Conhecimento e expectativas de acadêmicos de fisioterapia sobre a atuação profissional na atenção primária à saúde / Conocimientos y expectativas de estudiantes de fisioterapia sobre la actuación profesional en la atención primaria de salud / Physiotherapy undergraduates' knowledge and expectations of professional practice in primary health care

RESUMO A promulgação do SUS apontou uma nova concepção de saúde não mais focada na ausência de doenças. Fez-se necessário o fortalecimento de ações no nível primário sendo elaborada a Política Nacional de Atenção Básica para promover, proteger e reabilitar a saúde dos indivíduos e coletividades. A Fisioterapia precisa se adequar para se aproximar da Atenção Primária à Saúde (APS) e aos novos modelos de atenção à saúde, o que é recomendado pelas Diretrizes Curriculares Nacionais do Curso de Fisioterapia. O objetivo do estudo é investigar o conhecimento e as expectativas de acadêmicos de Cursos de Fisioterapia de Porto Alegre e região metropolitana sobre a atuação do fisioterapeuta na Atenção Primária à Saúde. Foi realizado estudo observacional, descritivo, transversal, com questionário on-line composto por 13 questões, objetivas e dissertativas. Para verificar as associações, utilizou-se o teste qui-quadrado e adotou-se significância de 5%. 171 acadêmicos de Fisioterapia (90,53% do sexo feminino, com idades entre 18 e 55 anos) participaram do estudo. A minoria dos participantes registrou corretamente as quatro atividades e locais de atuação da Fisioterapia na APS. Para as atividades, foram utilizados termos amplos como "promoção" e "prevenção"; "Unidade de Saúde" foi o local mais frequentemente citado. Do total, 43,2% apontaram se sentirem preparados.

RESUMEN La promulgación del Sistema Único de Salud (SUS) apuntó a una nueva concepción de salud que ya no se centra en la ausencia de enfermedades. Fue necesario fortalecer las acciones en el ámbito primario con el desarrollo de la Política Nacional de Atención Primaria para promover, proteger y rehabilitar la salud de las personas y las comunidades. La fisioterapia necesita adaptarse para acercarse a la Atención Primaria de Salud (APS) y los nuevos modelos de atención sanitaria, según lo recomendado por los Lineamientos Curriculares Nacionales para la Carrera en Fisioterapia. El objetivo de este estudio fue identificar los conocimientos y expectativas de universitarios y Carreras de Fisioterapia de Porto Alegre y región metropolitana sobre el rol del fisioterapeuta en la Atención Primaria de Salud. Se trata de un estudio observacional, descriptivo, transversal, que aplicó un cuestionario on line compuesto de 13 preguntas, tanto de elección única como de ensayo. Para verificar las asociaciones se utilizó la prueba de chi-cuadrado, y se adoptó un nivel de significancia del 5%. En el estudio participaron 171 estudiantes de fisioterapia (el 90,53% mujeres con edades entre 18 y 55 años). La minoría de los participantes contestaron correctamente las cuatro actividades y locales de actuación de la fisioterapia en la APS. Para las actividades, se utilizaron términos amplios como "promoción" y "prevención"; y el local de actuación más citado fue "Unidad de Salud". Del total, el 43,2% afirmaron sentirse preparados.

ABSTRACT The consolidation of SUS led to a new concept of health no longer focused on the absence of diseases. The strengthening of actions at the primary level was necessary, therefore the National Policy of Primary Care was created to promote, protect and rehabilitate people's health. Physiotherapy had to undergo a series of adjustments in order to fit the primary care system and, according to the National Curriculum Guidelines, undergraduate courses should observe the new models of health care. The objective was to assess the knowledge and expectations of Physiotherapy undergraduate students in the Porto Alegre and surrounding cities about the physiotherapist's role in primary care. The study was descriptive, observational, and cross-sectional. An online survey was conducted with 13 objective and dissertation questions. The chi-square test was used to verify associations and significance was found when p≤0.05. A total of 171 Physiotherapy undergraduate students (90.53% females, aging between 18 and 55 years) agreed to participate. A minority of participants correctly registered four activities to be developed and four places of practice for physiotherapists in primary care. Unspecific terms like "promotion" and "prevention" were used to describe the activities, while "Healthcare Units" was the most frequently cited place. Among our sample, 43.2% stated feeling prepared to act in primary care and 53.25% considered as an option to work in primary care. In conclusion, although participants showed limited knowledge about primary care, they mostly feel satisfied with the knowledge acquired on this topic.

Associação entre a ocorrência de dor e sobrecarga em cuidadores principais e o nível de independência de idosos nas atividades de vida diária: estudo transversal / Association between the occurrence of pain and caregivers overload on main and the elderly independence level in daily life activities: cross sectional study

Resumo Introdução Cuidar do idoso costuma ser uma tarefa árdua, e as demandas podem extrapolar a capacidade do cuidador, causando sobrecarga e dor. Objetivo Investigar a ocorrência de sobrecarga e dor em cuidadores de idosos, bem como verificar a relação dessas variáveis com o nível de independência do idoso. Método Amostra por conveniência que, a partir de Unidades de Saúde de uma região distrital de Porto Alegre, identificou potenciais idosos e seus cuidadores principais. Estes, em visitas domiciliares, responderam questões referentes ao perfil socioeconômico, à ocorrência de dor (questionário nórdico e escala visual analógica de dor), à sobrecarga do cuidador (Inventário de Sobrecarga do Cuidador) e ao nível de independência do idoso (índice de Katz). Foi realizada correlação de Spearman. Resultados Participaram 14 idosos e 14 cuidadores com idade média de 82,1 (±6,9) e 65,9(±11,3) anos, respectivamente. Dos idosos, 28,6% foram classificados independentes, 50% dependência moderada e 21,4% muito dependentes. Houve correlação forte e inversa entre o nível de independência do idoso e a sobrecarga do cuidador (ρ=-0,619; p=0,018) e com os domínios, separadamente, sobrecarga tempo dependente (ρ=-0,866; p=0,000) e sobrecarga à vida pessoal (ρ=-0,708; p=0,005). Conclusão Quanto mais independente o idoso, menor foi a sobrecarga atribuída ao seu cuidador. Não houve associação entre dor e sobrecarga do cuidador.

Abstract Background Caring for an elderly is often an arduous task, and the care demands go beyond the caregiver's capacity may cause overload and pain. Objective The aim of this study was to investigate the association between independence level of the elderly in daily life activities and the occurrence of pain and overload your primary caregiver. Method The study included 14 elderly residents in adscript territory of health units of the North Zone-Axis Baltazar area Baltazar North axis of the city Porto Alegre and their primary caregivers, in home visits, answered questions regarding the socioeconomic profile, the occurrence of pain (Nordic questionnaire and visual analog pain scale), the caregiver burden (Inventory caregiver overload) and the level of independence of the elderly (Katz index). Results The average age of the elderly is 82.1 years (± 6.9) and caregivers, 65.9 years (± 11.3). Of the 14 elderly, 28.6% were classified as independent, 50% as having moderate dependence and 21.4% as very dependent. There was strong inverse correlation between the old level of independence and caregiver burden (ρ = -0.619; p = 0.018). When evaluating areas of the inventory separately overload time dependent (ρ = -0.866; p = 0.000) and over the personal life (ρ = -0.708; p = 0.005) correlated to the level of independence of the elderly. Conclusion The study showed that the more independent for the elderly, the lower the burden attributed to the caregiver.

Effects of Exercise on Inflammatory, Oxidative, and Neurotrophic Biomarkers on Cognitively Impaired Individuals Diagnosed With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

Although the effects of physical exercise (PE) on cognitive function in dementia and mild cognitive impairment (MCI) have been largely studied, its biochemical effect is still poorly explored. The aim of this systematic review was to investigate the effects of PE on inflammatory, oxidative, and neurotrophic biomarkers of participants with MCI or dementia. Six electronic databases, (PubMed, Cochrane Central, Embase, PEDro, PsycINFO, and SportDiscus) were searched for randomized controlled trials assessing the effects of PE on serum and/or plasma biomarkers of elderly participants with MCI or dementia. After selection process, eight studies were included. Meta-analysis was performed by comparison of changes from baseline, using the random effects method. Meta-analysis showed a significant effect of aerobic exercise on interleukin-6 and tumor necrosis factor alpha decrease and positive effects on brain-derived neurotrophic factor expression. As only one study was included with oxidative biomarker assessment, the effects of PE on oxidative process remain unclear. Finally, even though it was possible to observe positive effects of PE on some biomarkers of MCI and dementia individuals, current evidence does not allow drawing specific practical recommendations such as type, frequency, intensity, or duration of PE in these population. Further researches aiming to estimate the PE effectiveness on biomarkers of MCI and Alzheimer's disease are needed.

Inflammatory response and oxidative stress in developing rat brain and its consequences on motor behavior following maternal administration of LPS and perinatal anoxia.

Cerebral palsy (CP) is a disorder of locomotion, posture and movement that can be caused by prenatal, perinatal or postnatal insults during brain development. An increased incidence of CP has been correlated to perinatal asphyxia and maternal infections during gestation. The effects of maternal exposure to low doses of bacterial endotoxin (lipopolysaccharide, LPS) associated or not with perinatal anoxia (PA) in oxidative and inflammatory parameters were examined in cerebral cortices of newborns pups. Concentrations of TNF-α, IL-1, IL-4, SOD, CAT and DCF were measured by the ELISA method. Other newborn rats were assessed for neonatal developmental milestones from day 1 to 21. Motor behavior was also tested at P29 using open-field and Rotarod. PA alone only increased IL-1 expression in cerebral cortex with no changes in oxidative measures. PA also induced a slight impact on development and motor performance. LPS alone was not able to delay motor development but resulted in changes in motor activity and coordination with increased levels of IL-1 and TNF-α expression associated with a high production of free radicals and elevated SOD activity. When LPS and PA were combined, changes on inflammatory and oxidative stress parameters were greater. In addition, greater motor development and coordination impairments were observed. Prenatal exposure of pups to LPS appeared to sensitize the developing brain to effects of a subsequent anoxia insult resulting in an increased expression of pro-inflammatory cytokines and increased free radical levels in the cerebral cortex. These outcomes suggest that oxidative and inflammatory parameters in the cerebral cortex are implicated in motor deficits following maternal infection and perinatal anoxia by acting in a synergistic manner during a critical period of development of the nervous system.