos que apresentaram os três seguintes termos:, realidade virtual idosos e aprendizagem motora. RESULTADOS: A busca inicial rendeu 49 artigos. Depois da remoção de duplicações, dois dos autores avaliaram independentemente o título e o resumo de cada artigo em relação aos critérios de inclusão do estudo. Destes, 45 artigos foram excluídos com base no título e resumo. Finalmente, quatro artigos preencheram os critérios de inclusão. CONCLUSÃO: Embora poucos estudos foram encontrados sobre a aprendizagem motora em pessoas idosas através da realidade virtual e, menos ainda eram de boa qualidade, foi mostrado que as pessoas idosas, com ou sem uma doença específica, podem se beneficiar de intervenções com base na realidade virtual para melhorar a habilidades de aprendizagem motora.

The education and language of indigenous peoples of the northern tyumen region: an analysis of tendencies and development perspectives

National education and native language are potential points of safety and development for indigenous small-numbered peoples OBJECTIVE: to analyze the tendencies in the field of native language and national education of indigenous small-numbered peoples of the Northern Tyumen region METHODS: descriptive and retrospective analysis of sociological monitoring was conducted from 1993 to 2011 over two-year intervals to reveal indigenous peoples' problems RESULTS: in 1993, 35% of indigenous small-numbered peoples of the Northern Tyumen region noted that they had mastered the native language, while only 24% did not master the language. Whereas towards 2011, only 6% of these peoples had mastered their native language and 65% had not mastered the language. At the end of our research, in 2011, an absolute majority of respondent indigenous peoples noted the need for lessons of their native language, 70% study in Russian language and 30% would like to study the native language CONCLUSION: there is a tendency of the indigenous small-numbered peoples of the Northern Tyumen region to assimilate their native language and they have a high interest in having their native language included as a component of national education...

A educação nacional e língua nativa são potenciais pontos de segurança e desenvolvimento para os pequenos povos indígenas OBJETIVO: analisar as tendências no domínio da língua materna e da educação nacional dos pequenos povos indígenas da região Norte de Tyumen, na Rússia MÉTODO: foi realizada uma análise sociológica descritiva e retrospectiva entre 1993 e 2011, em intervalos de dois anos RESULTADO: em 1993, 35% dos pequenos povos indígenas da região Norte de Tyumen observaram que tinham domínio da língua nativa, enquanto apenas 24% não dominavam a língua. Em 2011, apenas 6% desses povos dominavam sua língua nativa e 65% não dominavam. Ao final da pesquisa, em 2011, a maioria absoluta dos povos indígenas estudados referiram a necessidade de lições de sua língua nativa. 70% dessa população estudava no idioma russo e os outros 30% gostariam de estudar em sua língua nativa CONCLUSÃO: há uma tendência dos pequenos povos indígenas da região Norte de Tyumen em assimilar sua língua nativa e eles têm grande interesse em ter seu idioma nativo incluído como um componente da educação nacional...

Prediction of trip severity based on tri-axial accelerometry in healthy older adults

INTRODUCTION: falls among elderly are apublic health problem and fall prevention is of utmost importance. The ability to recovery from a trip or not might be indicative for fall risk OBJECTIVE: toanalyse the relationship between trunk accelerations during the initial phase of tripping and the severity of a tripin healthy older adults METHODS: fourteen healthy older adults (65-73 yrs)walked multiple times over a platform with embedded obstacles and were tripped while trunk accelerations were assessed. Supported bodyweight (BW) by a safety harness was used to classify severity of the tripping outcome into high (>50%BW) or low (<50%BW). Twelve parameters obtained from the acceleration signals and their derivatives (jerk) within the first second after tripping initiation and were divided into three levels of parameter values with equal amount of trials. These low, medium and high values were tested for their association with trip severity in a logistic regression analysis RESULTS: three acceleration parametersappeared to be significant predictors oftrip severity. High values of minimum anterior-posterior acceleration and minimum vertical jerkshowed lower likelihood of resulting in a high severity trip than in the low values (33% and 32%, respectively). Medium values of the maximum anterior-posterior accelerationshowed higher likelihood of resulting in a high severity trip than the low values (327%) CONCLUSION: high acceleration and jerk peaks detected within the first second after tripping predict a more severe outcome, indicating that trunk tri-axial accelerometryhas the potential to predict the severity oftripping outcome in healthy older adults.

Inflammatory breast neoplasms: a systematic review

OVERVIEW: Inflammatory Breast Cancer (IBC) is a rare and very aggressive type of cancer that tends to develop at a younger age, compared with other subtypes of breast cancer. Because a distinct lump may not be noticeable, correct diagnosis takes longer and, therefore, successful treatment may hinder a patient's prognostics. This study aims to conduct a systematic review of research articles on IBC. METHODS: This is a systematic review of studies in the PubMed database to April 2013, which fit the eligibility criterion of "Inflammatory Breast Neoplasms" (MeSH Terms), filtered by Languages (English OR Portuguese OR Spanish). FINDINGS: Of the 119studies identified, 25 complied with the eligibility criterion for the disease, diagnostics, treatment and prognostics. FINAL CONSIDERATIONS: Despite methodological differences, findings evidence that although IBC presents particular features (lower survival rate and worse prognostics than most types of breast cancer), very few studies examine its epidemiology and specific risk factors in depth and use any other therapeutic approaches than those commonly used for other breast cancer subtypes. Therefore, further investigation of the disease's aggressiveness is still necessary.