Evidence-based practice in undergraduate physiotherapy programs in Brazil: A cross-sectional document analysis study.

BACKGROUND AND PURPOSE: Physiotherapists worldwide are encouraged to integrate evidence-based practice (EBP) to provide safer and effective services. However, for professionals to consolidate this practice, the contact with EBP must begin at the university. In this study, we aimed to map and analyze the distribution of EBP courses and their characteristics in undergraduate physiotherapy programs in Brazil. METHODS: This web-based document analysis study analyzed the current curricula of undergraduate physiotherapy programs in Brazil according to their availability on university sites. The identification of curricular components and analysis of EBP course syllabi used evidence-based descriptive terms. A descriptive analysis was used to verify the frequency and the regional distribution of EBP courses. RESULTS: Of 1033 accredited programs in Brazil, 809 curricula were analyzed. Only 9.4% (76/809) of the analyzed curricula presented EBP courses; the mean duration of courses was 44.3 (SD 13.5) hours. Southeast region had the greatest number of undergraduate programs (46.5%, 376/809), and the north region had a proportionally greater number of EBP courses (24%, 12/50). In addition, 15.6% (10/64) and 8.9% (66/739) of the curricula of public and private institutions, respectively, provided EBP content. Critical appraisal was the most mentioned step among 15 undergraduate programs with complete EBP syllabi. DISCUSSION: Most undergraduate physiotherapy programs in Brazil did not offer an EBP course. Also, an unbalanced emphasis on the critical appraisal step was observed. The lack of EBP content and skills in the curricula of Brazilian undergraduate physiotherapy programs may negatively influence the training, decision-making, and clinical practice of physiotherapists. A re-evaluating of the current undergraduate programs and curricula for EBP-based education is needed.

Efetividade e segurança do treinamento muscular respiratório na apneia obstrutiva do sono: protocolo de uma revisão sistemática / Effectiveness and safety of respiratory muscle training in obstructive sleep apnea: systematic review protocol

Introdução: A apneia obstrutiva do sono (AOS) é o distúrbio respiratório do sono mais comum. O treino muscular respiratório tem surgido como uma intervenção promissora para a melhora dos sintomas e com boa adesão, porém muito ainda se tem discutido sobre sua efetividade e segurança. Objetivo: Avaliar a efetividade e segurança do TMR no tratamento de pacientes com AOS. Métodos: Para tanto, realizaremos uma revisão sistemática de ensaios clínicos randomizados (ECR). O protocolo do estudo foi registrado na Plataforma Prospero (CRD42018096980). Incluiremos indivíduos de idade superior ou igual a 18 anos, com diagnóstico de AOS, em uso ou não de pressão positiva nas vias aéreas. Excluiremos estudos com pacientes diagnosticados com lesão da medula espinhal ou doenças neuromusculares. As buscas serão realizadas nas bases de dados: Medical Literature Analysis and Retrieval System Online (Medline) via Pubmed, Excerpta Medica dataBASE (Embase) via Elsevier, Cochrane Central Register of Controlled Trials (Central) via Cochrane Library, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) via Portal da Biblioteca Virtual em Saúde e Physiotherapy Evidence Database (PEDro), sem restrições de idioma ou ano de publicação. Avaliaremos o rigor metodológico dos estudos incluídos e a certeza da evidência dos principais desfechos da revisão sistemática utilizando a ferramenta Risco de Viés 2.0 da Cochrane e a abordagem Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectivamente. A seleção dos estudos, extração de dados, avaliação do viés dos estudos incluídos e avaliação da certeza da evidência serão realizados por dois pesquisadores independentes. Resultados esperados: Espera-se que os resultados desta revisão forneçam informações úteis para a tomada de decisão clínica, exponham lacunas de conhecimento, assim como forneçam um bom embasamento para futuros ECR de alta qualidade sobre o assunto.

Influence of fruit age of the Brazilian Green Dwarf coconut on the relationship between Aceria guerreronis population density and percentage of fruit damage.

The coconut mite, Aceria guerreronis Keifer (Acari: Eriophyidae), is one of the main coconut pests in the American, African and parts of the Asian continents, reaching densities of several thousand mites per fruit. Diagrammatic scales have been developed to standardize the estimation of the population densities of A. guerreronis according to the estimated percentage of damage, but these have not taken into account the possible effect of fruit age, although previous studies have already reported the variation in mite numbers with fruit age. The objective of this study was to re-construct the relation between damage and mite density at different fruit ages collected in an urban coconut plantation containing the green dwarf variety ranging from the beginning to nearly the end of the infestation, as regularly seen under field conditions in northeast Brazil, in order to improve future estimates with diagrammatic scales. The percentage of damage was estimated with two diagrammatic scales on a total of 470 fruits from 1 to 5 months old, from a field at Ilhéus, Bahia, Brazil, determining the respective number of mites on each fruit. The results suggested that in estimates with diagrammatic scales: (1) fruit age has a major effect on the estimation of A. guerreronis densities, (2) fruits of different ages should be analyzed separately, and (3) regular evaluation of infestation levels should be done preferably on fruits of about 3-4 months old, which show the highest densities.