Musculoskeletal Pain and Musical Performance in First and Second Violinists of Professional Youth Chamber Orchestras: A Comparative Study.

OBJECTIVE: First and second violinists in orchestras use identical instruments, but the motor patterns used to execute the different notes may vary between the two groups and the biomechanical gestures may influence musculoskeletal complaints. The primary objective of this study was to compare the pain intensity and interference in musical performance of first and second violinists of professional youth chamber orchestras. Second, to investigate the correlation between pain and the musical practice profile in this population. METHODS: This cross-sectional study enrolled 74 violinists, aged 12 to 17 years, from three professional youth chamber orchestras in Brazil. Participants completed a validated self-administered questionnaire, the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians-Brazilian version (MPIIQM-Br). Variables related to musical practice profiles were also recorded. Data analysis applied t-tests for independent samples and Pearson's correlation coefficient. RESULTS: The sample of first violinists (n=39) presented 23 males and 16 females, and the second violinists (n=35) included 23 females and 12 males. The mean age was 13.9 yrs (SD 1.1) and 14.1 yrs (1.0) for the first and second violinist groups, respectively. Most participants (n=66, 89%) reported pain in at least one moment of their career, and 54 (76%) reported pain at the time of data collection. A higher pain prevalence was identified in the right shoulder (37.7%), in 28.2% of the second violinists and 9.4% of the first. The second violinists presented higher scores for most variables related to pain intensity and pain interference in performance (p < 0.05). A correlation was observed between time working at a professional level and the number of affected areas on the body pain map (r=0.30; 95% CI 0.23-0.42) and between the hours of daily practice and the number of affected areas on the body pain map (r=0.39; 95% CI 0.29-0.45). CONCLUSION: Second violinists had more complaints of pain and difficulty in playing their instrument compared to the first violinists. The study also found a correlation between the number of body areas with pain complaints and variables linked to the violinists' practice profile.

Effects of mild running on substantia nigra during early neurodegeneration.

Moderate physical exercise acts at molecular and behavioural levels, such as interfering in neuroplasticity, cell death, neurogenesis, cognition and motor functions. Therefore, the aim of this study is to analyse the cellular effects of moderate treadmill running upon substantia nigra during early neurodegeneration. Aged male Lewis rats (9-month-old) were exposed to rotenone 1mg/kg/day (8 weeks) and 6 weeks of moderate treadmill running, beginning 4 weeks after rotenone exposure. Substantia nigra was extracted and submitted to proteasome and antioxidant enzymes activities, hydrogen peroxide levels and Western blot to evaluate tyrosine hydroxylase (TH), alpha-synuclein, Tom-20, PINK1, TrkB, SLP1, CRMP-2, Rab-27b, LC3II and Beclin-1 level. It was demonstrated that moderate treadmill running, practiced during early neurodegeneration, prevented the increase of alpha-synuclein and maintained the levels of TH unaltered in substantia nigra of aged rats. Physical exercise also stimulated autophagy and prevented impairment of mitophagy, but decreased proteasome activity in rotenone-exposed aged rats. Physical activity also prevented H2O2 increase during early neurodegeneration, although the involved mechanism remains to be elucidated. TrkB levels and its anterograde trafficking seem not to be influenced by moderate treadmill running. In conclusion, moderate physical training could prevent early neurodegeneration in substantia nigra through the improvement of autophagy and mitophagy.

Lifestyle strategies to promote proteostasis and reduce the risk of Alzheimer's disease and other proteinopathies.

Unhealthy lifestyle choices, poor diet, and aging can have negative influences on cognition, gradually increasing the risk for mild cognitive impairment (MCI) and the continuum comprising early dementia. Aging is the greatest risk factor for age-related dementias such as Alzheimer's disease, and the aging process is known to be influenced by life events that can positively or negatively affect age-related diseases. Remarkably, life experiences that make the brain vulnerable to dementia, such as seizure episodes, neurotoxin exposures, metabolic disorders, and trauma-inducing events (e.g. traumatic injuries or mild neurotrauma from a fall or blast exposure), have been associated with negative effects on proteostasis and synaptic integrity. Functional compromise of the autophagy-lysosomal pathway, a major contributor to proteostasis, has been implicated in Alzheimer's disease, Parkinson's disease, obesity-related pathology, Huntington's disease, as well as in synaptic degeneration which is the best correlate of cognitive decline. Correspondingly, pharmacological and non-pharmacological strategies that positively modulate lysosomal proteases are recognized as synaptoprotective through degradative clearance of pathogenic proteins. Here, we discuss life-associated vulnerabilities that influence key hallmarks of brain aging and the increased burden of age-related dementias. Additionally, we discuss exercise and diet among the lifestyle strategies that regulate proteostasis as well as synaptic integrity, leading to evident prevention of cognitive deficits during brain aging in pre-clinical models.

Adenosine modulates alpha2-adrenergic receptors within specific subnuclei of the nucleus tractus solitarius in normotensive and spontaneously hypertensive rats.

Adenosine is known to modulate neuronal activity within the nucleus tractus solitarius (NTS). The modulatory effect of adenosine A1 receptors (A1R) on alpha2-adrenoceptors (Adr2R) was evaluated using quantitative radioautography within NTS subnuclei and using neuronal culture of normotensive (WKY) and spontaneously hypertensive rats (SHR). Radioautography was used in a saturation experiment to measure Adr2R binding parameters (Bmax, Kd) in the presence of 3 different concentrations of N6-cyclopentyladenosine (CPA), an A1R agonist. Neuronal culture confirmed our radioautographic results. [3H]RX821002, an Adr2R antagonist, was used as a ligand for both approaches. The dorsomedial/dorsolateral subnucleus of WKY showed an increase in Bmax values (21%) induced by 10 nmol/L of CPA. However, the subpostremal subnucleus showed a decrease in Kd values (24%) induced by 10 nmol/L of CPA. SHR showed the same pattern of changes as WKY within the same subnuclei; however, the modulatory effect of CPA was induced by 1 nmol/L (increased Bmax, 17%; decreased Kd, 26%). Cell culture confirmed these results, because 10(-5) and 10(-7) mol/L of CPA promoted an increase in [3H]RX821002 binding of WKY (53%) and SHR cells (48%), respectively. DPCPX, an A1R antagonist, was used to block the modulatory effect promoted by CPA with respect to Adr2R binding. In conclusion, our study shows for the first time an interaction between A1R that increases the binding of Adr2R within specific subnuclei of the NTS. This may be important in understanding the complex autonomic response induced by adenosine within the NTS. In addition, changes in interactions between receptors might be relevant to understanding the development of hypertension.

Analysis of the user satisfaction level in a public physical therapy service.

BACKGROUND: The concepts of quality management have increasingly been introduced into the health sector. Methods to measure satisfaction and quality are examples of this trend. OBJECTIVE: This study aimed to identify the level of customer satisfaction in a physical therapy department involved in the public area and to analyze the key variables that impact the usersâ€(tm) perceived quality. METHOD: A cross-sectional observational study was conducted, and 95 patients from the physical therapy department of the Hospital Universitário Gaffrée e Guinle - Universidade Federal do Estado do Rio de Janeiro (HUGG/UNIRIO) - Rio de Janeiro, Brazil, were evaluated by the SERVQUAL questionnaire. A brief questionnaire to identify the sociocultural profile of the patients was also performed. RESULTS: Patients from this health service presented a satisfied status with the treatment, and the population final average value in the questionnaire was 0.057 (a positive value indicates satisfaction). There was an influence of the educational level on the satisfaction status (χ²=17,149; p=0.002). A correlation was found between satisfaction and the dimensions of tangibility (rho=0.56, p=0.05) and empathy (rho=0.46, p=0.01) for the Unsatisfied group. Among the Satisfied group, the dimension that was correlated with the final value of the SERVQUAL was responsiveness (rho=0.44, p=0.01). CONCLUSIONS: The final values of the GGUH physical therapy department showed that patients can be satisfied even in a public health service. Satisfaction measures must have a multidimensional approach, and we found that people with more years of study showed lower values of satisfaction.

Transcultural adaptation of the Injustice Experience Questionnaire into Brazilian Portuguese / Adaptação transcultural do Injustice Experience Questionnaire para o português do Brasil

ABSTRACT BACKGROUND AND OBJECTIVES: It has been proposed that some individuals with musculoskeletal pain may perceive themselves as victims of injustice. Perception of injustice can have a significant impact on several pain-related outcomes, major depressive symptoms, disabilities, and absenteeism. The objective of this study consisted of a transcultural adaptation of the original instrument in English, Injustice Experience Questionnaire into a final version to be used in Brazil. METHODS: The whole translation process consisted of translation, back-translation and the review by a committee of experts. The pre-test was applied to 90 participants (41 participants with chronic musculoskeletal pain). For the psychometric analysis, the translated version was applied to 120 participants with chronic musculoskeletal pain. The internal consistency was verified by the Cronbach's alpha coefficient, and the construct validity was analyzed using factorial exploratory analysis. RESULTS: After the conclusion of the pre-test, there were no difficulties in understanding the translated questionnaire by more than 20% of the sample. The Cronbach alpha calculation for the 12 items of the Injustice Experience Questionnaire/Port-BR was 0.86 [CI (95%) = 0.83 to 0.90; p<0.001]. CONCLUSION: The questionnaire's Portuguese version proved to be easily understandable showing good semantic validation. Nevertheless, further studies should address other psychometric characteristics of this instrument.

RESUMO JUSTIFICATIVA E OBJETIVOS: Tem sido proposto que algumas pessoas com dor musculoesquelética podem desenvolver um sentimento de injustiça. A percepção da injustiça pode ter um impacto significativo em uma série de desfechos relacionados à dor, sintomas depressivos maiores, incapacidades e absenteísmo. O objetivo deste estudo consistiu em uma adaptação transcultural do instrumento original em inglês do Injustice Experience Questionnaire para uma versão final a ser utilizada no Brasil. MÉTODOS: Todo o processo consistiu em tradução, retrotradução e revisão pelo comitê de especialista. O pré-teste foi aplicado a 90 participantes (41 participantes com dor crônica musculoesquelética). Para a análise psicométrica, a versão traduzida foi aplicada a 120 participantes com dor crônica musculoesquelética. A consistência interna foi verificada pelo coeficiente alfa de Cronbach e a validade do construto foi analisada por meio de análise exploratória fatorial. RESULTADOS: Após a conclusão do pré-teste, não houve dificuldades em entender cada item do questionário traduzido por mais de 20% da amostra. O cálculo alfa de Cronbach para os 12 itens do Injustice Experience Questionnaire/Port-BR foi de 0,86 [IC (95%) = 0,83 a 0,90; p<0,001]. CONCLUSÃO: A versão em português do questionário mostrou-se facilmente compreensível com boa validação semântica. No entanto, estudos adicionais devem abordar outras características psicométricas desse instrumento.

Analysis of the user satisfaction level in a public physical therapy service

BACKGROUND: The concepts of quality management have increasingly been introduced into the health sector. Methods to measure satisfaction and quality are examples of this trend. OBJECTIVE: This study aimed to identify the level of customer satisfaction in a physical therapy department involved in the public area and to analyze the key variables that impact the usersâ€(tm) perceived quality. METHOD: A cross-sectional observational study was conducted, and 95 patients from the physical therapy department of the Hospital Universitário Gaffrée e Guinle - Universidade Federal do Estado do Rio de Janeiro (HUGG/UNIRIO) - Rio de Janeiro, Brazil, were evaluated by the SERVQUAL questionnaire. A brief questionnaire to identify the sociocultural profile of the patients was also performed. RESULTS: Patients from this health service presented a satisfied status with the treatment, and the population final average value in the questionnaire was 0.057 (a positive value indicates satisfaction). There was an influence of the educational level on the satisfaction status (χ‡Â²=17,149; p=0.002). A correlation was found between satisfaction and the dimensions of tangibility (rho=0.56, p=0.05) and empathy (rho=0.46, p=0.01) for the Unsatisfied group. Among the Satisfied group, the dimension that was correlated with the final value of the SERVQUAL was responsiveness (rho=0.44, p=0.01). CONCLUSIONS: The final values of the GGUH physical therapy department showed that patients can be satisfied even in a public health service. Satisfaction measures must have a multidimensional approach, and we found that people with more years of study showed lower values of satisfaction. .

Acute changes in 3H-PAC and 125I-PYY binding in the nucleus tractus solitarii and hypothalamus after a hypertensive stimulus.

Activation of alpha-2-adrenergic and neuropeptide Y (NPY) receptors in the nucleus tractus solitarii (NTS) induces hypotension and bradycardia. On the contrary, activation of angiotensin II (Ang II) receptors leads to hypertension. Acute changes in binding parameters of alpha-2-adrenergic, NPY and Ang II receptors were evaluated in the NTS and paraventricular hypothalamic nucleus (PVN) of rats after a hypertensive stimulus employing quantitative receptor autoradiography. Saturation experiments showed a decrease in the number (Bmax) of alpha-2-adrenergic binding sites in the NTS 6 hours after coarctation-induced hypertension. Furthermore, the affinity of NPY receptors was diminished as seen by the increase in the KD value of 125I-PYY. Tyrosine hydroxylase and NPY immunoreactivities were increased in the NTS and ventral medulla. Binding of 125I-Ang II was not changed in the NTS. Binding of all ligands analyzed was not altered in the PVN. The results suggest an acute down-regulation of alpha-2-adrenergic and NPY receptors involved with hypotension in response to hypertensive stimulus, which might be related to an increased availability of catecholamines and NPY in the NTS.