Multicomponent and mat Pilates training increased gait speed in individuals with Parkinson's disease when walking and carrying a load: A single-blinded randomized controlled trial.

BACKGROUND AND PURPOSE: Gait disorders in individuals with Parkinson's disease (IwPD) are among the most disabling symptoms. Physical exercise has been proposed for the treatment of IwPD because it shows positive effects on gait variables. Given the importance of physical activity in the rehabilitation process of IwPD, the assessment of interventions to identify those most promising for improving or maintaining gait performance is of great relevance. Therefore, this study evaluated the effects of Mat Pilates Training (MPT) and Multicomponent Training (MCT) on the spatiotemporal variables of gait in situations of daily dual-task performance in IwPD. Gait analysis in a daily dual-task context allows the simulation of real-life conditions where individuals have a higher risk of falling than in single-task walking. METHODS: We conducted a single-blinded randomized controlled trial with 34 mild-to-moderate IwPD (Hoehn-Yahr stage 1-2). They were randomized to one of two interventions: MPT or MCT. All participants performed the training for 60 min, three times per week, for 20 weeks. Spatiotemporal gait variables were evaluated in a daily life situation to increase the ecological validity of the measurements, which included gait speed, stride time, double support time, swing time, and cadence. The individuals walked on a platform holding two bags with a load corresponding to 10% of their body mass. RESULTS: After the intervention, there was a significant improvement in gait speed in both groups: MPT (p = 0.047) and MCT (p = 0.015). The MPT group reduced the cadence (p = 0.005) and the MCT group increased the stride length (p = 0.026) after the intervention. DISCUSSION: Both groups had positive effects on gait speed with load transport resulting from the two proposed interventions. However, the MPT group showed a spatiotemporal adjustment of speed and cadence that can increase gait stability, which was not found in the MCT group.

Influência de padrões de multimorbidade nas atividades de vida diária da pessoa idosa: seguimento de nove anos do Estudo Fibra / Influence of multimorbidity patterns on the activities in the day-to-day lives of the elderly: nine-year follow-up of the Fibra Study

Resumo O objetivo foi avaliar a influência da multimorbidade e seus padrões nas atividades básicas de vida diária da pessoa idosa residente na comunidade. Trata-se de estudo de coorte com dados provenientes do Estudo FIBRA, linha de base (2008-2009) e seguimento (2016-2017). As atividades básicas de vida diária (ABVD) foram avaliadas pelo questionário de Katz e as doenças crônicas foram classificadas como (1) multimorbidade e padrões de multimorbidade: (2) cardiopulmonar; (3) vascular-metabólico; e (4) mental-musculoesquelético. Para a análise de dados, utilizou-se o teste qui-quadrado e a regressão de Poisson. Foram analisados 861 indivíduos sem limitação para ABVD na linha de base. As pessoas idosas com multimorbidade (RR = 1,58; IC95%: 1,19-2,10) e classificados nos padrões cardiopulmonar (RR = 2,43; IC95%: 1,77-3,33), vascular-metabólico (RR = 1,50; IC95%: 1,19-1,89) e mental-musculoesquelético (RR = 1,30; IC95%: 1,03-1,65) tiveram maior risco de apresentar declínio funcional nas ABVD no seguimento em comparação aos que não tinham os mesmos padrões de doenças. A multimorbidade e seus padrões aumentaram o risco de incapacidade na pessoa idosa ao longo de nove anos.

Abstract The scope of this article was to evaluate the influence of multimorbidity and associated effects on the activities in the day-to-day lives of community-dwelling elderly individuals. It involved a cohort study with data from the FIBRA Study, the baseline (2008-2009) and follow-up (2016-2017). The basic activities in daily living (ADL) were evaluated using Katz's index, and the chronic diseases were classified as: (1) multimorbidity and multimorbidity patterns; (2) cardiopulmonary; (3) vascular-metabolic; and (4) mental-musculoskeletal. The chi-square test and Poisson regression data were used for analysis. A total of 861 older adults with no functional dependency at baseline were analyzed. Elderly individuals with multimorbidity (RR = 1.58; 95%CI: 1.19-2.10) and classified according to cardiopulmonary (RR = 2.43; 95%CI: 1.77-3.33), vascular-metabolic (RR = 1.50; 95%CI: 1.19-1.89) and mental-musculoskeletal (RR = 1.30; 95%CI: 1.03-1.65) had a higher risk of presenting functional decline in ADL in the follow-up compared to those who didn't have the same disease patterns. Multimorbidity and its patterns increased the risk of functional disability in older adults over the nine-year period.

A single-set functional training program increases muscle power, improves functional fitness, and reduces pro-inflammatory cytokines in postmenopausal women: A randomized clinical trial.

Introduction: Aging can be associated with reduced muscle power, functional decline, and increased plasma concentrations of proinflammatory cytokines. Functional training (FT) can improve muscle power, functional fitness and reduce plasma cytokines. However, the functional training optimal volume required to produce these adaptations must be clarified. Our study analyzed the effects of multiple-set functional training (MSFT) and single-set functional training (SSFT) on postmenopausal women's muscle power, functional fitness, and inflammatory profile. Methods: Forty-three women were randomly allocated into three groups: multiple-set functional training (n = 16, age 64.13 ± 5.17), single-set functional training (n = 14, age 63.79 ± 4.88), and control group (CG, n = 13, age 64.62 ± 5.44). The bench press and squat exercises evaluated upper and lower limb muscle power. The following tests assessed functional fitness: putting on and taking off a T-shirt, gallon-jug shelf-transfer, standing up and walking around the house, five times sit-to-stand, and 400-m walk. Plasma cytokine (TNF-α, IL-6, and IL 10) concentrations were measured by flow cytometry. Results: Single-set functional training and multiple-set functional training increased upper and lower limbs muscle power and improved functional fitness, except for the putting on and taking off a T-shirt test. Multiple-set functional training reduced TNF-α and IL-6, while single-set functional training reduced only TNF-α. IL-10 was unaffected by exercise. Discussion: Single-set functional training and multiple-set functional training, therefore, promoted similar muscle power and functional fitness improvements over 24 weeks. Multiple-set functional training was more effective than single-set functional training, reducing both TNF and IL-6, while single-set functional training only decreased TNF-α.

Musculoskeletal physiotherapy in physical sequelae of SARS-CoV-2 infection: A case report.

BACKGROUND: Patients infected with severe acute respiratory syndrome-CoV-2 can present physical complications that can make the return to their daily physical activities difficult. Despite the positive results in different pathologies through musculoskeletal physiotherapy, there are few reports in post-COVID-19 patients. This case describes an intervention based on musculoskeletal physiotherapy in a post-COVID-19 adult woman with physical sequelae. METHODS: As part of an initial evaluation in a woman with physical sequelaes post-COVID-19, it was decided to conduct a musculoskeletal physiotherapy over a course of 5 weeks distributed in 15 visits. To evaluate her progress the joint ranges were evaluated according to the American Academy of Orthopedic Surgeons (AAOS), the Numerical pain scale was used, the muscle strength evaluated according to the Daniel Scale, and finally the Unipodal Station Test used. RESULTS: Musculoskeletal physiotherapy improved the patient's physical symptoms. The patient's pain was reduced from a value of 10 to 3; the strength of the musculature increased from a value of 2 to 4; initial joint ranges were expanded from 67% to 100% in various body segments. Finally, the woman managed to stay up to 8 s in the monopodal position. DISCUSSION: Using musculoskeletal physical therapy and measuring progress through quantitative measurements at each visit, a post-COVID-19 woman was able to resume her daily physical activities. This therapy is a valuable tool to recover the musculoskeletal system that proves to be an important advance in the recovery of the quality of life in patients with musculoskeletal sequelae from COVID-19.

Assessment of a Robotic Walker in Older Adults With Parkinson's Disease in Daily Living Activities.

The constant growth of the population with mobility impairments, such as older adults and people suffering from neurological pathologies like Parkinson's disease (PD), has encouraged the development of multiple devices for gait assistance. Robotic walkers have emerged, improving physical stability and balance and providing cognitive aid in rehabilitation scenarios. Different studies evaluated human gait behavior with passive and active walkers to understand such rehabilitation processes. However, there is no evidence in the literature of studies with robotic walkers in daily living scenarios with older adults with Parkinson's disease. This study presents the assessment of the AGoRA Smart Walker using Ramps Tests and Timed Up and Go Test (TUGT). Ten older adults participated in the study, four had PD, and the remaining six had underlying conditions and fractures. Each of them underwent a physical assessment (i.e., Senior Fitness, hip, and knee strength tests) and then interacted with the AGoRA SW. Kinematic and physical interaction data were collected through the AGoRA walker's sensory interface. It was found that for lower limb strength tests, older adults with PD had increases of at least 15% in all parameters assessed. For the Sit to Stand Test, the Parkinson's group evidenced an increase of 23%, while for the Chair Sit and Reach Test (CSRT), this same group was only 0.04 m away from reaching the target. For the Ramp Up Test (RUT), the subjects had to make a greater effort, and significant differences (p-value = 0.04) were evidenced in the force they applied to the device. For the Ramp Down Test (RDT), the Parkinson's group exhibited a decrease in torque, and there were statistically significant differences (p-value = 0.01) due to the increase in the complexity of the task. In the Timed Up and Go Test (TUGT), the subjects presented significant differences in torque (p-value of 0.05) but not in force (p-value of 0.22) due to the effect of the admittance controller implemented in the study. Finally, the results suggested that the walker, represents a valuable tool for assisting people with gait motor deficits in tasks that demanded more physical effort adapting its behavior to the specific needs of each user.

Association between sensory processing and activity performance in children with cerebral palsy levels I-II on the gross motor function classification system.

BACKGROUND: Investigating the influence of sensory processing disorders on the level of function of children with cerebral palsy (CP) may help therapists identify specific impairments that impact activity and participation in these children. This may provide direction on selection of interventions to improve function and quality of life. OBJECTIVES: To investigate if sensory processing disorders in children with CP levels I and II on the Gross Motor Function Classification System (GMFCS) are associated with activity performance. METHODS: Sensory processing and activity performance of 28 children with CP between 5 and 15 years (mean ±â€¯standard deviation; 9.9 ±â€¯3.2 years) were evaluated using the Sensory Profile (SP) and Pediatric Evaluation of Disability Inventory (PEDI), respectively. Associations between the components of the SP and PEDI were assessed with Spearman correlation coefficients. Multiple linear regression analysis using backward stepwise method was used to determine the variables of sensory processing that are associated with activity performance on the PEDI. RESULTS: The category of Behavioral Outcomes of Sensory Processing was the only variable associated with Functional Abilities in self-care and social function (r2 = 0.30 and r2 = 0.39, respectively) and Caregiver Assistance (r2 = 0.36 and r2 = 0.37, respectively), (p < 0.05). CONCLUSION: Sensory processing in children with CP levels I-II on the GMFCS is associated with their ability to perform daily living activities and in their social interaction with the environment.

The Consumption of Two or Three Meals per Day with Adequate Protein Content Is Associated with Lower Risk of Physical Disability in Mexican Adults Aged 60 Years and Older.

Adequate protein intake per day has been associated with a lower risk of physical disability; however, if adequate protein intake per meal is also associated is unknown. The purpose of this study was to analyze the association between adequate protein intake per meal and physical disability in daily living activities in Mexican adults aged ≥60 years. We assessed the number of meals per day with an adequate protein content (24 h dietary recall), the presence of physical disability in daily living activities (two validated questionnaires), and their association in 187 participants through logistic regression. Consuming two or three meals per day with ≥30 g each was associated with lower risk of physical disability on Transportation (OR [95% CI]: 0.06 [0.01-0.50], p = 0.01), Shopping (0.05 [0.01-0.40], p = 0.004), Feeding (0.06 [0.01-0.74], p = 0.028), and Transfer (0.09 [0.01-0.98], p = 0.048). On the other hand, consuming two or three meals per day with ≥0.4 g/kg each was associated with lower risk of physical disability on Shopping (0.21 [0.05-0.89], p = 0.034) and Transportation (0.12 [0.03-0.48], p = 0.003). The consumption of two or three meals per day with adequate protein content is associated with lower risk of physical disability in Mexican adults aged 60 years and older.

O quotidiano dos trabalhadores da atenção básica: limites para a promoção da saúde / El día a dia de los trabajadores de la atención primaria: límites para promover la salud / The primary care worker's daily living: limits for health promotion

RESUMO Trata-se de pesquisa qualitativa, exploratória descritiva, com objetivo de compreender os limites do quotidiano para a Promoção da Saúde dos trabalhadores. Participaram da pesquisa 18 trabalhadores de um Centro de Saúde no sul do Brasil. A coleta de dados foi realizada, durante os meses de abril e maio de 2014, por meio de entrevistas semiestruturadas, tendo como questão norteadora: "Quais os limites do quotidiano para a promoção da saúde dos trabalhadores que atuam na Atenção Básica?" A análise dos dados foi feita à luz das noções e dos Pressupostos Teóricos e da Sensibilidade de Michel Maffesoli. Como resultado, encontramos algumas dimensões que expressam os limites do quotidiano em seu contexto geral de vida, envolvendo a falta e o excesso. Falta ter tempo e saber administrar o tempo; falta de companheirismo; falta fazer mais exercício e ter mais lazer. Dentre os excessos identificamos: excesso de tarefas diárias; trânsito; trabalho com carga horária excessiva; preguiça; gula. Enfatizamos a importância das reflexões e ações voltadas para a Promoção da Saúde do trabalhador em seu quotidiano, considerando-se no cuidado os limites como possibilidades a serem transfigurados pela potência do ser humano, contribuindo para a criação de ambientes saudáveis.

RESUMEN Es un estudio cualitativo, exploratorio, descriptivo, con el objetivo de comprender los límites de la vida cotidiana para la Promoción de la Salud de los trabajadores. Los participantes fueron 18 trabajadores dn un Centro de Salud en el sur de Brasil. La recolección de datos se llevó a cabo durante los meses de abril y mayo de 2014, a través de entrevistas semiestructuradas, con la pregunta guía: "¿Cuáles son los límites de la vida cotidiana para promover la salud de los trabajadores que trabajan en la Atención Primaria" Análisis de los datos se hizo a la luz de los conceptos y Supuestos Teóricos y de la Sensibilidad de Michel Maffesoli. Como resultado, hemos encontrado algunas dimensiones que expresan los límites diarios en su contexto general de la vida, que implicam la falta y el exceso. Falta de tiempo y saber cómo administrar el tiempo; falta de compañía; falta de más ejercicio y tener más tiempo libre. Entre los excesos identificados: el exceso de tareas diarias; tránsito; trabajar con excesiva carga de trabajo; la pereza; gula. Hacemos hincapié en la importancia de las reflexiones y acciones hacia la promoción de la salud de los trabajadores en su vida diaria, teniendo en cuenta el cuidado de los límites como las posibilidades de ser transfigurados por el poder del ser humano, lo que contribuye a la creación de ambientes saludables.

ABSTRACT This is a qualitative, descriptive, exploratory rsearch, aiming to understand the limits of everyday life for the Health Promotion of workers. The participants were 18 workers at a health center in southern Brazil. Data collection occurred conducted during the months of April and May 2014, through semi-structured interviews, with the guiding question: "What are the limits of everyday life to promote the health of workers who work in primary care?" Analysis data was made in the light of the Sensitvity and Theoretecial Concepts of Michel Maffesoli. As a result, we found some dimensions that express the daily limits in its general context of life, involving the lack and excess. Lack of time and knowledge on how to manage time; lack of companionship; lack of more exercise and leisure. Among the excesses identified: excessive daily tasks; traffic; work with excessive workload; laziness; greediness. We emphasize the importance of reflections and actions towards Health Promotion of workers in their daily lives, considering, during the care, the limits as possibilities for the power of human beings to transfigure, contributing to create healthy environments.

Effect of a rehabilitation program using virtual reality for balance and functionality of chronic stroke patients / Efeito de um programa de reabilitação utilizando realidade virtual para o equilíbrio e funcionalidade de pacientes com AVC crônico / Efecto de un programa de rehabilitación utilizando la realidad virtual para el equilibrio y la funcionalidad de los pacientes con accidente cerebrovascular crónico

This study aimed to investigate the effect of a rehabilitation program using virtual reality (VR) in addition to conventional therapy for improvement of balance (BERG scale) and functional independence (FIM scale) in chronic stroke patients. Ten individuals, mean age of 51.4 (± 6.7 years), participated of eight 60-minute sessions comprising kinesiotherapy (15min), Nintendo Wii (30min) and Learning transfer (15min) exercises. After training, nonparametric statistical analysis showed significant improvement in total FIM (p= .01) and BERG scores (p= .00), and in some of their subitems: FIM - dressing lower body (p= .01), transfer to bathtub/shower (p= .02) and locomotion: stairs (p= .03); BERG - reaching forward with outstretched arm (p= .01), retrieving object from the floor (p= .04), turning 360º (p= .01), placing alternate foot on step (p≤ .01), standing with one foot in front (p= .01), and one leg stand (p= .03). These findings suggest a positive influence of virtual reality exercises adjunct to conventional therapy on rehabilitation of balance and functionality post stroke, and indicate the feasibility of the proposed VR-based rehabilitation program.

Este estudo objetivou investigar o efeito de um programa de reabilitação utilizando adição de Realidade Virtual (RV) à terapia convencional para melhora do equilíbrio (Escala de BERG) e independência funcional (escala MIF) de pacientes com AVC crônico. Dez indivíduos, idade média de 51,4 (± 6,7 anos), participaram de oito sessões de 60 minutos incluindo exercícios de cinesioterapia (15min), Nintendo Wii (30min) e transferência de aprendizagem (15min). Após o treinamento, análise estatística não paramétrica mostrou evolução significativa nos scores totais das escalas MIF (p= 0,01) e BERG (p= 0,00), e em alguns de seus subitens: MIF - vestir membros inferiores (p= 0,01), transferência para o chuveiro (p= 0,02) e locomoção: escadas (p= 0,03); BERG - alcance de braço (p= 0,01), coletar objeto no chão (p= 0,04), girar 360º (p= 0,01), pé degrau alternado (p ≤ 0,01), pé à frente (p= 0,01), e apoio unipodal (p= 0,03). Estes achados sugerem uma influência positiva de exercícios com realidade virtual adjuntos à terapia convencional na reabilitação do equilíbrio e funcionalidade pós AVC, e indicam a viabilidade do programa de reabilitação baseado em RV conforme proposto.

El objetivo de este estudio fue investigar el efecto de un programa de rehabilitación combinado de Realidad Virtual (RV) con terapia convencional en pacientes con accidente cerebrovascular crónico para la mejora del equilibrio (escala de BERG) y la independencia funcional (escala MIF). 10 sujetos, con una edad media de 51,4 (± 6,7 años), participaron en ocho sesiones rehabilitación de 60 minutos. Las sesiones incluyeron ejercicios de kinesioterapia (15min), Nintendo Wii (30min) y transferencia del aprendizaje (15min). Tras el entrenamiento, el análisis estadístico con test no paramétricos confirma una evolución significativa en las puntuaciones totales en las escalas MIF (p= 0,01) y BERG (p= 0,00) y en alguno apartados de las escalas: MIF - vestido de los miembros inferiores (p= 0,01), uso de la ducha (p= 0,02) y locomoción: escaleras (p= 0,03); BERG - alcance del brazo (p= 0,01), recuperar un objeto del suelo (p= 0,04), girar 360º (p= 0,01), pies en escalones alternos (p≤ 0,01), pie al frente (p= 0,01) y apoyo unipodal (p= 0,03). Estos resultados sugieren una influencia positiva de la VR como complemento a la terapia convencional en la rehabilitación del equilibrio y capacidad funcional tras un accidente cerebrovascular y confirman la viabilidad del programa combinado de rehabilitación propuesto.

Everyday life of women with a history of domestic violence and abortion / Cotidiano de mujeres con historia de violencia doméstica y aborto causados / Cotidiano de mulheres com história de violência doméstica e aborto provocado

This is a qualitative study based on the Comprehensive Sociology. Aimed to understand the daily life of women with a history of domestic violence who had an abortion. We conducted in-depth interviews with ten women who were admitted to the hospital for abortion and reported experiencing domestic violence. Mostly characterized by being black, low education, between 18 and 40 years. The process of organizing and analyzing the data was based on the notions of Comprehensive Sociology and theoretical sensitivity. The daily life of women who had an abortion is marked by the experience of domestic violence as a child and teenager, expressed by abandonment and rejection, and also by domestic violence. The early sexual activity is related to the unplanned pregnancy and lack of support from family and partner. It is necessary a professional look for recognition of domestic violence as a health condition of women.

Investigación cualitativa dirigida a comprender la vida cotidiana de las mujeres con un historial de violencia doméstica que tuvo un aborto. Se realizaron entrevistas en profundidad con diez mujeres que fueron ingresados en el hospital por el aborto y reportaron haber experimentado violencia doméstica. En la mayor parte, se caracterizan por ser negras, de bajo nivel educativo y con edad entre 18 y 40 años. El proceso de organización y análisis de los datos fueron basados en las nociones de la Sociología Comprensiva y la sensibilidad teórica. La vida de las mujeres que tuvieron un aborto está marcada por la experiencia de la violencia doméstica cuando niña y adolescente, expresado por el abandono y el rechazo, y también por la violencia doméstica. La actividad sexual temprana está relacionada con el embarazo no deseado y la falta de apoyo de la familia y de la pareja. Es necesaria una visión profesional para el reconocimiento de la violencia doméstica como un problema de salud de la mujer.

Trata-se de um estudo qualitativo, com base na Sociologia Compreensiva. Teve como objetivo compreender o cotidiano de mulheres com história de violência doméstica que provocaram aborto. Realizou-se entrevista em profundidade com dez mulheres que estavam internadas na maternidade por aborto provocado e declararam vivência de violência doméstica. Na sua maioria, caracterizavam-se por serem negras, com baixa escolaridade, entre 18 e 40 anos. O processo de organização e análise dos dados baseou-se nas noções da Sociologia Compreensiva e nos pressupostos teóricos da sensibilidade. O cotidiano das mulheres que provocaram aborto é marcado pela vivência de violência doméstica, quando criança e adolescente, expressa pelo abandono e rejeição, e também pela violência conjugal. A atividade sexual precoce guarda relação com a gravidez não planejada e a falta de apoio dos familiares e companheiro. Necessário se faz um olhar profissional para reconhecimento da violência doméstica como agravo à saúde das mulheres.

Limitation of Activities of Daily Living and Quality of Life Based on COPD Combined Classification.

BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 update recommends that the management and treatment of COPD be made to combine the impact of disease and future risk of exacerbation. These patients have worsening quality of life and limitation of activities of daily living (ADLs), which can be manifested as a decrease in S(pO2) and progressive dyspnea. The aim of this study was to determine whether the COPD combined classification proposed by GOLD 2011 is able to differentiate patients with ADL limitation, such as oxygen desaturation or dyspnea, and impaired quality of life. METHODS: This was an observational, cross-sectional study. Forty-four subjects were categorized in 4 GOLD groups (A-D). The mean age was 69 ± 8.8 y, with FEV1 of 1.33 ± 0.53 L (49 ± 15.7% of predicted). The Modified Medical Research Council dyspnea and London Chest Activity of Daily Living (LCADL) scales and the St George Respiratory Questionnaire (SGRQ) were applied. The 6-min walk test and ADL simulation in an appropriate laboratory were also conducted. RESULTS: There was no association between the COPD combined evaluation groups and the presence of oxygen desaturation and dyspnea (chi-square test), although a higher prevalence of oxygen desaturation was noticed in group D subjects. With regard to dyspnea, there were subjects with dyspnea in all groups when ADLs were performed. No correlation between dyspnea and oxygen desaturation variation was found. Group B and D subjects showed higher ADL dyspnea (total LCADL scores of 28% and 30%) compared with group A subjects. Group D subjects showed poorer quality of life (total SGRQ score of 49.3%) compared with less symptomatic groups. CONCLUSIONS: The COPD combined classification was not efficient in determining oxygen desaturation and dyspnea while subjects were performing ADLs. The subjects in the symptomatic groups with increased risk of exacerbation showed poorer quality of life and higher dyspnea levels. (ClinicalTrials.gov registration NCT01977469).

Atividades de vida autônoma na escola de tempo integral: aluno com deficiência visual - perspectivas educacionais / Daily living activities in full-time schools: students with visual impairment - educational perspectives

Este estudo trata sobre percepções de professores e de alunos com deficiência visual (DV) na Escola de Tempo Integral (ETI) do Estado de São Paulo, e as atividades de vida autônoma (AVA) contextualizadas na inclusão educacional. Estes alunos requererem atenção às suas necessidades educacionais especiais (NEE) para a aquisição de conhecimentos e o desenvolvimento de competências e habilidades autônomas em sua escolarização. Objetivou-se conhecer as percepções dos professores para com a sua ação docente e à prática das AVA na ETI pelo aluno com DV. Realizaram-se 12 entrevistas com professores do ensino comum. A análise de conteúdo identificou atendimento às suas NEE; as experiências inclusivas dos professores da ETI. Os dados coletados refletiram os processos das ações pedagógicas inclusivas, sobre o atendimento educacional especializado e a formação integral do aluno com DV. Evidenciou-se o desenvolvimento das AVA como fonte de saberes; o despreparo docente em relação às especificidades desse aluno; e, a educação especial desvinculada do ensino comum. Conclui-se ser necessário redimensionar o ensino comum e a prática das AVA, para que não sejam objetos de resistência dos envolvidos, e para que, estas, qualifiquem este ensino e favoreçam a escolarização e o protagonismo dos alunos com DV na ETI.

This study addresses perspectives of teachers and students with visual impairments (VI) at the Full-time School (ETI) in the State of São Paulo (Brazil) regarding daily living activities (DLA) within the context of educational inclusion. These students require attention to their special educational needs in order to acquire knowledge and to develop competencies and autonomous abilities in their schooling process. The aim of the study was to understand teacher perceptions regarding DLA practice at ETI for students with VI. Twelve semi-structured interviews with regular school teachers were carried out. Content analysis revealed that the special educational needs were being met and that ETI provided for inclusive experiences for teachers. The data that was collected revealed the processes of inclusive pedagogical practices related to specialized educational services and the broad preparation of students with VI. The study showed that DLA can be a source of understanding, that teachers are often unprepared regarding the specific needs of these students; and special education is disconnected from regular teaching. In conclusion, regular teaching requires adjustments in teaching and practicing DLA so that such activities not be the focus of resistance for those involved, contributing to improving teaching and enabling schooling and empowerment of students with VI at ETI.

Calidad de vida y estatus funcional en pacientes que requirieron ventilación mecánica: Seguimiento al año del alta de terapia intensiva

Objetivo: Evaluar el estatus funcional (EF) y calidad de vida (CV) posterior al alta de terapia intensiva (UTI) en pacientes con ventilación mecánica invasiva (VM) y compararla con la población de referencia. Diseño: Cohorte prospectivo. Ambito: UTI Sanatorio Anchorena, Buenos Aires, Argentina. Pacientes: Aquellos ingresados a UTI entre septiembre 2008 y abril 2009 con más de 24 hs de VM. Intervenciones: A los 4 meses y al año se evaluó telefónicamente la CVa través del cuestionario EQ-5D y el EF con el índice de Barthel que evalúa actividades de la vida diaria (AVD). Resultados: 77 pacientes recibieron VM, 41 mujeres (53%), mediana de edad 65 años [IC25-75% 55-77)], SAPSII 41 [28-52], días de VM 4 [2-8]. 47 pacientes sobrevivieron a la internación y fueron evaluados, 40 (85.1%) a los 4 meses y 34 (72.3%) al año. El EQ-5D a los 4 meses (mediana 0.693 IC25-75% 0.182-0.982) y al año (mediana 0.841 IC25-75% 0.493-1), se diferenciaron significativamente de la población argentina (p = 0.0004 y 0.024 respectivamente). A los 4 meses, la mitad de los pacientes presentaban dificultades en todos los dominios del EQ-5D y el 57% eran dependientes en las AVD. Al año, el 54% de los pacientes no había regresado a sus actividades previas y padecían ansiedad/depresión mientras que el 45% aún eran dependientes en las AVD. Conclusiones: Las consecuencias de la internación en UTI por una enfermedad aguda están presentes a los 4 meses y al año del alta, determinando una población con una CV significativamente menor a la no expuesta y un EF deteriorado.(AU)

Objective: To study functional status (FS) and quality of life (QoL) after discharge from intensive care unit (ICU) in patients who had > 24 hours of mechanical ventilation (MV) and to compare them with reference Argentine population. Design: Prospective cohort study. Setting: ICU at Sanatorio Anchorena, Buenos Aires , Argentina. Patients: All patients admitted to the ICU between September 2008 and April 2009 with more than 24 hours of MV. Procedures: QoL was assessed by EQ-5D and FS was evaluated through Barthel index [evaluation of daily life activities (DLA)] by telephone at 4 months and 1 year after discharge from ICU. Results: 77 patients required MV, 41 females (53%), median age 65 years (IQR 55-77), SAPSII 41 (28-52), days of MV 4 (2-8). 47 patients survived after hospitalization, 40 (85.1%) at 4 months and 34 (72.3%) one year later. The EQ-5D at 4 months (median 0.693 IQR0.182-0.982) and at 1 year (median 0.841 IQR0.493-1) of follow up were significantly lower compared with general Argentine population (p = 0.0004 and 0.024 respectively). At 4 months, half of the patients had problems in all dimensions of the Euroqol and 57% were dependent on DLA. At 1 year, 54% could not return to their previous activities, suffered from anxiety/depression and 45% were dependent on DLA. Conclusions: Effects of critical illness and ICU stay are present at 4 months and 1 year after discharge. Survivors suffer a lower quality of life and functional status than general population.(AU)

Calidad de vida y estatus funcional en pacientes que requirieron ventilación mecánica: Seguimiento al año del alta de terapia intensiva / Quality of Life and Functional Status in Patients with Mechanical Ventilation. One Year Follow-up After Discharge from ICU

Objetivo: Evaluar el estatus funcional (EF) y calidad de vida (CV) posterior al alta de terapia intensiva (UTI) en pacientes con ventilación mecánica invasiva (VM) y compararla con la población de referencia. Diseño: Cohorte prospectivo. Ámbito: UTI Sanatorio Anchorena, Buenos Aires, Argentina. Pacientes: Aquellos ingresados a UTI entre septiembre 2008 y abril 2009 con más de 24 hs de VM. Intervenciones: A los 4 meses y al año se evaluó telefónicamente la CVa través del cuestionario EQ-5D y el EF con el índice de Barthel que evalúa actividades de la vida diaria (AVD). Resultados: 77 pacientes recibieron VM, 41 mujeres (53%), mediana de edad 65 años [IC25-75% 55-77)], SAPSII 41 [28-52], días de VM 4 [2-8]. 47 pacientes sobrevivieron a la internación y fueron evaluados, 40 (85.1%) a los 4 meses y 34 (72.3%) al año. El EQ-5D a los 4 meses (mediana 0.693 IC25-75% 0.182-0.982) y al año (mediana 0.841 IC25-75% 0.493-1), se diferenciaron significativamente de la población argentina (p = 0.0004 y 0.024 respectivamente). A los 4 meses, la mitad de los pacientes presentaban dificultades en todos los dominios del EQ-5D y el 57% eran dependientes en las AVD. Al año, el 54% de los pacientes no había regresado a sus actividades previas y padecían ansiedad/depresión mientras que el 45% aún eran dependientes en las AVD. Conclusiones: Las consecuencias de la internación en UTI por una enfermedad aguda están presentes a los 4 meses y al año del alta, determinando una población con una CV significativamente menor a la no expuesta y un EF deteriorado.

Objective: To study functional status (FS) and quality of life (QoL) after discharge from intensive care unit (ICU) in patients who had > 24 hours of mechanical ventilation (MV) and to compare them with reference Argentine population. Design: Prospective cohort study. Setting: ICU at Sanatorio Anchorena, Buenos Aires , Argentina. Patients: All patients admitted to the ICU between September 2008 and April 2009 with more than 24 hours of MV. Procedures: QoL was assessed by EQ-5D and FS was evaluated through Barthel index [evaluation of daily life activities (DLA)] by telephone at 4 months and 1 year after discharge from ICU. Results: 77 patients required MV, 41 females (53%), median age 65 years (IQR 55-77), SAPSII 41 (28-52), days of MV 4 (2-8). 47 patients survived after hospitalization, 40 (85.1%) at 4 months and 34 (72.3%) one year later. The EQ-5D at 4 months (median 0.693 IQR0.182-0.982) and at 1 year (median 0.841 IQR0.493-1) of follow up were significantly lower compared with general Argentine population (p = 0.0004 and 0.024 respectively). At 4 months, half of the patients had problems in all dimensions of the Euroqol and 57% were dependent on DLA. At 1 year, 54% could not return to their previous activities, suffered from anxiety/depression and 45% were dependent on DLA. Conclusions: Effects of critical illness and ICU stay are present at 4 months and 1 year after discharge. Survivors suffer a lower quality of life and functional status than general population.

Reflexões sobre o quotidiano profissional de enfermeiras / Reflexiones sobre el cotidiano de la enfermera / Reflections about the everyday life of a nurse

Este artigo apresenta reflexões sobre as vivências no exercício da prática profissional da enfermeira e as formas de enfrentamentos para as exigências institucionais, no quotidiano da enfermagem em hospitais privados na cidade de Salvador. Objetiva refletir sobre a prática profissional de enfermeiras frente às mudanças ocorridas no cenário hospitalar nos últimos tempos. Neste, as autoras refletem pela vertente pós-moderna, à luz de Michel Maffesoli, sobre o quotidiano das enfermeiras, as relações de socialidade nas relações profissionais e sobre as formas de sobrevivência no ambiente de trabalho e fora dele, diante de determinadas condições desfavoráveis impostas pelas organizações. Percebe-se, nesta análise, que o trabalho da enfermeira precisa ser negociado nos ambientes de trabalho, a partir da análise compreensiva das relações orgânicas, necessárias à humanização dos serviços e à qualidade de vida dos profissionais(AU)

Este artículo presenta reflexiones sobre las vivencias en el ejercicio de la práctica profesional de la enfermera y las formas de enfrentamientos para las exigencias institucionales, en lo cotidiano de la enfermería en hospitales particulares en la ciudad de Salvador de Bahía. Tiene como objetivo reflexionar sobre la práctica profesional de la enfermera y los cambios que acontecieron en el contexto hospitalario en los últimos tiempos. En él, las autoras tienen en cuenta la vertiente postmoderna, a la luz de Michel Mafessoli, sobre lo cotidiano de la(o)s enfermera(o)s, las relaciones de sociabilidad en las relaciones profesionales y sobre las formas de supervivencia en el ambiente laboral y fuera de él, ante determinadas condiciones desfavorables impuestas por las instituciones. Se observa, en este análisis, que la labor de la enfermera necesita ser negociada en los ambientes de trabajo, a partir del análisis comprensivo de las relaciones orgánicas, necesarias a la humanización de los servicios y a la calidad de vida de los profesionales(AU)

This article presents reflections on the daily experiences in the course of professional practice of nurses and ways of coping with institutional requirements, in private hospitals in the city of Salvador. The objective of the article is to reflect about the professional practice of nurses, as well as recent changes that have occurred in the hospital setting. In this manner, the authors reflect on the postmodern aspect of Michel Maffesoli, regarding the daily life of nurses, social and work relations and survival mechanisms, both in and out of the workplace, when faced with certain unfavorable conditions imposed upon by the institution. This analysis demonstrates that the professional necessities of nurses must be negotiated in the workplace, including comprehensive analysis of organic relations, which is necessary for the humanization of services and quality of life for professionals(AU)

Stress and satisfaction of family members and independent living skills of psychiatric outpatients

BaACKGROUND. There are several parameters that must be included in the evaluation psychosocial rehabilitation. OBJECTIVES. To describe and correlate the degree of stress of family members who live with schizophrenic and bipolar disorder patients, their satisfaction with mental health services and the level of daily living skills of the patient. METHOD. Cross-sectional and correlational study, from 2012 to 2013, with a sample of 100 caregivers. The Family Satisfaction with Mental Health Services Rating Scale (SATIS-BR), the Independent Living Skills Survey (ILSS-BR), and the General Health Questionnaire (GHQ-12) were used. Data were analyzed using SPSS v.21, with the Mann-Whitney test, Jonckheere-Terpstra test, and Pearson's, Spearman's and Partial correlations, and a significance level α = 0.05. RESULTS. The score for the SATIS-BR scale was 4.28, 1.59 for the ILSS, and 7.39 for the GHQ-12. The value of the Pearson correlation coefficient between the SATIS-BR and ILSS was r = -0.27, and r = -0.23 between the GHQ-12 and SATIS-BR. The Spearman's correlation coefficient between Education and the GHQ-12 was r = -0.24 and there was a negative linear trend between stress and the level of education (JT = -2.54, p < 0:01). DISCUSSION. The caregivers presented a very high level of psychological distress, therefore, it is critical that mental health services perform more effective psychosocial rehabilitation actions.