Ethnobotanical knowledge on non-conventional food plants and medicinal plants in Extractivist Reserve in the Brazilian Amazon / Conocimiento etnobotánico sobre plantas alimenticias no convencionales y plantas medicinales en una Reserva Extractivista en la Amazonía Brasileña

Information on the knowledge and ways of using food and medicinal plants by traditional populations, family farmers and Brazilian native population in the Amazon is essential to guarantee the food sovereignty of these groups. This study was conducted using semi-structured interviews applied to local respondents. A total of 269 species of both non-conventional food plants and medicinal plants were identified, distributed in 83 botanical families and 198 genera. The Arecaceae and Lamiaceae families had the highest species richness (11 and 7, respectively). The Shannon-Wiener (H') and Pielou (J') diversity indices were considered high (5.02 and 0.9, respectively) when compared to other ethnobotanical works. In the environment in which these families are found, these species become the only food and medicinal resources available.

La información sobre los saberes y formas de uso de las plantas alimenticias y medicinales por parte de las poblaciones tradicionales, agricultores familiares e indígenas brasileños en la Amazonía es fundamental para garantizar la soberanía alimentaria de estos grupos. Este estudio se realizó utilizando entrevistas semiestructuradas aplicadas a encuestados locales. Se identificaron un total de 269 especies tanto de plantas alimenticiasno convencionales como de plantas medicinales, distribuidas en 83 familias botánicas y 198 géneros. Las familias Arecaceae y Lamiaceae tuvieron la mayor riqueza de especies (11 y 7, respectivamente). Los índices de diversidad de Shannon-Wiener (H') y Pielou (J') fueron considerados altos (5,02 y 0,9, respectivamente) en comparación con otros trabajos etnobotánicos. En el ambiente en que se encuentran estas familias, estas especies se convierten en los únicos recursos alimenticios y medicinales disponibles.

Renal Sympathetic Denervation: A Comprehensive Review.

In 2017, the American College of Cardiology and American Heart Association released its updated blood pressure guidelines, redefining hypertension to be any systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. Among United States adults, these new parameters increased the prevalence of hypertension from 72.2 million (31.9%) to 103.3 million (45.6%) adults and decreased the rate of medication-controlled hypertension from 53.4% to 39% with the prevalence of resistant hypertension ranging from 12% to 18%. Results of the pivotal SPRINT trial showed that more intensive blood pressure control in diabetic patients decreased both cardiovascular events and all-cause mortality. However, even with ideal goals in mind, compliance remains an issue due to multiple causes, and approximately half of study participants had stopped taking their antihypertensive drug within a year. Renal sympathetic denervation is a process in which catheter-based techniques are used to ablate specific portions of the renal artery nerves with the goal of decreasing sympathetic nerve activity and reducing blood pressure. Several studies using renal artery denervation have already shown benefit in patients with resistant hypertension, and now newer trials are beginning to focus on those with stage II hypertension as an additional potential treatment population. This review will seek to summarize the current evidence surrounding renal artery denervation and discuss some of its future trials, current issues, and potential roles both in hypertension and other comorbidities.

Moral meta-narratives, marginalization, and youth development.

Morality, a central dimension of culture, is crucial for research on the development of youth experiencing marginalization. In this article, we discuss two main meta-narratives as moral frameworks that provide different meaning to the past and to cultural change: liberal progress, focused on the struggle of those who have historically experienced marginalization (e.g., racial/ethnic minorities), and community lost, focused on those who are experiencing some forms of marginalization in response to cultural and economic changes (e.g., rural Whites). Because these two meta-narratives represent a false dichotomy, we use relational epistemology principles-holism, identity of opposites, opposites of identity, and synthesis of wholes-to formulate an integrated metanarrative, community progress, to overcome this polarity and promote research on the development of all youth experiencing marginalization. Acknowledging and understanding these moral meta-narratives is crucial because they influence scientific discourse, political action, and policy that impacts marginalization and youth development. (PsycINFO Database Record

Longitudinal Outcomes Following a Randomized Controlled Trial of Dynamic Splint Stretching for Carpal Tunnel Syndrome.

Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies. The intervention used was Dynasplint stretching that delivered a prolonged duration of low load stretching. Patients who were randomly chosen for the Experimental category wore the device for two 30-minute sessions per day with regular increases in splint tension for 60 days. Control patients received nonsteroidal anti-inflammatory medication plus instructions on daily home stretching. Results: The final, longitudinal outcome showed a 72% reduction in surgery chosen by the experimental group (n = 25), compared with 38% reduction for control patients (n = 25). Conclusions: Immediate treatment with Dynasplint stretching showed a 2 to 1 reduction in surgery, with abundant financial savings.

Systematic review of contracture reduction in the lower extremity with dynamic splinting.

INTRODUCTION: Joint contractures are relatively common disorders that can result in significant, long-term morbidity. Initial treatment is non-operative and often entails the use of mechanical modalities such as dynamic and static splints. Although widely utilized, there is a paucity of data that support the use of such measures. The purpose of this systematic review was to evaluate the safety and efficacy of dynamic splinting as it is used to treat joint contracture in lower extremities, and to determine if duration on total hours of stretching had an effect on outcomes. METHODS: Reviews of PubMed, Science Direct, Medline, AMED, and EMBASE websites were conducted to identify the term 'contracture reduction' in manuscripts published from January 2002 to January 2012. Publications selected for inclusion were controlled trials, cohort studies, or case series studies employing prolonged, passive stretching for lower extremity contracture reduction. A total of 354 abstracts were screened and eight studies (487 subjects) met the inclusion criteria. The primary outcome measure was change in active range of motion (AROM). RESULTS: The mean aggregate change in AROM was 23.5º in the eight studies examined. Dynamic splinting with prolonged, passive stretching as home therapy treatment showed a significant direct, linear correlation between the total number of hours in stretching and restored AROM. No adverse events were reported. DISCUSSION: Dynamic splinting is a safe and efficacious treatment for lower extremity joint contractures. Joint specific stretching protocols accomplished greater durations of end-range stretching which may be considered to be responsible for connective tissue elongation.

Relationism and relational developmental systems: a paradigm for developmental science in the post-Cartesian era.

This chapter argues that the Cartesian-split-mechanistic scientific paradigm that until recently functioned as the standard conceptual framework for subfields of developmental science (including inheritance, evolution, and organismic--prenatal, cognitive, emotional, motivational, sociocultural--development) has been progressively failing as a scientific research program. An alternative scientific paradigm composed of nested metatheories with relationism at the broadest level and relational developmental systems as a midrange metatheory is offered as a more progressive conceptual framework for developmental science. Termed broadly the relational developmental systems paradigm, this framework accounts for the findings that are anomalies for the old paradigm; accounts for the emergence of new findings; and points the way to future scientific productivity.

Relational developmental systems: a paradigm for developmental science in the postgenomic era.

This commentary argues that the anomalies suffered by the population behavior genetics paradigm are more widespread than suggested by Charney, including many made in the field of developmental science. Further, it is argued that, according to the criteria established by Kuhn, there is and has been available an alternative scientific paradigm that provides the formative context for Charney's postgenomic view. This is the relational developmental systems paradigm.

Dynamic splinting for postoperative hallux limitus: a randomized, controlled trial.

BACKGROUND: Hallux limitus (HL) is a pathology of degenerative arthritis in the first metatarsophalangeal joint (MTJ) of the great toe. Chief complaints of HL include inflammation, edema, pain, and reduced flexibility. The onset of HL commonly occurs after one of the two most common surgical procedures for foot pathologies, a bunionectomy or a cheilectomy. The purpose of this study is to determine the efficacy of dynamic splinting in treating patients with postoperative hallux limitus, in a randomized, controlled trial. METHODS: Fifty patients (ages 29 to 69) were enrolled after diagnosis of HL following surgery. The duration of this study was eight weeks, and all patients received nonsteroidal anti-inflammatory drugs, orthotics, and instructions for a home exercise program. Experimental patients were also treated with dynamic splinting for first MTJ extension (60 minutes, three times per day). The dependent variable was change in active range of motion (AROM). A repeated measures analysis of variance was used with independent variables of patient categories, surgical procedure (cheilectomy vs. bunionectomy) and duration since surgery. RESULTS: There was a significant difference in change of AROM for experimental vs. control patients (P < 0.001, T = 4.224, N = 48); there was also a significant difference for patient treated within 2 months of surgery (P = 0.0221). CONCLUSIONS: Dynamic splinting was effective in reducing contracture of postoperative hallux limitus in this study; experimental patients gained a mean 250% improvement in AROM. This modality should be considered for standard of care in treating postoperative hallux limitus.

Dual-systems and the development of reasoning: competence-procedural systems.

Dual-system, dual-process, accounts of adult cognitive processing are examined in the context of a self-organizing relational developmental systems approaches to cognitive growth. Contemporary adult dual-process accounts describe a linear architecture of mind entailing two split-off, but interacting systems; a domain general, content-free 'analytic' system (system 2) and a domain specific highly contextualized 'heuristic' system (system 1). In the developmental literature on deductive reasoning, a similar distinction has been made between a domain general competence (reflective, algorithmic) system and a domain specific procedural system. In contrast to the linear accounts offered by empiricist, nativist, and/or evolutionary explanations, the dual competence-procedural developmental perspective argues that the mature systems emerge through developmental transformations as differentiations and intercoordinations of an early relatively undifferentiated action matrix. This development, whose microscopic mechanism is action-in-the-world, is characterized as being embodied, nonlinear, and epigenetic. WIREs Cogni Sci 2011 2 231-237 DOI: 10.1002/wcs.120 For further resources related to this article, please visit the WIREs website.

Dynamic splinting in wrist extension following distal radius fractures.

BACKGROUND: Wrist flexion contracture is a common pathology which presents secondary to distal radius fractures. Joint stability, restoration and early mobilization are frequently achieved through surgical treatment after such an injury. The purpose of this retrospective study was to evaluate the initial effect of dynamic splinting on wrist extension (active range of motion), in both surgical and non-surgical patients following distal radius fractures. METHODS: Records were obtained from 133 patients who were treated with a Wrist Extension Dynasplint (WED) following distal radius fractures, between May 2007 and May 2009. Forty-two of these patients received surgical treatment for their fractures. This study specifically examined the initial usage of the WED as a home therapy. The retrospective analysis included categorization of patients who received the WED exclusively vs. patients who received WED treatment with concurrent hand therapy; surgical categorization included surgical patients vs. nonsurgical patients. RESULTS: There was a significant improvement in maximal active range of motion (AROM) for all patients (P < 0.0001) after a mean duration of 3.9 weeks of dynamic splinting. Patients showed a mean 62% increase in active extension. There was not a significant difference between patients who had received surgical treatment for the fracture vs. nonsurgical. CONCLUSION: This dynamic splinting modality contributed 138 to 185 hours of stretching at the end range of motion for these patients in their first month following fracture. This unique regime is considered directly responsible for significant gains in AROM.

Plantar fasciopathy treated with dynamic splinting: a randomized controlled trial.

BACKGROUND: Plantar fasciopathy (or plantar fasciitis) is considered to be one of the most common foot abnormalities, affecting up to 2 million Americans each year, and the chief complaint is acute heel pain. Therapeutic protocols for this condition have included stretching exercises, corticosteroid injections, physical therapy, and foot orthoses, but a single modality has not been found to be universally effective. We sought to determine the efficacy of stretching with dynamic splinting for the treatment of plantar fasciitis. METHODS: Sixty patients (76 feet) were enrolled in this 12-week study from four different clinics across the United States. Patients were randomly categorized into experimental and control groups. All of the patients received nonsteroidal anti-inflammatory drugs, orthoses, and corticosteroid injections if needed. Thirty experimental patients also received dynamic splinting for nightly wear to obtain a low-load, prolonged-duration stretch with dynamic tension. The dependent variable was change from baseline in Plantar Fasciopathy Pain/Disability Scale score, and the independent variable was group (experimental versus control). RESULTS: Two-sample t tests were calculated, and there was a significant difference in the mean change scores of experimental versus control patients (-33 versus -2 points, P < .0001). CONCLUSIONS: Dynamic splinting was effective for reducing the pain of plantar fasciopathy, and this modality should be included in the standard of care for treating plantar fasciopathy.

Thinking about thinking - thinking about measurement: a Rasch analysis of recursive thinking.

Two studies were conducted to examine the dimensionality and hierarchical organization of a measure of recursive thinking. In Study 1, Rasch analysis supported the claim that the recursive thinking task measures a single underlying dimension. Item difficulty, however, appeared to be influenced not only by level of embeddedness but also by syntactic features. In Study 2, this hypothesis was tested by adding new items to the recursive thinking measure. Rasch analysis of the modified recursive thinking task produced evidence for the undimensionality and segmentation. However, Study 2 did not support the idea that syntactic features influence item difficulty.

Dynamic splinting home therapy for toe walking: a case report.

Serial casting is frequently prescribed for toe-walking but that does not allow continued physical therapy (PT). This report described a child and family who chose dynamic splinting (DS) with concurrent PT for treatment. The patient presented with right hemiparesis; below average motor skills and a gait pattern of toe contact (without ankle foot orthosis). Four months of PT plus 6 hours/night of DS as home therapy, the patient's passive dorsiflexion increased 14 degrees and she gained the ability to walk in "flat foot" contact without the Ankle Foot Orthosis. This concurrent treatment achieved improved gait pattern and strength training not possible with casting.

Frequency of exercise for body fat loss: a controlled, cohort study.

The purpose of this study is to examine the changes in body fat mass of previously sedentary, deconditioned subjects who began following the U.S. Surgeon General's recommendation in frequency of exercise. Ninety subjects of both sexes were recruited; ages ranged from 22 to 74 (mean 37.5 +/- 13) years. Subjects were prescribed exercise of 4 times a week, 30 minutes of continuous exercise, for 8 weeks. Eighty subjects completed the 8-week study and were categorized based on voluntary compliance: control (no exercise); exercise less than 2 times/week; exercise 3 to 4 times/week; exercise 4 or more times/week. Body fat mass was the dependent variable in this study, as measured by air displacement plethysmography, and data analysis was accomplished with a repeated measures analysis of variance. There was a significant change in body fat mass in this study, but the only significant difference between groups was for the group that exercised 4 or more times/week, (p = 0.004). Adherence to the U.S. Surgeon General's Guidelines for frequency of exercising 4 times per week for 30 minutes was effective in reducing subjects' body fat mass in this study.

Adhesive capsulitis and dynamic splinting: a controlled, cohort study.

BACKGROUND: Adhesive Capsulitis (AC) affects patient of all ages, and stretching protocols are commonly prescribed for this condition. Dynamic splinting has been shown effective in contracture reduction from pathologies including Trismus to plantar fasciitis. The purpose of this study was to examine the efficacy of dynamic splinting on patients with AC. METHODS: This controlled, cohort study, was conducted at four physical therapy, sports medicine clinics in Texas and California. Sixty-two patients diagnosed with Stage II Adhesive Capsulitis were grouped by intervention. The intervention categories were as follows: Group I (Control); Group II (Physical Therapy exclusively with standardized protocols); Group III; (Shoulder Dynasplint system exclusively); Group IV (Combined treatment with Shoulder Dynasplint and standardized Physical Therapy). The duration of this study was 90 days for all groups, and the main outcome measures were change in active, external rotation. RESULTS: Significant difference was found for all treatment groups (p < 0.001) following a one-way ANOVA. The greatest change with the smallest standard deviation was for the combined treatment group IV, (mean change of 29 degrees ). CONCLUSION: The difference for the combined treatment group was attributed to patients' receiving the best PT combined with structured "home therapy" that contributed an additional 90 hours of end-range stretching. This adjunct should be included in the standard of care for adhesive Capsulitis. TRIAL NUMBER: NCT00873158.

Dynamic splinting for runner's toe: a case report with gait analysis.

We present a case report of runner's hallux limitus and the effect of dynamic splinting in reducing contracture as measured by gait analysis. After 4 months of treatment with dynamic splinting, the patient regained 45 degrees in active range of motion, and the gait analysis showed significant and beneficial changes.

Dynamic splinting after treatment with botulinum toxin type-A: a randomized controlled pilot study.

INTRODUCTION: Over 1.5 million Americans are diagnosed with a stroke each year, and excessive flexion or extension (hypertonia) of upper extremity joints are common secondary conditions. The purpose of this study was to compare the efficacy of botulinum toxin type-A and manual therapy, with the adjunct treatment of dynamic splinting on range of motion, spasticity, and elbow flexor hypertonia, in a randomized trial. METHODS: Thirty-six subjects were recruited for this pilot study and all exhibited hypertonia in elbow flexion. Six patients were excluded due to noncompliance. Testing was done with pre/post active range of motion in elbow extension, and the Modified Ashworth Scale (extension) for spasticity. All patients received the current standard of care: botulinum toxin type-A injections and manual therapy. Experimental patients were randomly assigned adjunct treatment with Elbow Extension Dynasplint. RESULTS: Thirty patients completed the study (mean age [SD] 52+/-17 years). The percentage of change in active range of motion in elbow extension was greater for the experimental than for control subjects (33.5% vs. 18.7%). The Modified Ashworth Scale (extension) scores showed comparable changes of a mean 9.3% improvement for experimental versus 8.6% for the control subjects. CONCLUSION: This study confirmed the efficacy of botulinum toxin type-A in tone management and occupational therapy in contracture reduction. It also showed the value of dynamic splinting in maintaining gains in range of motion.

Pegfilgrastim for peripheral CD34+ mobilization in patients with solid tumours.

The efficacy of pegfilgrastim+/-chemotherapy for mobilizing stem cells in patients with solid tumours was assessed. In cycle 0, a 14-day prechemotherapy cycle, patients (N=61) were randomized open-label to single doses of pegfilgrastim (6, 12 or 18 mg) on day 1, or daily filgrastim (10 microg/kg) for < or =7 days. Mean peak peripheral CD34+ cell counts increased with pegfilgrastim dose, but were significantly higher than filgrastim only at the 18 mg dose (10.17 vs 4.96 x 10(4)/ml; P=0.014). In the clinically relevant period of days 3-7, both 12 and 18 mg pegfilgrastim doses produced significantly higher peak CD34+ counts (8.18 and 9.96 vs 4.51 x 10(4)/ml for filgrastim; P=0.034 and 0.006). In cycle 1, patients received carboplatin/paclitaxel on day 1, followed from day 2 by pegfilgrastim 6-18 mg or daily filgrastim (5 microg/kg/day for < or =14 days) as per randomization in cycle 0. There were no significant differences in mean peak CD34+ count between pegfilgrastim and filgrastim, but there was an advantage for pegfilgrastim 18 mg in the relevant period of days 7-12 (3.14 vs 1.19 x 10(4)/ml; P=0.043). A single pegfilgrastim dose (> or =6 mg) could be substituted for daily filgrastim in cytokine-only peripheral CD34+ cell mobilization.

Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report.

Total Knee Arthroplasty operations are increasing in frequency, and knee flexion contracture is a common pathology, both pre-existing and post-operative. A 61-year-old male presented with knee flexion contracture following a total knee arthroplasty. Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. After 28 physical therapy sessions, the active range of motion improved from -20 degrees to -12 degrees (stiff knee still lacking full extension), and after eight additional weeks with nightly wear of dynamic splint, the patient regained full knee extension, (active extension improved from -12 degrees to 0 degrees ).

Pegfilgrastim successfully mobilizes megakaryocyte progenitors into the peripheral blood in subjects with solid tumours.

Cytokine-mobilized PBPC transplants result in rapid neutrophil and platelet engraftment following high-dose chemotherapy. A total of 61 patients with solid tumours, sensitive to carboplatin and paclitaxol, were recruited as part of a phase I/II study and randomized to receive a single dose of 6, 12 or 18 mg pegfilgrastim on day 1 of a 14-day prechemotherapy cycle or daily filgrastim (10 microg/kg) for up to 7 days. The kinetics of megakaryocyte progenitor mobilization were studied using immunohistochemical assays and flow cytometry in a subset of 31 patients. There was no significant difference among treatment groups with respect to the timing of total progenitor colony-forming units (CFUs) and megakaryocyte progenitor (CFU-MK) mobilization, with the highest median peak falling on day 4/5 in all groups. In the pegfilgrastim 18 mg group, the mean peak total CFUs and CFU-MK were statistically significantly higher than in the filgrastim group (2.031x10(4) vs 8.06x10(3) per millilitre, P=0.024 and 1.12x10(4) vs 4.56x10(3) per millilitre, P=0.024, respectively). The kinetic profiles generated using immunohistochemical assays for CFU-MK and FACS analysis for CD41a were closely correlated suggesting that CD41a can be used as a surrogate marker for megakaryocytic mobilization.