Validity and reliability of a ruler drop test to measure dual-task reaction time, choice reaction time and discrimination reaction time.

BACKGROUND: The aim of this study was to determine the absolute and relative reliability of the Ruler Drop Test (RDT) for assessing dual-task, choice, and discrimination reaction time. In addition, the construct validity of the RDT is examined in comparison to the Deary-Liewald reaction time (DLRT). METHODS: Tests were administered by the same evaluator, one week apart. Intraclass Correlation Coefficient (ICC3.1) was used to measure relative reliability, and the standard error of measurement (SEM) and minimal detectable change (MDC95) were used to measure absolute reliability. Spearman correlation test was used to measure construct validity. RESULTS: The results showed that the relative reliability was good for the choice ruler drop (ICC = 0.81), moderate for the dual-task ruler drop test (ICC = 0.70) and discrimination ruler drop test (ICC = 0.72), and good for simple ruler drop test. However, the simple ruler drop test had poor reliability (ICC = 0.57). The RDT shows construct validity compared to the DLRT. CONCLUSION: We conclude that the RDT is a suitable instrument for measuring dual-task, choice and discrimination reaction time. Future studies should explore the reliability of these measures in other populations.

Effects of Multimodal Exercise With Augmented Reality on Cognition in Community-Dwelling Older Adults.

OBJECTIVES: This study aims to investigate the effects of an exercise intervention using multimodal exercise with augmented reality and multimodal exercise-only on cognitive function in older adults living in a community dwelling. DESIGN: Quasi-experimental research study. SETTING AND PARTICIPANTS: In this control study, 78 participants were divided into 2 experimental groups (with sessions 3 times a week for 12 weeks) and a control group (CG). METHODS: EG1 participated in a multimodal exercise-only intervention program, EG2 participated in a multimodal exercise program with augmented reality exergames, and CG continued its usual activities. Participants were assessed at baseline and postintervention after 12 weeks. RESULTS: Comparison between baseline and postintervention at 12 weeks showed significant improvements in executive functions, verbal fluency, choice reaction time, and dual task in EG1, whereas there were improvements in general cognition, executive functions, verbal fluency, discrimination reaction time, and depression in EG2 (P ≤ .05). The clinical effect sizes of the interventions were large for overall cognition, executive functions, and reaction time on single- and dual-task reaction time in EG1 and for overall cognition, executive functions, and verbal fluency in EG2. CONCLUSION AND IMPLICATIONS: The intervention programs showed significant improvements in several cognitive domains. The multimodal exercise-only showed improvements in more variables than the multimodal exercise with augmented reality, but the augmented reality group showed greater changes between baseline and postintervention.

Debilidad muscular en pacientes críticos: efectos de un programa de rehabilitación sistematizado de enfermería / Muscle weakness in critically ill patients: Effects of a systematized rehabilitation nursing program

Objetivo: La debilidad adquirida en la unidad de cuidados intensivos (DAUCI) en pacientes críticos es frecuente, y se asocia a resultados negativos. La rehabilitación es una estrategia para mejorar los resultados. El propósito de este estudio fue evaluar los efectos de un programa de enfermería de rehabilitación al recibir el alta de la unidad de cuidados intensivos. Métodos: Estudio cuasi-experimental, en el que se comparan pacientes que se sometieron a cuidados habituales de rehabilitación de enfermería y pacientes que se sometieron a un programa de enfermería de rehabilitación sistematizado. Muestra no probabilística secuencial de 42 pacientes críticos ventilados, 21 pacientes en el grupo de control y 21 pacientes en el grupo de intervención (de junio 2017 a junio 2019), en 3 unidades de cuidados intensivos de un gran hospital universitario portugués. Se realizó la prueba de Mann-Whitney para comparar los valores de la puntuación total del Medical Research Council Sum Score (MRC-SS) entre los grupos. Resultados: Los pacientes que recibieron el programa de rehabilitación sistematizado, presentaron una disminución de la DAUCI en el momento del alta de la UCI (media de MRC-SS=38 vs. media de MRC-SS=42,7; p=0,043; U=152,5). Se produjo una disminución de la debilidad muscular severa (9,5 vs. 28,6%) y debilidad muscular significativa (42,9 vs. 52,4%) y un aumento de pacientes sin debilidad muscular (47,6 vs. 19%). Conclusiones: El programa de enfermería de rehabilitación sistemática puede mejorar la fuerza muscular, y reducir la incapacidad funcional en el momento del alta de cuidados intensivos.(AU)

Objective: Intensive care unit-acquired muscle weakness (ICUAW) in critically ill patients is frequent and associated with negative outcomes. Early rehabilitation is a strategy to improve outcomes. The aim was to assess the effects of a rehabilitation nursing programme at discharge from intensive care unit. Methods: Quasi-experimental study with the comparison between two groups: one enrolled in a systematized nursing rehabilitation program and the other with usual nursing rehabilitation care. A non-probabilistic sample, sequential, of 42 critically ill ventilated patients, 21 patients in the control group and 21 patients the intervention group (June 2017 to June 2019), in three intensive care units of one large Portuguese teaching hospital. Mann-Whitney test was performed to compare Medical Research Council Sum Score (MRC-SS) values between groups. Results: Patients undergoing the rehabilitation program had a decrease in ICUAW (at ICU discharge mean MRC-SS=38 vs. mean MRC-SS=42.7; p=0.043; U=152.5). There was a decrease in severe muscle weakness (9.5% vs. 28.6%) and significant muscle weakness (42.9% vs. 52.4%) and an increase without muscle weakness (47,6% vs. 19%). Conclusions: The systematic rehabilitation nursing program can improve muscle strength and reduce functional disability at the time of discharge from intensive care.(AU)

Marine Bacteroidetes enzymatically digest xylans from terrestrial plants.

Marine Bacteroidetes that degrade polysaccharides contribute to carbon cycling in the ocean. Organic matter, including glycans from terrestrial plants, might enter the oceans through rivers. Whether marine bacteria degrade structurally related glycans from diverse sources including terrestrial plants and marine algae was previously unknown. We show that the marine bacterium Flavimarina sp. Hel_I_48 encodes two polysaccharide utilization loci (PULs) which degrade xylans from terrestrial plants and marine algae. Biochemical experiments revealed activity and specificity of the encoded xylanases and associated enzymes of these PULs. Proteomics indicated that these genomic regions respond to glucuronoxylans and arabinoxylans. Substrate specificities of key enzymes suggest dedicated metabolic pathways for xylan utilization. Some of the xylanases were active on different xylans with the conserved ß-1,4-linked xylose main chain. Enzyme activity was consistent with growth curves showing Flavimarina sp. Hel_I_48 uses structurally different xylans. The observed abundance of related xylan-degrading enzyme repertoires in genomes of other marine Bacteroidetes indicates similar activities are common in the ocean. The here presented data show that certain marine bacteria are genetically and biochemically variable enough to access parts of structurally diverse xylans from terrestrial plants as well as from marine algal sources.

Translation, Cultural Adaptation, and Reliability of the 15D Portuguese Version: A Generic Health-Related Quality of Life (HRQoL) Instrument.

(1) Background: Purpose: The assessment of quality of life is essential to the human condition and can be measured through questionnaires. This study aims to translate and culturally adapt the 15D questionnaire to assess the population's quality of life, as well as explore its relative reliability and internal consistency; (2) Methods: The translation and cultural adaptation of the 15D questionnaire was carried out independently, considering two translations. The synthesis version was applied to eight subjects, distributed by gender. Cognitive interviews were conducted to observe clarity, acceptability, and familiarity with the version of the questionnaire. The final version of the questionnaire, in Portuguese, was again translated into the official language by two translators who had never had contact with the questionnaire. To assess the test-retest reliability and internal consistency of the 15D questionnaire, 43 participants were interviewed; (3) Results: Participants indicated that they had some doubts about dimensions, breathing, and discomfort and symptoms; however, as there were no suggestions for change, the questionnaire had no changes. Items were clear and understandable. Internal consistency was observed using Cronbach's alpha, with values between 0.76 and 0.98. The test-retest reliability values were between 0.77 and 0.97; and (4) Conclusions: The Portuguese version of the 15D questionnaire was proved to be equivalent to the English version and to be reliable for the Portuguese population. This instrument is easy to access and apply.

Muscle weakness in critically ill patients: Effects of a systematized rehabilitation nursing program.

OBJECTIVE: Intensive care unit-acquired muscle weakness (ICUAW) in critically ill patients is frequent and associated with negative outcomes. Early rehabilitation is a strategy to improve outcomes. The aim was to assess the effects of a rehabilitation nursing programme at discharge from intensive care unit. METHODS: Quasi-experimental study with the comparison between two groups: one enrolled in a systematized nursing rehabilitation program and the other with usual nursing rehabilitation care. A non-probabilistic sample, sequential, of 42 critically ill ventilated patients, 21 patients in the control group and 21 patients the intervention group (June 2017 to June 2019), in three intensive care units of one large Portuguese teaching hospital. Mann-Whitney test was performed to compare Medical Research Council Sum Score (MRC-SS) values between groups. RESULTS: Patients undergoing the rehabilitation program had a decrease in ICUAW (at ICU discharge mean MRC-SS = 38 vs. mean MRC-SS = 42.7, p = 0.043, U = 152,5). There was a decrease in severe muscle weakness (9.5% vs. 28.6%) and significant muscle weakness (42.9% vs. 52.4%) and an increase without muscle weakness (47,6% vs. 19%). CONCLUSIONS: The systematic rehabilitation nursing program can improve muscle strength and reduce functional disability at the time of discharge from intensive care.

Phase Angle as a Predictor for Physical Function in Institutionalized Independent Older Adults.

The aim of this study was to investigate the relationship between phase angle (PhA) and physical function in institutionalized, independent older adults. Physical function was evaluated using the Senior Fitness Test Battery. PhA was measured by electrical bioimpedance at 50 khz, and body composition parameters were also registered. Results showed that PhA significantly correlated with all physical fitness tests, except for arm curls. Regarding the results of the multivariate analysis, three models were created: Model 1, formed by a dependent variable "PhA" and two predictor variables "8 ft up-and-go" and "6 min walk"; Model 2, formed by a dependent variable "PhA" and three predictor variables "8 ft up-and-go", "6 min walk" and "30-s chair stand"; and Model 3, formed by a dependent variable "PhA" and four predictor variables "8 ft up-and-go", "6 min walk", "30-s chair stand" and "arm curl". Results showed that predictor variables had a significant influence on the PhA for all three models (Model 1: p = 0.001, 12.5%; Model 2: p = 0.002, 12.9%; and Model 3: p = 0.005, 13.1%). For women, Model 1 showed a significant influence of predictor variables on the PhA (p = 0.030, 9.3%). The results for men in Models 1, 2 and 3 showed significant influences on the PhA (p = 0.002, 31.2%; p = 0.006, 31.6%; and p = 0.016, 31.6%; respectively). This study confirmed previous studies regarding to the relationship between PhA and physical function. It also indicates that PhA could be an excellent predictor of physical function.

Acute Effects of Augmented Reality Exergames versus Cycle Ergometer on Reaction Time, Visual Attention, and Verbal Fluency in Community Older Adults.

BACKGROUND: This study aims to investigate the acute effects of an augmented reality session and a cycle ergometer session compared to no exercise on the reaction times, cognitive flexibility, and verbal fluency of older adults. METHODS: Each participant did a familiarization with cognitive tests and the following three sessions: cycle ergometer, no exercise (control group), and augmented reality exergame (Portable Exergame Platform for Elderly) sessions. The participants were randomized in a within-group design into one of six possible combinations. Each moment had a 30 min duration, and after the session, the participants performed a Trail Making Test, a verbal fluency test, and a Deary-Liewald reaction time task. The data were analyzed with a one-way ANOVA with a Bonferroni adjustment. RESULTS: The analysis between the no exercise, cycle ergometer, and augmented reality sessions showed no significant differences in the cognitive measurements. CONCLUSIONS: One session of the cycle ergometer exercise or the augmented reality exergames does not acutely improve the reaction times, cognitive flexibility, or verbal fluency in the elderly.

Intrauterine growth restriction and its impact on intestinal morphophysiology throughout postnatal development in pigs.

Intrauterine growth restriction (IUGR) compromises fetal development, leading to low birth weight, and predisposes to gastrointestinal disorders. Pigs that suffered IUGR present poor postnatal development, resulting in great economic losses to the industry. The small intestine may be involved with impaired development, but studies investigating this issue are still limited. Thus, the present study aimed to investigate small intestine morphofunctional alterations in IUGR pigs throughout the production phases (birth to 150 days). IUGR pigs presented lower body weight from birth to the finishing phase (P < 0.05). Although histomorphometrical parameters were not affected during the pre-weaning period, their commitment was observed specifically in the duodenum of the IUGR group at older ages (P < 0.05). The most detrimental effects on the small intestine, such as deeper duodenum crypts' depth, lower villus height:crypt depth ratio and absorptive area, increased apoptosis and lower proliferation of the duodenum epithelium were noticed at 70 days of age (P < 0.05). Additionally, IUGR pigs presented the lowest chymotrypsin and amylase activities at 70 and 150 days of age, respectively (P < 0.05). These findings may contribute to the elucidation of morphofunctional disorders of the small intestine in IUGR pigs throughout the different production phases, suggesting that poor postnatal development may be due to intestinal damage.

Replacing Sedentary Behavior With Physical Activity of Different Intensities: Implications for Physical Function, Muscle Function, and Disability in Octogenarians Living in Long-Term Care Facilities.

BACKGROUND: We investigated the associations of replacing sedentary behavior (SB) with physical activity of different intensities on the physical function of octogenarians living in long-term care facilities. METHODS: This pooled study recruited 427 older adults aged 80 years and older (69.1% female; body mass index: 27.53). For 345 participants who provided valid data, we assessed device-measured time spent in SB, light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA). We assessed lower limb physical function, strength, mobility, and disability. We used compositional data analysis to investigate the associations of replacing SB with physical activity on the outcomes. RESULTS: Reallocation of SB to LIPA and MVPA was associated with a higher number of 30-second Chair Stand cycles (LIPA: +0.21, MVPA: +1.81; P < .001), greater peak force (LIPA: +11.96 N, MVPA: +27.68 N; P < .001), peak power (LIPA: +35.82 W, MVPA: +92.73 W; P < .001), peak velocity (LIPA: +0.03 m/s, MVPA: +0.12 m/s; P < .001), higher levels of grip strength (LIPA: +0.68 kg, MVPA: +2.49 kg; P < .001), and less time in the Time Up and Go (LIPA: -7.63 s, MVPA: -12.43 s; P < .001). CONCLUSIONS: Replacing SB with LIPA or MVPA is associated with physical function and disability of older adults living in long-term care facilities.

Can Physical Activity Make Up for the Self-Care Disability Effects of Too Much Sitting? A Moderation Analysis in Octogenarians Residing in Living Care Facilities.

BACKGROUND AND PURPOSE: Physical activity can delay the progression of self-care disability in older adults residing in living care facilities. Nonetheless, older adults residing in living care facilities spend most of their time sedentary and do not meet the physical activity recommendation, which may result in increasing self-care disability in this population group. In this study, we aimed to determine whether the association between sedentary time and self-care disability was moderated by moderate-to-vigorous physical activity (MVPA) in older adults residing in living care facilities. METHODS: Sedentary time and MVPA were both measured with accelerometers. Self-care disability was assessed with the Barthel Index. A multivariate regression model was used to ascertain the effects of the interaction between sedentary time and MVPA on the self-care disability of participants. The Johnson-Neyman technique was then used to estimate the exact MVPA threshold at which the effect of sedentary time on self-care disability became nonsignificant. RESULTS: We found a significant effect of sedentary time on self-care disability (standardized ß=-1.66; 95% CI -1.77 to -1.54, P = .013). Results indicated that MVPA moderates the relationship between self-care disability status and sedentary time (standardized ß= 1.14; 95% CI 1.13 to 1.14, P = .032). The Johnson-Neyman technique determined that 51 min/day of MVPA would offset the negative effects of sedentary time on self-care disability. CONCLUSIONS: Our results suggest physical therapists should focus on reducing sedentary time alongside physical activity to prevent the progression to dependency in octogenarians residing in living care facilities.

Factors associated with changes in inpatients' smoking pattern during hospitalization and one month after discharge: A cohort study.

INTRODUCTION: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. OBJECTIVES: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. METHODS: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25-item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi-square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. RESULTS: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical-surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). CONCLUSIONS: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence-based tobacco cessation programs at the organizational-level, including post-discharge active quitting smoking support. CLINICAL RELEVANCE: Three-quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking.

Psychometric properties of a computerized and hand-reaction time tests in older adults using long-term facilities with and without mild cognitive impairment.

The aim of this study was to determine the absolute and relative reliability and validity of two reaction time (RT) tests in older adults using long-term facility: the ruler drop test (RDT, a simple RT) and the Deary-Liewald RT task (DLRT, simple and four-choice RT). Participants (≥65 years old) using long-term facilities were distributed into a group without cognitive impairment (GWCI, n = 41), and a group with mild cognitive impairment (GCI, n = 32). The tests were administered one week apart, by the same evaluator. Relative reliability was measured by the Intraclass Correlation Coefficient (ICC3.1), absolute reliability by the standard error of measurement (SEM) and minimal detectable change (MDC95) and convergent validity by the Pearson correlation. The results showed that the relative reliability was good for the RDT (GWCI, ICC = 0.84; GCI, ICC = 0.80) and moderate for the Deary Liewald RT simple (DLRT-S) (GWCI, ICC = 0.61; GCI, ICC = 0.65). The relative reliability of the Deary Liewald RT choice (DLRT-C) was good (ICC = 0.89) for the GWCI and excellent (ICC = 0.93) for the GCI. However, the DLRT-C had low feasibility in the GCI, as most participants were unable to complete the test. Measurement precision was acceptable for the RDT and DLRT-C (GWCI) and for the DLRT-C (GCI). There were no significant associations between the RDT and DLRT scores. We conclude that the RDT could be more suitable than the DLRT-S for assessing simple RT in older adults. Future studies should explore if fewer than the four stimulus-response alternatives used in the DLRT-C could be more appropriate for assessing choice RT in older adults with cognitive impairment.

Test-retest reliability of the functional reach test and the hand grip strength test in older adults using nursing home services.

OBJECTIVE: This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes. METHODS: Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC95), and Bland-Altman plots. RESULTS: The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC95 = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC95 = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC95 = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups. DISCUSSION: Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.

A visita domiciliária na transição hospital-domicílio à pessoa com doença mental: uma revisão integrativa da literatura / The home visit in the hospital-domicile transition of the person with a mental disorder: an integrative review of the literature / La visita a domicilio em la transición hospital-domicilio a la persona com enfermedad mental: una revisión integrativa de la literatura

CONTEXTO: A mudança de um paradigma hospitalocêntrico para um de raiz comunitária vem sendo desde há vários anos contemplada como prioritário. No entanto, continua a existir uma escassa resposta de estruturas necessárias de apoio às pessoas com doença mental e seus cuidadores. O processo de vivência da transição hospital-domicílio pode expor a pessoa a um risco potencial de desenvolver um processo de adaptação desajustado, pelo que a visita domiciliária pode ser um recurso interessante, na medida em que promove a acessibilidade e a aceitabilidade, podendo influenciar positivamente o envolvimento das pessoas e dos seus cuidadores no tratamento destas patologias. OBJETIVO: Identificar os benefícios da visita domiciliária às pessoas com doença mental na continuidade de cuidados hospital-domicílio. MÉTODO: Realizou-se uma revisão integrativa da literatura, recorrendo-se a pesquisa nas bases de dados EBSCO e B-ON e no RCAAP, tendo resultado em cinco artigos compreendidos no horizonte temporal 2013-2018. RESULTADOS: A visita domiciliária permite manter o contacto da pessoa com doença mental e os cuidados de saúde, assegura a continuidade de cuidados, demonstrando ter benefícios quer a nível da sintomatologia, da funcionalidade ou da qualidade e vida das pessoas e das suas famílias, reduzindo o desperdício de recursos consumidos durante os reinternamentos por causa das recaídas, além de promover igualmente a sua inserção na comunidade. CONCLUSÕES: A visita domiciliária deve ser explorada no que concerne aos cuidados a pessoas com doença mental, por ser um recurso que pode diminuir algumas das barreiras identificadas na continuidade de cuidados pós-hospitalar e pelos benefícios que acarreta.

BACKGROUND: Changing the hospital-centered to a community-based care paradigm has been seen as a priority for a long time. However, there still is a limited response from all the organizations needed to help and support patients with Mental Illnesses and their caretakers. The hospital-home transition and how the patients cope with it might lead to maladjusted adaptation mechanisms. As such, home visits are an important tool that promote accessibility and acceptability, positively influencing patients’ and their caretakers’ involvment in the treatment of the underlying disease. AIM: To understand the benefits that home visits can have in promoting the continuity of hospital-home care for the patients with mental illness. METHODS: An integrative literature review was conducted using the EBSCO and B-ON databases and RCAAP, resulting in five articles included in the 2013-2018 time horizon. RESULTS: The home visit allows the person with mental illness to maintain contact with the health care system, ensures continuity of care, demonstrating benefits in terms of symptoms, functionality or quality of life and life of individuals and their families, reducing the waste of resources consumed during readmissions due to relapses, and also promoting their integration into the community. CONCLUSIONS: Home visits should be explored with regard to the care of people with mental illness, as this is a resource that can reduce some of the barriers identified in the continuity of post-hospital care and the benefits it brings.

CONTEXTO: El cambio de un paradigma centrado en el hospital a uno basado en la comunidad ha sido considerado una prioridad durante varios años. Todavía hay poca respuesta de las estructuras de apoyo necesarias para las personas con enfermedades mentales y sus cuidadores. El proceso de experimentar la transición entre el hospital y el domicilio puede exponer a la persona a un riesgo potencial de desarrollar un proceso de adaptación inapropiado, por lo que la visita a domicilio puede ser un recurso interesante, ya que promueve la accesibilidad, la aceptabilidad y la participación de las personas y sus cuidadores en el tratamiento de estas patologías. OBJETIVO: Identificar los beneficios de las visitas domiciliarias a personas con enfermedades mentales en la continuidad de la atención hospitalaria domiciliaria. METODOLOGÍA: Se llevó a cabo una revisión integrativa de la literatura utilizando las bases de datos de EBSCO y B-ON y RCAAP, lo que resultó en la inclusión de cinco artículos en el horizonte temporal 2013-2018. RESULTADOS: La visita domiciliaria asegura la continuidad de la atención, demuestra beneficios en términos de síntomas, funcionalidad o calidad de vida de las personas y sus familias, reduce el derroche de recursos consumidos, y también promueve su integración en la comunidad. CONCLUSIONES: Se deben explorar las visitas domiciliarias en relación con la atención de las personas con enfermedades mentales, ya que se trata de un recurso que puede reducir algunas de las barreras identificadas en la continuidad de la atención poshospitalaria y los beneficios que aporta.

A systematic review of studies that included both measures of physical activity and sedentary behaviour in older adults / Revisión sistemática de estudios que incluyen mediciones de actividad física y conductas sedentarias en ancianos / Uma revisão sistemática de estudos que incluem ambas as medidas de atividade física e comportamento sedentário em pessoas idosas

OBJECTIVE: The main aim of this study is to identify, appraise and synthesize evidence on the level of physical activity and sedentary behavior in older adults. METHOD: This review was restricted to studies published between January 2006 and January 2019 and included studies that reported physical activity and sedentary behavior in older adults (≥65 years old) without chronical health conditions. RESULTS: Twenty studies met the inclusion criteria. Two studies reported data for older adults residing at assisted care facilities, showing results of moderate to vigorous physical activity much lower than those reported in studies with older adults living in the community (2 min/per day and 37.2 min/per day, respectively). CONCLUSION: Sedentary behavior is high in the elderly, with men presenting higher values than women. moderate to vigorous physical activity has very low values, and with the advancing age there is a decrease in the same

OBJETIVO: El principal objetivo de este estudio es identificar, evaluar y sintetizar evidencias sobre el nivel de actividad física y comportamiento sedentario en mayores. MÉTODO: Esta revisión fue restringida a estudios publicados entre enero de 2006 y enero de 2019, incluyendo estudios que incluyeron actividad física y comportamiento sedentario en personas mayores (≥65 años de edad) sin condiciones crónicas de enfermedad. RESULTADOS: Veinte estudios cumplieron los criterios de inclusión. Dos estudios reportaron datos para personas mayores institucionalizadas, mostrando resultados de actividad física moderada a vigorosa muy inferiores a los reportados en estudios con personas mayores que viven en la comunidad (2 min/día y 37,2 min / día, respectivamente). CONCLUSIÓN: El comportamiento sedentario es elevado en las personas mayores, los hombres presentan valores más altos que las mujeres. La actividad física moderada a vigorosa presenta valores muy bajos, siendo que con el avance de la edad se produzca una disminución

OBJETIVO: O principal objetivo deste estudo é identificar, avaliar e sintetizar evidências sobre o nível de atividade física e comportamento sedentário em pessoas idosas. MÉTODO: Esta revisão foi restrita a estudos publicados entre janeiro de 2006 e janeiro de 2019, e incluiu estudos que relataram atividade física e comportamento sedentário em pessoas idosas (≥65 anos de idade) sem condições crônicas de saúde. RESULTADOS: Vinte estudos preencheram os critérios de inclusão. Apenas dois estudos relataram dados para pessoas idosas institucionalizadas, mostrando resultados de atividade física moderada a vigorosa muito inferiores aos relatados em estudos com pessoas idosas que vivem na comunidade (2 min/dia e 37,2 min/por dia, respetivamente. CONCLUSÃO: O comportamento sedentário é elevado nas pessoas idosas, sendo que os homens apresentam valores mais altos do que as mulheres. A atividade física moderada a vigorosa apresenta valores muito baixos, sendo que com o avançar da idade há uma diminuição da mesma

Effect of growth hormone (GH) and resistance training on the collagen properties of femoral bone tissue / Efecto de la hormona de crecimiento (HC) y el entrenamiento de fuerza en las propiedades colágenas del tejido óseo femoral

The indiscriminate use of anabolic steroids in gyms has been growing in a generalized way, among which, the most common is growth hormone (GH). In the short term GH may potentiate muscle growth, especially when taken in combination with resistance training. However, the effects of this hormone are not yet fully understood in the literature, especially in relation to collagen properties. The objective of this study was to evaluate the effect of the application of growth hormone (GH) and resistance training (RT) on the collagen properties of femoral bone tissue using Raman Spectroscopy. In this study 40 male rats were randomly distributed into four groups (n=10): control (C), control and GH application (GH), resistance training (T), and resistance training and GH application (GHT). The training consisted of four series of 10 water jumps, performed three times a week, with an overload corresponding to 50 % of body weight and duration of four weeks. GH was applied at a dosage of 0.2 IU/Kg (0.067 mg/kg) to each animal, three times a week, every other day. The animals were euthanized and the right femurs were collected for analysis of bone structure. Raman spectroscopy (RS) was used to observe the following compounds from their respective bands: type I collagen (662 cm-1), amide III (1243 cm-1), proteins including type I collagen (1278 cm-1), woven collagen (1322 cm-1), association of collagen, phospholipids, nucleic acid, and phosphate (1330 cm-1), and collagen and protein deformation (1448 cm-1). The results demonstrated an increase in the collagen properties in all analyzed variables, however, the T group presented a statistically significant difference (p<0.05). It is possible to conclude that isolated physical training was shown to be more efficient than when combined with the application of GH to increase the collagen properties of the femoral bone tissue.

El uso indiscriminado de anabolizantes en los gimnasios ha aumentado de forma generalizada, entre éstos la hormona de crecimiento (HC) es una de las más utilizadas, y a corto plazo puede potencializar el crecimiento muscular, principalmente cuando es realizado en combinación con el entrenamiento de fuerza. Sin embargo, los efectos de esta hormona aún no están totalmente esclarecidos en la literatura, especialmente en relación a las propiedades colágenas. El objetivo del estudio fue evaluar el efecto de la aplicación del HC y entrenamiento de fuerza (E) en las propiedades colágenas del tejido óseo femoral a partir de la utilización de la espectroscopía Raman. Se usaron 40 ratas Wistar distribuidos en cuatro grupos (n=10): control (C), control y aplicación del HC (HCC), entrenamiento de fuerza (E) y entrenamiento de fuerza y aplicación del HC (THC). El entrenamiento fue compuesto por cuatro series de 10 saltos acuáticos, realizados tres veces por semana, con sobrecarga correspondiente a 50 % del peso corporal y duración de cuatro semanas. El HC fue aplicado en una dosificación de 0,2 UI/Kg (0,067 mg/kg) en cada animal, tres veces por semana, en días no consecutivos. Los animales fueran eutanasiados y se retiró el fémur derecho para realización del análisis de la estructura ósea. La espectroscopía Raman (ER) fue utilizada para observar los siguientes compuestos a partir de las respectivas bandas: colágeno tipo I (662 cm-1), amida III (1243 cm1), proteínas, incluido colágeno tipo I (1278 cm-1), colágeno retorcido (1322 cm-1), asociación de colágeno, fosfolípidos, ácidos nucleicos y fosfato (1330 cm-1), deformación de colágeno y proteína (1448 cm-1). Hubo aumento en las propiedades colágenas en todas las variables analizadas, sin embargo, solamente el grupo E demostró una diferencia estadísticamente significativa (p<0,05). En conclusión, para el aumento de las propiedades colágenas del tejido óseo femoral, el entrenamiento físico aislado es más eficiente que el entrenamiento combinado con el uso de HC.

Keep on Going: Apoio à escolha estratégica do estágio curricular / Keep On Going: Support for the strategic choice of the curriculum internship / Keep on Going: Apoyo a la elección estratégica en las prácticas curriculares

No presente artigo é apresentado e descrito um projeto de intervenção no domínio da psicologia vocacional designado Keep-on-Going. A intervenção em causa visa apoiar jovens na fase final do processo formativo, na escolha estratégica do contexto de estágio curricular. Tem como base teórica o Modelo de Exploração Reconstrutiva do Investimento Vocacional, e estrutura-se em seis momentos-chave num total de 10 sessões com duas a três horas cada. Participaram na 1.ª edição cinco estudantes (do sexo feminino) do 1.º ano do Mestrado em Psicologia da Educação. Os resultados da avaliação contínua apontam para valores médios de seis numa escala de 1 a 7, em termos da qualidade geral do projeto. Na avaliação de follow-up as dimensões "Evolução na capacidade de escolher" e "Utilidade do projeto", são as mais pontuadas confirmando que a participação no projeto se revelou uma experiência de valor para as estudantes.

This article presents and describes an intervention project in the field of vocational psychology named Keep-on-Going. This intervention aims to support young people in the final stage of the training process, in the strategic choice of the context of curricular internship. Its theoretical basis is the Reconstructive Exploitation Model of Vocational Investment, and it is structured into six key moments in a total of 10 sessions with two to three hours each. Five female students participated in the first edition of the 1st year of the Master's in Educational Psychology. The results of the continuous evaluation point to average values ​​of six on a scale of 1 to 7, in terms of the overall quality of the project. In the follow-up assessment, the dimensions "Evolution in the ability to choose" and "Project usefulness" are the highest scores confirming that participation in the project has proved to be a valuable experience for the students.

En el presente artículo se presenta y describe un proyecto de intervención en el ámbito de la psicología vocacional designado Keep-on-Going. La intervención en cuestión pretende apoyar a los jóvenes en la fase final del proceso formativo para la elección estratégica del contexto de la práctica curricular. Se tiene como base teórica el Modelo de Exploración Reconstructiva de la Inversión Vocacional, y se estructura en seis momentos clave en un total de 10 sesiones de dos a tres horas cada una. Participaron en la primera edición cinco estudiantes (sexo femenino) del primer año de la Maestría en Psicología de la Educación. Los resultados de la evaluación continua apuntan valores medios de seis en una escala de 1 a 7, en términos de la calidad general del proyecto. En la evaluación de seguimiento, las dimensiones "Evolución en la capacidad de escoger" y "Utilidad del proyecto" son las más puntuadas, confirmando que la participación en el proyecto constituyó una experiencia de valor para las estudiantes.

Dependência funcional na alta dos cuidados intensivos: relevância para a enfermagem de reabilitação / Functional dependence at discharge from the intensive care unit: relevance for rehabilitation nursing / Dependencia funcional del alta de cuidados intensivos: relevancia para la enfermería de rehabilitación

Enquadramento: O internamento em cuidados intensivos pode provocar efeitos adversos que originam situações de incapacidade funcional, que persistem por tempo prolongado. A reabilitação precoce pode impedir ou limitar essas situações. Objetivos: Caracterizar o nível funcional e dependências na alta dos cuidados intensivos e verificar o momento de início das intervenções de enfermagem de reabilitação. Metodologia: Estudo descritivo/exploratório, método quantitativo, numa amostra de 30 doentes. Resultados: Valor médio do Medical Research Council de 27 (primeira avaliação) e de 38 (alta). O valor médio da Medida de Independência Funcional, nos autocuidados, mobilidade/transferências foi de 2. A primeira intervenção de enfermagem de reabilitação ocorreu, em média, ao 10º dia, e o primeiro levante após 13 dias. Conclusão: No momento da alta verificaram-se elevados níveis de dependência funcional no autocuidado básico e mobilidade/transferências, sendo necessário melhorar a sua caraterização para a continuidade de cuidados de reabilitação. A mobilização dos doentes críticos deve acontecer precocemente.

Background: Stays in the intensive care unit can cause adverse effects that lead to situations of functional disability, which persist for a long time. Early rehabilitation can prevent or limit such situations. Objectives: To characterize the functional level and dependencies at discharge from intensive care. To assay the timing for initiating rehabilitation nursing interventions. Methodology: Descriptive/exploratory study, quantitative method, in a sample of 30 patients. Results: Average of Medical Research Council value was 27 (first evaluation) and 38 (at discharge). The mean value of the Functional Independence Measure, in the area of self-care, mobility / transfers was 2. The first intervention of rehabilitation nursing occurred, on average, on the 10th day and the patient got out of bed after 13 days. Conclusion: At discharge, there were high levels of functional dependence at the level of basic self-care and mobility/transfers, and their characterization should be improved for the continuity of rehabilitation care. Early mobilization of critical patients is necessary.

Marco contextual: El ingreso en cuidados intensivos puede causar efectos adversos que conducen a situaciones de incapacidad funcional, que persisten durante mucho tiempo. La rehabilitación temprana puede prevenir o poner límite a estas situaciones. Objetivos: Caracterizar el nivel funcional y las dependencias en el alta de cuidados intensivos y verificar el momento de inicio de las intervenciones de enfermería de rehabilitación. Metodología: Estudio descriptivo/exploratorio, método cuantitativo, en una muestra de 30 pacientes. Resultados: Puntuación media del Medical Research Council de 27 (primera evaluación) y 38 (alta). El valor medio de la Medida de Independencia Funcional en autocuidado, movilidad/transferencia fue 2. La primera intervención de enfermería de rehabilitación ocurrió, de media, en el 10º día, y la primera vez que se levanta después de 13 días. Conclusión: En el momento del alta se observaron niveles altos de dependencia funcional en el autocuidado básico, así como la movilidad/transferencia, por lo que fue necesario mejorar su caracterización para la continuidad de los cuidados de rehabilitación. La movilización de los pacientes en estado crítico debe tener lugar en una fase temprana.

Desafios na tessitura do filosofar: a prática da docência no ensino médio / Challenges of philosophy: teaching practice in high school

Resumo: A discussão sobre a filosofia e seu ensino representa o tema central deste trabalho. No cenário atual, a filosofia tem seu lugar definido no currículo, conforme determina o Parecer 038/2006. A disciplina de filosofia no Ensino Médio tem uma importância crucial na formação crítica dos estudantes, apontada pelos teóricos e também pelos professores em sua prática pedagógica. Assim, a problemática proposta é tratar a filosofia nesse nível de ensino, tendo em vista os depoimentos dos professores entrevistados e os variados aspectos/inquietações deste processo de filosofar. A trajetória da filosofia na escola se (re)organiza nas complexas relações estabelecidas pela disciplina no cenário da Educação e, também, no universo político que caracteriza cada contexto vivido. Portanto, este artigo discute a forma como os docentes compreendem e significam a prática pedagógica do ensino de filosofia, buscando problematizar estratégias/investigações capazes de fomentar a ensinabilidade desta área do saber.

Abstract: In this work we discuss the new approach to teaching Philosophy following its reinsertion in the national Brazilian curriculum, according to law 038/2006. In High School, Philosophy has been (re)organized through complex relationships established between the subject in the educational scenario and also in the political universe that characterizes each lived context. In High School, Philosophy has a crucial impact in educating students to be critical citizens, as pointed out by both theoreticians and teachers during their pedagogical practice. Thus, we propose an understanding of this subject at the High School level, considering the point of view of teachers and varied aspects/uneasiness of the process of philosophizing. We discuss how teachers understand and signify their pedagogical practice, problematizing strategies/investigations that are able to foster the teaching of philosophy.