[Satisfaction of wheelchair users in the Baixada Santista Metropolitan Region]. / Satisfação dos usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista.

This article seeks to identify user satisfaction in relation to wheelchairs and the provision of public and private health services in the Baixada Santista Metropolitan Region. It involved a cross-sectional study with a quantitative approach. Participants answered a sociodemographic questionnaire and the Brazilian version of the Quebec Assistive Technology User Satisfaction Assessment. Data were analyzed using descriptive and comparative statistics by means of Student's t test. Cohen's d effect sizes were also calculated. Participants (n = 42) were "more or less satisfied" with the wheelchairs and "quite satisfied" with the services provided. Rigid frame wheelchair users were significantly more satisfied with their wheelchairs compared to users of wheelchairs weighing over 198 lbs. (p = 0.010, d = 1.04). Users of private services showed significantly greater satisfaction with the provision of the service compared to public services users (p = 0.021, d = 0.75). Wheelchair users in the Baixada Santista Metropolitan Region are more satisfied with the rigid frame wheelchair and less satisfied with public services.

O objetivo deste artigo é identificar a satisfação dos usuários em relação às cadeiras de rodas e à prestação de serviços públicos e privados de saúde da Região Metropolitana da Baixada Santista. Estudo transversal com abordagem quantitativa. Os participantes responderam a um questionário sociodemográfico e à versão brasileira do Quebec Assistive Technology User Satisfaction Assessment. Os dados foram analisados utilizando a estatística descritiva e comparativa por meio do teste t de Student. Os tamanhos de efeito d de Cohen foram calculados. Os participantes (n = 42) estavam "mais ou menos satisfeitos" com as cadeiras de rodas e "pouco satisfeitos" com a prestação de serviços. Os usuários de cadeiras de rodas monobloco apresentaram satisfação significativamente maior com suas cadeiras em comparação com usuários de cadeiras de rodas acima de 90kg (p = 0,010, d = 1,04). Os usuários de serviços privados apresentaram satisfação significativamente maior com a prestação de serviço em comparação aos usuários de serviços públicos (p = 0,021, d = 0,75). Os usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista estão mais satisfeitos com as cadeiras de rodas monobloco e menos satisfeitos com os serviços públicos.

Wheelchair outcome measurement instruments for children: a scoping review protocol.

Purpose: The proposed scoping review aims to explore and map wheelchair outcome measurement instruments for children in the literature.Method: The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. The review question and eligibility criteria were developed using the PCC (population, concept, context) mnemonic as follows: (P) children manual or motorised wheelchair users (aged ≤ 18 years), (C) wheelchair outcome measurement instruments, (C) primary sources of literature. The search will be conducted in nine relevant electronic databases. including grey literature from Academic Google. Study screening, selection, and data extraction will be performed independently by two authors. A third reviewer will resolve discrepancies between the authors. General characteristics, population, feasibility, interpretability data will be extracted in accordance with the COSMIN methodology (Consensus-based Standards for the selection of health Measurement Instruments). This will encompass data pertaining to the measurement properties of the domains of reliability, validity and responsiveness. A descriptive analysis will be carried out, and the results will be classified into categories and presented in tables accompanied by a descriptive summary.Results: The results can inform future research directions, clinical practice and the development of wheelchair outcome measurement instruments. Furthermore, it will help professionals in rehabilitation and wheelchair services to find the wheelchair outcome measurement instruments according to the target population and cultural context.

IMPLICATIONS FOR REHABILITATIONThis review has the potential to enhance understanding of wheelchair outcome measurement instruments, thereby enabling rehabilitation professionals to assess the impact and progress of wheelchair use within the target population.The findings related to measurement properties may guide future research in the field of wheelchair outcome measurement instruments.Additionally it will assist clinical professionals in identifying appropriate wheelchair outcome measurement instruments based on the target population and cultural context.

Satisfação dos usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista / Satisfaction of wheelchair users in the Baixada Santista Metropolitan Region

Resumo O objetivo deste artigo é identificar a satisfação dos usuários em relação às cadeiras de rodas e à prestação de serviços públicos e privados de saúde da Região Metropolitana da Baixada Santista. Estudo transversal com abordagem quantitativa. Os participantes responderam a um questionário sociodemográfico e à versão brasileira do Quebec Assistive Technology User Satisfaction Assessment. Os dados foram analisados utilizando a estatística descritiva e comparativa por meio do teste t de Student. Os tamanhos de efeito d de Cohen foram calculados. Os participantes (n = 42) estavam "mais ou menos satisfeitos" com as cadeiras de rodas e "pouco satisfeitos" com a prestação de serviços. Os usuários de cadeiras de rodas monobloco apresentaram satisfação significativamente maior com suas cadeiras em comparação com usuários de cadeiras de rodas acima de 90kg (p = 0,010, d = 1,04). Os usuários de serviços privados apresentaram satisfação significativamente maior com a prestação de serviço em comparação aos usuários de serviços públicos (p = 0,021, d = 0,75). Os usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista estão mais satisfeitos com as cadeiras de rodas monobloco e menos satisfeitos com os serviços públicos.

Abstract This article seeks to identify user satisfaction in relation to wheelchairs and the provision of public and private health services in the Baixada Santista Metropolitan Region. It involved a cross-sectional study with a quantitative approach. Participants answered a sociodemographic questionnaire and the Brazilian version of the Quebec Assistive Technology User Satisfaction Assessment. Data were analyzed using descriptive and comparative statistics by means of Student's t test. Cohen's d effect sizes were also calculated. Participants (n = 42) were "more or less satisfied" with the wheelchairs and "quite satisfied" with the services provided. Rigid frame wheelchair users were significantly more satisfied with their wheelchairs compared to users of wheelchairs weighing over 198 lbs. (p = 0.010, d = 1.04). Users of private services showed significantly greater satisfaction with the provision of the service compared to public services users (p = 0.021, d = 0.75). Wheelchair users in the Baixada Santista Metropolitan Region are more satisfied with the rigid frame wheelchair and less satisfied with public services.

Barreiras e facilitadores ambientais na participação da criança com paralisia cerebral em atividades de recreação e lazer: uma revisão integrativa / Environmental barriers and facilitators to the participation of children with cerebral palsy in recreational and leisure activities: an integrative review

Resumo A participação de crianças com paralisia cerebral (PC) em atividades de recreação e lazer pode ser influenciada por fatores ambientais. O reconhecimento e compreensão desses fatores como barreiras ou facilitadores dessas atividades são essenciais para garantir o direito de participação dessas crianças em condições de igualdade com as demais pessoas da sociedade. Neste contexto, o objetivo desta revisão integrativa foi identificar as barreiras e facilitadores ambientais na participação de crianças com PC em atividades de recreação e lazer. Utilizou-se o método de revisão integrativa proposto por Whittemore e Knafl (2005). Estudos publicados entre 2011 e 2022 nos idiomas português e/ou inglês foram selecionados a partir das fontes de indexação MEDLINE via PubMed, EMBASE, SciELO, LILACS, SCOPUS e Web of Science. Nove estudos foram incluídos na revisão - a maioria de desenho transversal e abordagem qualitativa. Os seguintes facilitadores da participação foram identificados: apoio dos pais, pares e professores; interação com adultos; terapias; condições materiais; atividades em casa, na escola e na comunidade; diversidade de brinquedos; e atividades culturais. As seguintes barreiras à participação foram identificadas: falta de acesso a transportes públicos; atitudes negativas; falta de escolha e menor interação dos pais; e falta de adequação das atividades. A Classificação de Funcionalidade, Incapacidade e Saúde (CIF) e os conceitos pirâmide de participação e família de constructos foram fundamentais para identificar as barreiras e facilitadores ambientais na participação de crianças com PC. Sugere-se que estudos futuros sejam conduzidos para avaliar a qualidade e a força da evidência para participantes com 11 anos de idade incompletos.

Abstract The participation of children with cerebral palsy (CP) in recreation and leisure activities can be influenced by environmental factors. The recognition and understanding of these factors as barriers or facilitators of these activities are essential to guarantee the right of these children to participate on equal terms with other people in society. In this context, the objective of this integrative review was to identify environmental barriers and facilitators in the participation of children with CP in recreation and leisure activities. The integrative review method proposed by Whittemore and Knafl (2005) was used. Studies published between 2011 and 2022 in Portuguese and/or English were selected from MEDLINE indexing sources via PubMed, EMBASE, SciELO, LILACS, SCOPUS and Web of Science. Nine studies were included in the review - most of them cross-sectional in design and qualitative in approach. The following participation facilitators were identified: support from parents, peers and teachers; interaction with adults; therapies; material conditions; activities at home, school and in the community; diversity of toys; and cultural activities. The following barriers to participation were identified: lack of access to public transport; negative attitudes; lack of choice and less parental interaction; and lack of adequacy of activities. The Classification of Functioning, Disability and Health (ICF) and the concepts of participation pyramid and family of constructs were fundamental in identifying environmental barriers and facilitators in the participation of children with CP. It is suggested that future studies be conducted to assess the quality and strength of the evidence for participants under 11 years of age.

Conceptual mapping proposed to comprehend the effect of wheelchair mobility on social participation and quality of life: a systematic review.

PURPOSE: To identify and synthesise the available evidence on the effect of mobility on social participation and quality of life (QoL) of wheelchairs (WC) on adults who use WC as their primary means of mobility. MATERIALS AND METHODS: Systematic review undertaken in accordance with the Centre for Reviews and Dissemination Guidelines and registered in the PROSPERO International Prospective Register of Systematic reviews. Nine electronic databases (MEDLINE via PubMed, EMBASE, Cochrane Library, LILACS, CINAHL, PEDro, SCOPUS, Web of Science, and BVS ECOS) were searched with the following PICO eligibility criteria: (P) Population was individuals with mobility limitations that live in their community, aged 18 or older; (I) Intervention was mobility devices, such as manual and powered wheelchairs; (C) Comparators, not applied; (O) Outcome was factors that can be influenced by wheelchair use, such as: social participation, health-related quality of life and QOL. Critical appraisal of methodological quality of studies were undertaken. RESULTS: A total of 18 studies were included. The proportion of studies evaluating the effects of mobility on participation was higher than to mobility on QoL. WC quality, device benefit (ease of repairs and maintenance), confidence using a WC and WC skills were key factors determining participation. The provision of WC according to the eight steps service proposed by the Word Health Organisation contributed to higher levels of physical health, WC satisfaction, hours using the WC and QoL enhancement. CONCLUSION: Attention should be given to enhance WC service provision (with continuous service support) as well as professional continuing education.IMPLICATIONS FOR REHABILITATIONWheelchair technology is a key element in rehabilitation. Significant effort should be made to provide and maintain the wheelchair as a facilitator to participation. A great attention should be done to enhance wheelchair services as well as professional continuous education.Wheelchair skills are associated with participation and may be targeted in clinical intervention.

Maternal high-fat diet increases anhedonic behavior and modulates hippocampal Mash1 and BDNF expression in adult offspring.

BACKGROUND: The consumption of a high-fat diet (HFD) during pregnancy and perinatal periods can lead to long-term effects in the offspring central nervous system, affecting pathways related to neurogenesis and behavior, and increasing predispositions to depressive and anxiety-like behaviors. Thus, this study aimed to investigate the effects of a maternal HFD on the hippocampi of adult offspring and behaviors related to anxiety and depression. METHODS: The protein and mRNA expression of the brain-derived neurotrophic factor (BDNF), Mash1, Notch1, Hes5, serotonin transporter (SERT), 5-HT1A serotonergic receptor (5-HT1A), tryptophan hydroxylase 2 (TPH2, key enzyme of serotonin synthesis), JNK and pJNK were analyzed in the hippocampi of male Swiss mice. Hippocampal serotonin levels were measured using ELISA. The lipid peroxidation, total oxidant status, total antioxidant status, and GSH/GSSG were evaluated as oxidative stress measures. For the behavioral analysis, the open field, elevated plus maze, and sucrose preference tests were used. RESULTS: Maternal HFD led to increased body weight in dams and their offspring, as well as altered body composition and LDL levels in the offspring. There were no alterations in oxidative stress or JNK phosphorylation. Hippocampal Mash1 and BDNF expression were altered in HFD offspring. The HFD offspring exhibited anhedonic behavior. CONCLUSION: These findings suggest that maternal HFD leads to long-term alterations in the offspring's neurotrophic systems, impairing their behavior.

Fatores relacionados à eficiência da propulsão em cadeira de rodas manual de usuários com paraplegia devido à lesão medular / Factors related to propulsion efficiency in manual wheelchair users with paraplegia due to spinal cord injury

Resumo Introdução Indivíduos com paraplegia devido à lesão medular (LM) realizam propulsão de cadeira de rodas manual (CRM), a fim de promover mobilidade funcional para realização das atividades cotidianas. No entanto, a ineficiência da propulsão causada pela inadequada configuração da CRM, assim como dores e lesões nos membros superiores (MMSS), pode resultar na diminuição da mobilidade do usuário. Objetivo Por meio da metodologia da revisão integrativa, buscou-se identificar e avaliar fatores relacionados à eficiência da propulsão em CRM de usuários com paraplegia devido à LM. Método Foram selecionados estudos indexados na PubMed, LILACS e SciELO sobre a biomecânica da propulsão de usuários de CRM com paraplegia devido à LM, entre os anos de 2008 e 2018. Resultados Dentre os 10 estudos incluídos na revisão, dois foram classificados como nível III-2 e oito como nível IV de evidência. Foram identificados como fatores relacionados à eficiência da propulsão: os momentos não propulsivos; a velocidade dos MMSS na fase de recuperação; a posição da mão no período de liberação; o tamanho do encosto; a manutenção do peso corporal; o nível de atividade diária e a força de adutores de ombro; a intensidade da propulsão; a orientação dos MMSS; e o tempo de LM. Conclusão As evidências sobre ciclo e padrões de propulsão, configurações de CRM, características do usuário e dores e lesões nos MMSS demonstraram ser fatores relacionados à eficiência da propulsão em CRM de usuários com paraplegia devido à LM.

Abstract Introduction Individuals with paraplegia due to spinal cord injury (SCI) perform manual wheelchair (MWC) propulsion to promote functional mobility to perform daily activities. However, the inefficiency of propulsion caused by inadequate MWC setting, as well as pain and upper limb injury (UL), can result in decreased user mobility. Objective Through the methodology of the integrative review, sought to identify and evaluate factors related to propulsion efficiency in MWC of users with paraplegia due to SCI. Method We selected indexed studies in PubMed, LILACS, and SciELO on the biomechanics of the propulsion of users with paraplegia due to SCI between 2008 and 2018. Results Among the 10 studies included in the review, two studies were classified as level III-2 and eight as level IV evidence. Factors related to propulsion efficiency were identified as: non-propulsive moments; the speed of the UL in the recovery phase; the position of the hand in the release period; the size of the backrest; maintaining body weight; the level of daily activity and shoulder adduction strength; the intensity of the propulsion; the orientation of the UL and the SCI time. Conclusion Evidence regarding the cycle and propulsion patterns, MWC settings, user characteristics, and pain and injury in the UL proved to be factors related to propulsion efficiency in MWC of users with SCI paraplegia.

Maternal high-fat diet stimulates proinflammatory pathway and increases the expression of Tryptophan Hydroxylase 2 (TPH2) and brain-derived neurotrophic factor (BDNF) in adolescent mice hippocampus.

Maternal high-fat diet (HFD) consumption can promote a systemic inflammatory condition that may impair the offspring brain development, damaging memory and learning, when it reaches the hippocampus. This study aims to evaluate maternal HFD effects, during pregnancy and lactation, upon dams/mice offspring nutritional status, protein and gene expression of inflammatory pathway (JNK, pJNK and TNF-α), serotonin system molecules (Tryptophan Hydroxylase 2 (TPH2), key-enzyme of serotonin synthesis, serotonin transporter (SERT); 5-HT1A serotonergic receptor (5-HT1A)) and brain derived neurotrophic factor (BDNF) on recently weaned mice offspring hippocampus. Female Swiss mice were fed a control diet (CD, 11,5% fat) or a HFD (45.0% fat) from pre-mating to lactation. After weaning, the offspring received CD up to 28 post-natal days (PND28). Body weight and visceral adiposity (retroperitoneal and gonadal adipose tissue) of dams and offspring were measured. After euthanasia, the offspring hippocampus was dissected for evaluations of BDNF, inflammatory pathway and serotonergic system molecules protein and gene expression, through the techniques of Western Blotting, RTqPCR and ELISA. Our findings show that, during pregnancy, HFD-dams and HFD-offspring exhibited an increase in body weight gain and visceral adipose tissue compared to control animals. The hippocampus of HFD-offspring showed increased protein expression of TPH2, BDNF, pJNK and increased mRNA levels of TNF-α. However, the TPH2 increase in HFD-offspring did not alter hippocampal serotonin levels quantified through ELISA. Maternal HFD promoted an obesity phenotype in its offspring with increased body weight and visceral adiposity, increased protein and gene expression of the pro-inflammatory proteins pJNK and TNF-α. These changes were accompanied by increased TPH2 and BDNF protein expression. Thus, our findings show that maternal HFD during gestation and lactation increased pJNK and TNF-α expression in their offspring hippocampus indicating a pro-inflammatory state, with increased BDNF expression and alterations in its serotonergic system reflected by increased TPH2 expression.