Current On-Skin Flexible Sensors, Materials, Manufacturing Approaches, and Study Trends for Health Monitoring: A Review.

Due to an ever-increasing amount of the population focusing more on their personal health, thanks to rising living standards, there is a pressing need to improve personal healthcare devices. These devices presently require laborious, time-consuming, and convoluted procedures that heavily rely on cumbersome equipment, causing discomfort and pain for the patients during invasive methods such as sample-gathering, blood sampling, and other traditional benchtop techniques. The solution lies in the development of new flexible sensors with temperature, humidity, strain, pressure, and sweat detection and monitoring capabilities, mimicking some of the sensory capabilities of the skin. In this review, a comprehensive presentation of the themes regarding flexible sensors, chosen materials, manufacturing processes, and trends was made. It was concluded that carbon-based composite materials, along with graphene and its derivates, have garnered significant interest due to their electromechanical stability, extraordinary electrical conductivity, high specific surface area, variety, and relatively low cost.

In-person and virtual assessment of oral radiology skills and competences by the Objective Structured Clinical Examination.

PURPOSE: Clinical education is an essential part of the Dental School curriculum and assessment is a fundamental component of the teaching-learning process. OBJECTIVES: With the purpose of implementing a structured and objective assessment method in the teaching of Oral Radiology, undergraduate dentistry students were submitted to an assessment of clinical competences and skills in radiology by the Objective Structured Clinical Examination (OSCE), applied both in-person and virtually (VOSCE). METHODS: The same group of students was evaluated by the OSCE and VOSCE in six-station circuits that involved the assessment of clinical skills in Oral Radiology. For each station, an individual evaluative checklist (per station) was prepared and the participants' general scores were obtained. The students' anxiety level was also assessed before and after the exams and a meta-evaluation was performed to indicate the participants' perception of the assessment methods. RESULTS: The OSCE (0.61) and VOSCE (0.81) reliability values were considered substantial and almost perfect, respectively. The students evaluated showed a better performance in the OSCE (p ≤ 0.05). Anxiety levels were considered moderate in both assessments and showed no difference between the two exams. The meta-evaluation showed a positive evaluation for the items "time of execution", "clarity", "degree of difficulty" and "importance for clinical practice", both for the OSCE and the VOSCE. CONCLUSIONS: The OSCE was effective for evaluating clinical competencies and skills in Oral Radiology, both in face-to-face and virtual examinations, but with a limitation in the online method for evaluating technical skills.

Effect of photobiomodulation therapy on performance and running economy in runners: A randomized double-blinded placebo-controlled trial.

The objective of this study was to evaluate effects of photobiomodulation therapy (PBMT) on the 3000 m running performance (primary outcome), running economy (RE), metabolic cost and ratings of perceived exertion during running (secondary outcomes). Twenty male endurance athletes performed 4-min treadmill rectangular test at 12 km.h-1 monitored by a gas analyser. After that, PBMT or placebo in each lower limb was applied, followed performed a maximum test of 3000 m. Immediately after 3000 m test, the athletes repeated the treadmill test. Another application of PBMT/placebo was done after the treadmill test, and athletes went back to the laboratory 24 h later to repeat the treadmill test. After a 72 h interval, athletes repeated all procedures with another treatment intervention (PBMT/placebo). Athletes performed the 3000 m running test ~7s faster when treated with PBMT with similar effort score compared placebo condition. The RE remains unchanged immediately post 3000 m running test, nonetheless RE measured post-24 h improved by 5% with PBMT application without changes in metabolic cost. The PBMT pre- and post-conditioning enhanced the 3000 m running performance and improved RE 24 h following the 3000 m test. However, no changes on ratings of perceived exertion and metabolic cost with the application of PBMT.

Pork quality after electrical or carbon dioxide stunning at slaughter.

A total of 172 pigs were randomly allocated to two stunning treatments: carbon dioxide (CO2) and electrical stunning at a commercial abattoir. The Longissimus lumborum (LL) muscle was used to evaluate the effects of stunning methods on pork quality and financial losses of carcasses and viscera condemnation was also determined following by sanitary inspection. There was no effect due to stunning method on quality parameters (P > .137) of pH 24, drip or thaw loss, lipid oxidation, myofibrillar fragmentation index, shear force or PSE / DFD meat incidence. The LL muscle of the electrically stunned pigs had a higher L * value (P < .05), higher cooking loss (P < .001) and lower pH 45 (P < .05) compared to those stunned with CO2. CO2 stunned pigs had fewer carcasses condemned due to fractures / lesions (P < .05), hepatic and renal congestion (P < .05). CO2 stunning can be beneficial from an economic point of view because it has reduced losses through condemnation at the slaughterhouse.

Treating High-Caries Risk Occlusal Surfaces in First Permanent Molars through Sealants and Supervised Toothbrushing: A 3-Year Cost-Effective Analysis.

We conducted a 3-year cost-effectiveness analysis on the cavitated dentine carious lesion preventive capabilities of composite resin (CR) (reference group) and atraumatic restorative treatment (ART) high-viscosity glass-ionomer cement (HVGIC) sealants compared to supervised toothbrushing (STB) in high-risk first permanent molars. School children aged 6-7 years in 6 schools (2 per group) received CR and ART/HVGIC sealants or STB daily for 180 days each school year. Data were collected prospectively and cost estimates were made for sample data and a projection of 1,000 sealants/STB high-risk permanent molars. Although STB had the best outcome, its high implementation cost (95% of cost for supervisors visiting schools 180 days/school year) affected the results. ART/HVGIC was cost-effective compared to CR for the sample data (savings of USD 37 per cavitated dentine carious lesion prevented), while CR was cost-effective compared to ART/HVGIC for the projection (savings of USD 17 per cavitated dentine carious lesion prevented), and both were cost-saving compared to STB. Two STB scenarios were tested in sensitivity analyses with variations in caries incidence and number of supervision days; results showed STB had lower costs and higher savings per cavitated dentine carious lesion prevented than CR and ART/HVGIC. A major assumption is that both scenarios have the same high effectiveness rate experienced by STB under study conditions; however, they point to the value of further research on the benefits of adopting STB as a long-term venture in a general population of school children.

Perfil do estilo de vida de universitários de Educação Física da cidade do Rio de Janeiro / Lifestyle profile of Physical Education students in the city of Rio de Janeiro

Diversos hábitos adquiridos durante os anos cursados nas universidades permanecem incorporados ao cotidiano dos estudantes, mesmo após a conclusão do curso. O objetivo deste estudo é avaliar fatores específicos relacionados ao estilo de vida e à qualidade de vida em universitários do curso de Educação Física da Universidade do Estado do Rio de Janeiro (UERJ). Trata-se de um estudo descritivo com abordagem quantitativa com alunos do primeiro ao último período acadêmico com matrícula ativa no curso de graduação em Educação Física (Licenciatura e Bacharelado) da UERJ, com ingresso por meio do vestibular. Foi aplicado um questionário adaptado do Perfil do Estilo de Vida Individual, contendo oito componentes: alimentação, atividade física, autoimagem, relacionamentos, controle do estresse, finanças, comportamento preventivo e sono restaurador. Utilizou-se o teste de Spearman para analisar a associação entre os domínios do questionário (p < 0,05). A amostra foi composta por 103 estudantes (idade: 22,16 ± 3,85 anos), 66,02% do sexo masculino e 33,98% do sexo feminino. A análise dos componentes revelou uma tendência de os jovens universitários apresentarem, ao iniciar a fase adulta, dificuldade em manter níveis ideais de sono restaurador (3,19 ± 2,02) e finanças (4,14 ± 2,15). O componente relacionamentos (7,49 ± 1,61) apresentou os melhores níveis. Pode-se concluir que os estudantes de Educação Física pesquisados nem sempre conseguem seguir as recomendações que eles mesmos irão disseminar para clientes e alunos. Esse distanciamento entre o discurso e a prática se manifestou em diferentes graus, configurando diversos níveis de inadequações às práticas concernentes à saúde. Assim sendo, os conhecimentos acerca da importância dos hábitos de saúde nem sempre se manifestaram no comportamento alimentar, na atividade física, no sono e demais componentes atrelados à qualidade de vida e ao estilo de vida da amostra do presente estudo....(AU)

Several habits acquired during routed years in universities remain embedded in the daily lives of students, even after completing the course. The aim of this study is to evaluate specific factors related to lifestyle and quality of life in undergraduates of the Physical Education course at the State University of Rio de Janeiro (UERJ). This is a descriptive study with a quantitative approach with students from the first to the last academic period with active enrollment in the undergraduate degree in Physical Education (Licentiate and Bachelor's degree) of UERJ, with admission through the entrance exam. We applied a questionnaire, adapted from the Individual Lifestyle Profile, containing eight components: nutrition, physical activity, self-image, relationships, stress management, finance, preventive behavior and restorative sleep. We used the Spearman test to analyze the association between the domains of the questionnaire (p < 0.05). The sample consisted of 103 students (age: 22.16 ± 3.85 years), 66.02% male and 33.98% female. The analysis of the components revealed a tendency for university students present, at the beginning of adulthood, difficulty in maintaining optimal levels of restorative sleep (3.19 ± 2.02) and finance (4.14 ± 2.15). The component relationships (7.49 ± 1.61) showed the best levels. It can be concluded that the students of Physical Education researched do not always follow the recommendations that they themselves will disseminate to clients and students. This distance between discourse and practice has manifested itself in different degrees, setting different levels of inadequacies in health practices. Therefore, knowledge about the importance of health habits was not always manifested in the eating behavior, physical activity, sleep and other components related to the quality of life and lifestyle in the sample of the present study....(AU)

Different Methods for Long-term Systematic Assessment of Challenging Behaviors in People with Severe Intellectual Disability.

The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used.

[Health among persons with intellectual disability in Spain: the European POMONA-II study]. / La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II.

INTRODUCTION: International studies show that both the pattern of health and the healthcare provided for persons with intellectual disability (ID) and the general population are different. AIMS: To obtain data about the state of health of persons with ID and to compare them with data about the general population. PATIENTS AND METHODS: The P15 set of health indicators was used in a sample of 111 subjects with ID. The health data that were found were compared according to the subjects' type of residence and the 2006 National Health Survey was used to compare these data with those for the general population. RESULTS; The sample with ID presented 25 times more cases of epilepsy and twice as many cases of obesity. Twenty per cent presented pain in the mouth and the presence of sensory and mobility problems, as well as psychosis, was high. We also found, however, a low presence of pathologies like diabetes, hypertension, osteoarthritis and osteoporosis. They also displayed a lower rate of participation in prevention and health promotion programmes, a higher number of hospital admissions and a lower usage of emergency services. CONCLUSIONS: The pattern of health of persons with ID differs from that of the general population, and they use healthcare services differently. It is important to develop programmes of health promotion and professional training that are specifically designed to attend to the needs of persons with ID. Likewise, it is also necessary to implement health surveys that include data about this population.

The Caries Assessment Spectrum and Treatment (CAST) index: rational and development.

Serious difficulties in reporting results were encountered when using ICDAS II and PUFA separately in an epidemiological survey in a child population in Brazil. That necessitated the development of a comprehensive but pragmatic caries assessment index. This publication describes the rationale, development and content of a novel caries assessment index. Strengths and weaknesses of ICDAS II, PUFA and other indices were analysed. The novel caries index developed for use in epidemiological surveys is termed 'Caries Assessment Spectrum and Treatment' (CAST). 'Spectrum' indicates what is considered the main strength of the new index - its usefulness in describing the complete range of stages of carious lesion progression: from no carious lesion, through caries protection (sealant) and caries cure (restoration) to lesions in enamel and dentine, and the advanced stages of carious lesion progression in pulpal and tooth-surrounding tissue. CAST combines elements of the ICDAS II and PUFA indices, and the M- and F-components of the DMF index. A DMF score can easily be calculated from the CAST score, thereby enabling retention of the use of existing DMF scores. The CAST index for use in epidemiological surveys is very promising. It should be validated and its reliability and usefulness be tested in different age groups in different countries and cultures.

Met and unmet needs of children with epilepsy in a paediatric tertiary care setting.

OBJECTIVE: To investigate the extent to which the health needs were met or unmet in children with epilepsy attending a tertiary care outpatient setting. PATIENTS AND METHOD: A semi-structured interview was used to collect relevant information from the parents. It focused on ascertaining the quality of health care received by the children, including the extent to which attention was given to epilepsy related physical, behavioural, social and educational impairments that were identified by the parents. RESULTS: There was satisfactory seizure control in the majority. Most children received only one anticonvulsant and side-effects were reported to be minimal. A large majority had behavioural problems, and social and educational difficulties to a lesser extent. Parents were concerned about the implications of these problems, but there was little communication about them in the doctor-patient contact. Even where the problems were communicated, parent satisfaction about the interventions was low. Parents identified the availability of more consultation time and provision of more information on epilepsy as their expectations from doctors. CONCLUSIONS: This study shows that awareness and communication about the multiple health problems of children with epilepsy are necessary to improve the quality of health care given to them.

Assessment of the patient with acute asthma in the emergency department. A factor analytic study.

Acute asthma is a very common medical emergency. Thus, a variety of measures are currently used to assess severity; most are logical and seem reasonably effective but have never been scientifically tested in a comprehensive manner. Additionally, simple brief measures are needed for greater specificity in describing variables and in assessing different aspects of asthma. The purpose of this study was to examine the most common clinical and objective measures utilized in the assessment of acute asthma in the emergency department for determining whether these variables comprise separate or distinct dimensions. To carry out the above purpose, we used the multivariate statistical technique of factor analysis. Measures of age, duration of attack, heart rate, respiratory rate, peak expiratory flow (PEF), FVC, FEV1 percent of predicted, accessory-muscle use, dyspnea, wheezing, steroid use, and early response to treatment in 194 patients with acute asthma (mean age = 32.8 +/- 11.9 years) were factor analyzed through the method of principal components. Factors extracted with this method were then rotated orthogonally through the Varimax procedure. The first factor contained the three measures of lung function (PEF, FVC, and FEV1 percent of predicted) and early response of treatment. The second factor extracted contained respiratory rate, accessory-muscle use, and dyspnea. Factor 3 contained heart rate and wheezing, and factor 4 contained age, duration of attack, and steroid use. Exploratory analysis of subgroups (by randomization, by severity of airflow obstruction, and by use of steroids) confirmed the results of the primary analysis. The coefficients of congruence obtained were above 0.90. Early response of treatment measured by the percent variation of FEV1 at 30 min over baseline value significantly correlated with a broad variety of asthma characteristics (PEF, FVC, FEV1 percent of predicted, accessory-muscle use, and duration of attack), resulting in a rather general measure, and suggesting that its measure can be a reliable assessment of acute adult asthma. Finally, early response to treatment was the most important predictor of the patient outcome (r = 0.48, p < 0.00). In summary, the results of this study support the hypothesis that most of the subjective and objective measures utilized in the assessment of patients with acute adult asthma represent separate and nonoverlapping dimensions and provided a useful summary of acute asthma. Early response to treatment in combination with measures of the four identified factors could be included in other acute adult asthma research protocols promoting greater comparable among studies.