RESUMO
BACKGROUND: Multicomponent physical training in patients with Parkinson disease may improve their functional independence, especially in terms of gait speed and coordination. AIM: To assess the effects of an eight weeks multicomponent physical training program in patients with Parkinson disease. MATERIAL AND METHODS: Fourteen patients with Parkinson disease participated in a physical training program that lasted eight weeks. Three sessions lasting 60 minutes per week were carried out. Patients were assessed using the six minutes walk, timed up and go and the unipodal stance test. RESULTS: After the training period, significant improvements in the six minute walk test and timed up and go were observed. No significant changes were observed in the unipodal stance test. CONCLUSIONS: The eight weeks training program improved gait speed and functional status in these patients with Parkinson disease.
Assuntos
Terapia por Exercício/métodos , Marcha/fisiologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/reabilitação , Condicionamento Físico Humano/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica/fisiologia , Valores de Referência , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Teste de CaminhadaRESUMO
BACKGROUND: Massive implementation of malaria diagnostics in low-resource countries is regarded as a pivotal strategy in control and elimination efforts. Although malaria rapid diagnostic tests (RDTs) are considered a viable alternative, there are still obstacles to the widespread implementation of this strategy, such as reporting constraints and lack of proper quality assurance of RDT-based programmes at point-of-care (POC). METHODS: A prospective cohort of patients, seeking routine care for febrile episodes at health centres in malaria-endemic areas of Colombia, was used to assess the diagnostic performance of a device based on smartphone technology (Deki ReaderTM, former codename "GenZero"), that assists users at POC to process RDTs. After informed consent, patients were enrolled into the study and blood samples were collected for thick blood smear (TBS) and RDT. The RDT results were interpreted by both visual inspection and Deki Reader device and concordance between visual and device interpretation was measured. Microscopy corrected by real-time polymerase chain reaction (PCR) and microscopy were "gold standard" tests to assess the diagnostic performance. RESULTS: In total, 1,807 patients were enrolled at seven health centres in malaria-endemic areas of Colombia. Thirty-three Plasmodium falciparum and 100 Plasmodium vivax cases were positive by corrected microscopy. Both sensitivity and specificity were 93.9% (95% CI 69.7-95.2) and 98.7% (95% CI 98.5-99.4) for P. falciparum, and 98.0% (95% CI 90.3-98.9) and 97.9% (95% CI 97.1-98.5) for P. vivax. Percentage concordance between visual and device interpretation of RDT was 98.5% and 99.0% for P. vivax and P. falciparum, respectively.The RDT, when compared to TBS, showed high sensitivity and specificity for P. falciparum in both visual and device interpretation, and good overall diagnostic performance for P. vivax. Comparison between PCR as gold standard and visual and device interpretation showed acceptable overall performance for both species. CONCLUSIONS: The diagnostic performance of the Deki Reader was comparable to visual interpretation of RDTs (without significant differences) for both malaria species. Providing standardized automated interpretation of RDTs at POC in remote areas, in addition to almost real-time reporting of cases and enabling quality control would greatly benefit large-scale implementation of RDT-based malaria diagnostic programmes.
Assuntos
Processamento Eletrônico de Dados/métodos , Malária Falciparum/diagnóstico , Malária Vivax/diagnóstico , Parasitologia/métodos , Sistemas Automatizados de Assistência Junto ao Leito , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Colômbia/epidemiologia , Doenças Endêmicas , Feminino , Humanos , Lactente , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: Parasitological confirmation of malaria is now recommended in all febrile patients by the World Health Organization (WHO) to reduce inappropriate use of anti-malarial drugs. Widespread implementation of rapid diagnostic tests (RDTs) is regarded as an effective strategy to achieve this goal. However, the quality of diagnosis provided by RDTs in remote rural dispensaries and health centres is not ideal. Feasible RDT quality control programmes in these settings are challenging. Collection of information regarding diagnostic events is also very deficient in low-resource countries. METHODS: A prospective cohort of consecutive patients aged more than one year from both genders, seeking routine care for febrile episodes at dispensaries located in the Bagamoyo district of Tanzania, were enrolled into the study after signing an informed consent form. Blood samples were taken for thick blood smear (TBS) microscopic examination and malaria RDT (SD Bioline Malaria Antigen Pf/Pan™ (SD RDT)). RDT results were interpreted by both visual interpretation and Deki Reader™ device. Results of visual interpretation were used for case management purposes. Microscopy was considered the "gold standard test" to assess the sensitivity and specificity of the Deki Reader interpretation and to compare it to visual interpretation. RESULTS: In total, 1,346 febrile subjects were included in the final analysis. The SD RDT, when used in conjunction with the Deki Reader and upon visual interpretation, had sensitivities of 95.3% (95% CI, 90.6-97.7) and 94.7% (95% CI, 89.8-97.3) respectively, and specificities of 94.6% (95% CI, 93.5-96.1) and 95.6% (95% CI, 94.2-96.6), respectively to gold standard. There was a high percentage of overall agreement between the two methods of interpretation. CONCLUSION: The sensitivity and specificity of the Deki Reader in interpretation of SD RDTs were comparable to previous reports and showed high agreement to visual interpretation (>98%). The results of the study reflect the situation in real practice and show good performance characteristics of Deki Reader on interpreting malaria RDTs in the hands of local laboratory technicians. They also suggest that a system like this could provide great benefits to the health care system. Further studies to look at ease of use by community health workers, and cost benefit of the system are warranted.
Assuntos
Automação Laboratorial/métodos , Testes Diagnósticos de Rotina/métodos , Malária/diagnóstico , Parasitologia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sangue/parasitologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Microscopia , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Tanzânia , Adulto JovemRESUMO
This study sought to verify whether the constructs measured on the WISC-V are equivalent according to sex and age group in Chilean students to substantiate intergroup comparisons. For this, the measurement invariance of two variants of the five-factor intelligence model was explored with the ten primary subtests (hierarchical and oblique) using multigroup confirmatory factor analysis. Seven hundred and forty participants between 6 and 16 years of age from the Chilean standardization sample were assessed. The results show complete invariance according to sex, but incomplete according to the age group. The implications of these findings in both the professional area of psychology and future research are discussed.
RESUMO
Background: Multicomponent physical training in patients with Parkinson disease may improve their functional independence, especially in terms of gait speed and coordination. Aim: To assess the effects of an eight weeks multicomponent physical training program in patients with Parkinson disease. Material and Methods: Fourteen patients with Parkinson disease participated in a physical training program that lasted eight weeks. Three sessions lasting 60 minutes per week were carried out. Patients were assessed using the six minutes walk, timed up and go and the unipodal stance test. Results: After the training period, significant improvements in the six minute walk test and timed up and go were observed. No significant changes were observed in the unipodal stance test. Conclusions: The eight weeks training program improved gait speed and functional status in these patients with Parkinson disease.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença de Parkinson/fisiopatologia , Doença de Parkinson/reabilitação , Terapia por Exercício/métodos , Condicionamento Físico Humano/métodos , Marcha/fisiologia , Valores de Referência , Fatores de Tempo , Resultado do Tratamento , Estatísticas não Paramétricas , Recuperação de Função Fisiológica/fisiologia , Teste de CaminhadaRESUMO
La transmisión de memorias acerca de la violencia política es apremiante en sociedades que han vivido autoritarismos. Este artículo se focaliza en dicho problema, en el contexto de la dictadura militar chilena (1973-1990) y la memoria que actualmente se construye acerca de ella, a cuarenta años del golpe de Estado. Desde una perspectiva dialógica, se analiza el tipo de relación que se produce entre generaciones cuando hacen memoria de la dictadura militar. Se realizaron seis grupos de discusión, participando un total de 48 personas convocadas según: a) grupo etario, b) posición ideológica, c) nivel socioeconómico y d) territorio. El análisis discursivo releva la constitución de tres generaciones -protagonista del pasado, protagonista del presente y zona gris- que al hacer memoria de la dictadura adoptan como forma dialógica el debate, no realizando mayores cuestionamientos respecto de los contenidos considerados al momento de construir versiones de dicho pasado en la conversación.
The transmission of memories about political violence is a pressing need in societies which have experienced authoritarian rule. The article focuses on this issue in the context of the Chilean military dictatorship (1973-1990) and the memory currently being constructed about it, forty years after the coup. From a dialogic perspective, the text analyzes the type of relationship established between generations when they think back about the military dictatorship. Six discussion groups were set up, with a total of 48 participants selected according to their a) age group, b) political stance, c) socioeconomic level, and d) territory. The discursive analysis reveals the establishment of three generations -protagonist of the past, protagonist of the present, and a gray area- whose members, when recalling the dictatorship, use debate as their dialogic form without truly questioning the contents employed to construct versions of this past in their conversations.
Assuntos
Violência , MemóriaRESUMO
Se optimizó la formulación de premezclas en polvo de queque y bizcocho dietéticos, aplicando la metodología superficie de respuesta (MSR). La calidad sensorial fue determinada para ambas formulaciones utilizando el método de puntaje compuesto con un panel entrenado de 18 jueces. Las variables seleccionadas paraqueque fueron: por ciento agente emulsionante y tiempo de horneo; para bizcocho por ciento agente emulsionante y por ciento harina clorada. Analizando el mapa de contorno y teniendo en cuenta aspectos económicos se determinó que la mejor respuesta para la formulación de queque dietético, estuvo dada por la combinación de variables: agente emulsionante 2 por ciento y 48 minutos de tiempo de horneo. Para el caso del bizcocho dietético, los niveles óptimos fueron agentes emulsionante 6,2 por ciento y harina clorada 48,2 por ciento. Ambos productos demostraron ser estables bajo condiciones aceleradas de almacenamiento de 30ºC durante 75 días, no encontrándose diferencias sensoriales significativas (p<0,05) en los productos horneados con relación a formulaciones recién preparadas. El índice de peróxido se mantuvo por debajo de los valores señalados por la bibliografía para detectar rancidez organoléptica. Datos obtenidos por la prueba hedónica muestran que estos productos dietéticos tienen una buena eceptabilidad, ampliando por consiguiente el rango de oferta de productos dietéticos de pastelería para satisfacer demandas del mercado actual