Comparative analysis of pelvic floor muscle training and Pilates in managing urinary incontinence among postmenopausal women: a randomized controlled trial.

INTRODUCTION AND HYPOTHESIS: This study is aimed at comparing the effectiveness of pelvic floor muscle training (PFMT) and Pilates on the improvement of urinary incontinence (UI), strength, and endurance of the pelvic floor muscles (PFMs), and the impact of UI on the quality of life in postmenopausal women. METHODS: Forty postmenopausal women were randomly divided in to two groups: PFMT (n = 20) and Pilates (n = 20). The participants were followed for 12 weeks, three times a week on nonconsecutive days. UI was assessed using the pad test and the voiding diary, PFM strength and resistance using bidigital assessment and manometry, and the impact of UI on quality of life using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), before and after the 3-month treatment. RESULTS: There was a significant intra-group improvement in both groups for the pad test, mean daily urinary loss, and ICIQ-SF. The strength was significantly improved only in the PFMT group, and the endurance in both groups. Peak strength manometry was significantly improved only in the Pilates group, and the mean strength manometry in both groups. There was also an improvement in both groups for peak endurance manometry and mean endurance manometry. In the inter-group comparison, there was a significant improvement only in muscle strength, which was positive for group. CONCLUSIONS: There was no difference between Pilates and PFMT for the management of women in post-menopause with stress urinary incontinence, provided that voluntary contraction of the PFMs is performed. However, further randomized clinical trials need to be carried out.

Impact of the Presence Anti-SARS-CoV-2 IgA in the Colostrum of Women Infected by COVID-19 During the Pregnancy in Neonatal Clinical Outcomes: A Cross-Sectional Study.

OBJECTIVES: To describe the presence of anti-SARS-CoV-2 IgA and IgG in the blood and colostrum of women with COVID-19 infection during pregnancy and associate the presence of anti-SARS-CoV-2 IgA in colostrum with clinical symptoms of their newborns. METHODS: A cross-sectional study was developed with 165 participants with COVID-19 infection during pregnancy and their newborns. DATA COLLECTED: characteristics COVID-19 infection in pregnant women, gestational age, and clinical symptoms in their newborns (fever, hypothermia, respiratory distress, hypotonia, hypoactivity, hypoglycemia, cyanosis, vomiting/regurgitation, abdominal distention, and jaundice). Maternal blood and colostrum samples were collected postpartum to to detect the presence of IgA and IgG anti-SARS-CoV-2. RESULTS: The median interval between COVID-19 diagnosis and delivery was 37.5 days (IQ = 12.0, 73.0 days). Clinical symptoms during hospitalization were observed in 55 newborns (33.3%), and two (1.6%) tested RT-PCR positive for COVID-19. Positive colostrum for anti-SARS-CoV-2 IgA was found in 117 (70.9%) women. The presence of anti-SARS-CoV-2 IgA in colostrum was associated independently with lower clinical symptoms in their newborns (OR = 0.42; 95% CI 0.202 to 0.84; p = 0.015). CONCLUSIONS FOR PRACTICE: The presence of anti-SARS-CoV-2 IgA in colostrum was detected in more than two-thirds of the women evaluated and was associated with a lower frequency of clinical symptoms in their newborns.

Evaluation of Maternal Fetal Outcomes of Pregnant Women and Mothers with Suspected Infection by SARS-CoV-2 Treated at the Municipal Hospital of São Bernardo do Campo (HMU-SBC), Brazil.

OBJECTIVES: The impact of Covid-19 infection on pregnancy and perinatal outcomes is not fully known. To describe the risk factors and perinatal outcome of pregnant women with suspected COVID-19 infection. METHODS: We evaluated medical records of women with suspected or confirmed SARS-CoV-2 infection who received health care services at the University Hospital of São Bernardo do Campo from March 1 to July 31, 2020, and personal, clinical, and laboratory data of these women and their newborns. RESULTS: Of the 219 women identified, 29% were asymptomatic. Considering the total population, 26% and 17% had obesity and hypertensive syndrome, respectively. Fever measured in the emergency room was the main reason for hospitalization. The presence or not of flu-like symptoms did not impact on perinatal outcomes. Pregnant women requiring hospitalization had newborns with lower birth weight (p < 0.01), shorter length (p = 0.02), and smaller head circumference (p = 0.03), and, in these cases, a higher number of cesarean section deliveries was observed. CONCLUSION: COVID-19 infection did not affect the prognosis of pregnancy and newborns. However, the worst clinical outcome, requiring hospitalization, had an impact on the anthropometric measurements of newborns.

What is already known on this subject?The SARS-CoV-2 infection is not fully undestood, specially during pregnancy and puerperae. There are conflicted information about this in the literature so far. However, it is known that respiratory infections such as influenza and SARS can develop unfavorably in pregnant women, since pregnancy changes the women's physiological condition, including altered immunity to tolerate placenta and fetus proper development.What this study adds?COVID-19 did not affect the prognosis of pregnancy and newborns in this study, but, the worst clinical outcome (hospitalization), impacted the anthropometric measurements of newborns.

Remote cognitive rehabilitation in patients post-cerebrovascular accident: an experience report.

BACKGROUND: Aiming to contribute to the reduction of cognitive impairment, as well as to improve the quality of life of patients affected by stroke, it was proposed to carry out a cognitive rehabilitation focused on attentional aspects (sustained, alternate, selective and divided attention). Due to the new Coronavirus pandemic and the need for social isolation, the rehabilitation was adapted to the remote model. METHODS: The rehabilitation was designed and carried out with six patients, coming from a public neurology outpatient service, who had suffered a stroke within a period of up to one year before the start of rehabilitation. Fifteen sessions of cognitive rehabilitation were carried out, lasting approximately 50 minutes, once a week, for four months. In all functions, the four types of attention were worked on. In addition, there were also unassisted activities performed by the patients after each session. RESULTS: The protocol was carried out by Psychology and Medicine students, who elaborated and adapted all activities to be performed by video call. The adaptations were made based on the knowledge and effectiveness of face-to-face rehabilitation for this population. Patients and family members collaborated in the activities, but the emergency adaptation to the remote model also had limitations, such as the withdrawal of some patients due to difficulty access or unstable internet connection. However, there were also positive results, such as the possibility of participation by people from other cities and people with mobility difficulties. This experience allowed students to develop skills in interacting with patients, as well as strategies to deal with the challenges of remote care. Thus, it was not necessary to interrupt the students´ education, moreover, the skills developed are important for the e-health context, which is an increasingly present demand in today's world. CONCLUSION: Remote cognitive rehabilitation is a possibility for patients who have suffered cognitive impairment due to stroke. Despite the difficulties arising from the pandemic, it was an important experience, with significant value for academic training, which stimulated the skills needed to care for patients, in addition to creativity and adaptation in the face of adversity.

Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth.

BACKGROUND: Premature birth is the main cause of mortality in children under 1 year, and vitamin D deficiency during gestation is associated with prematurity. The effects of vitamin D are mediated by its receptor, which is encoded by the VDR gene. VDR variants-such as single nucleotide variation (SNV)-are associated with increased risk of prematurity, but there are conflicting results. We evaluated serum vitamin D concentrations and the frequency of TaqI/A > G, BsmI/C > T, ApaI/C > A, and FokI/A > T VDR variants in mothers and preterm (PTN) and full-term (FTN) newborns. METHODS: We conducted a case-control study comprising 40 pairs of mothers and their PTNs (gestational age < 32 weeks and/or weight < 1500 g), and 92 pairs of mothers and FTNs as controls. Genotyping was performed by real-time PCR, and plasma vitamin D concentrations were measured by electrochemiluminescence. RESULTS: Vitamin D levels were significantly lower in PTN mothers. Genotypes TaqI/GG and BsmI/TT, and haplotypes AAG (TaqI/A-ApaI/A-FokI/G) and GCA (TaqI/G-ApaI/C-FokI/A) were significantly more frequent in PTN mothers, and genotypes TaqI/AG, ApaI/AA, and FokI/AG resulted in significantly lower vitamin D levels. Genotypes BsmI/TT and ApaI/AA were associated with vitamin D deficiency and 2.36 and 7.99 times greater likelihood of PTB, respectively. Vitamin D levels were also lower in PTNs, although it was not statistically significant. Genotypes BsmI/TT, ApaI/AA, and FokI/GG, and haplotype GAG (TaqI/G-ApaI/A-FokI/G) were significantly more frequent in PTNs. Those with FokI/GG genotypes had significantly lower vitamin D levels. CONCLUSIONS: VDR variants contribute to variations in vitamin D concentrations and the increased risk of prematurity.

Proposed protocol for post COVID-19 cognitive rehabilitation for attention and memory.

Since the beginning of the COVID-19 pandemic, many people suffered from Long Covid Syndrome, in which affected individuals do not recover immediately after the end of the infectious and inflammatory process caused by the virus. The most common neuropsychological symptoms of this syndrome are: memory decline, lack of attention, anxiety and depression. Objective: The purpose of this study was to develop a proposed cognitive rehabilitation protocol for post-COVID individuals with cognitive symptoms. Methods: A rehabilitation proposed protocol focusing on attention and memory was developed, based on the tests used in the neuropsychological evaluation of affected patients. Researchers held weekly sessions for six months, each lasting 60 minutes. Homework activities were also assigned and corrected in the following session. The attention and memory sessions were conducted with activities based on the applied tests. Results: Despite the methodological separation of attention and memory, the activities indirectly affect other cognitive functions and abilities, such as executive function, language, reasoning, execution strategies, and cognitive flexibility. A computer, a sheet of paper, and a pen were used to present the slides for the activities. Attention training included all types of attention: sustained, alternating, selective and divided. Memory training sessions included activities that stimulated both short-term and long-term memory. With each session, the difficulty of the activities was gradually increased. Conclusion: Cognitive rehabilitation already has more consolidated evidence about its effectiveness for the treatment of other pathologies, so it can be thought that it will also be a promising strategy for COVID-19 too.

Desde o início da pandemia de COVID-19, muitas pessoas sofreram com a síndrome da COVID longa, em que os indivíduos afetados não se recuperam após o término do processo infeccioso e inflamatório causado pelo vírus. Os sintomas neuropsicológicos mais comuns dessa síndrome são: declínio da memória, falta de atenção, ansiedade e depressão. Objetivo: Desenvolver uma proposta de protocolo de reabilitação cognitiva para indivíduos pós-COVID com sintomas cognitivos. Métodos: Foi desenvolvida uma proposta de protocolo de reabilitação com foco na atenção e na memória, baseada nos testes utilizados na avaliação neuropsicológica dos pacientes afetados. Os pesquisadores realizaram sessões semanais durante seis meses, cada uma com duração de 60 minutos. As atividades de lição de casa também foram atribuídas e corrigidas na sessão seguinte. As sessões de atenção e memória foram realizadas com atividades baseadas nos testes aplicados. Resultados: Apesar da separação metodológica entre atenção e memória, as atividades afetam indiretamente outras funções e habilidades cognitivas, como função executiva, linguagem, raciocínio, estratégias de execução e flexibilidade cognitiva. Foram utilizados computador, folha de papel e caneta para a apresentação dos slides das atividades. O treinamento da atenção incluiu todos os tipos de atenção: sustentada, alternada, seletiva e dividida. As sessões de treinamento de memória incluíram atividades que estimularam memória de curto e longo prazo. A cada sessão, a dificuldade das atividades foi aumentando gradativamente. Conclusão: A reabilitação cognitiva já possui evidências mais consolidadas sobre a sua eficácia para o tratamento de outras patologias, pelo que se pode pensar que na COVID-19 será também uma estratégia promissora.

Environmental monitoring of SARS-CoV-2 in the metropolitan area of Porto Alegre, Rio Grande do Sul (RS), Brazil.

Since starts the coronavirus disease 2019 (COVID-19) pandemic identified the presence of genomic fragments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various environmental matrices: domestic sewage, surface waters, and contaminated freshwater. Environmental monitoring of SARS-CoV-2 is a tool for evaluating trend curves over the months, compared to several clinical cases of the disease. The objective of this study was to monitor the SARS-CoV-2 in environmental samples collected in different sites in a metropolitan area of Porto Alegre, Southern Brazil. During 10 months from 2020 to 2021, 300 samples were collected weekly and biweekly from nine points located in 3 cities: one point from a wastewater treatment plant (WWTP) in São Leopoldo (fortnightly collection), two points in Dilúvio Stream in Porto Alegre (fortnightly collection), two points in Pampa and Luiz Rau Streams (weekly collection), and two points in public fountains (fortnightly collection) in Novo Hamburgo. After collection, samples were concentrated by ultracentrifugation, and viral nucleic acids were extracted using MagMax® Core Nucleic Acid Purifications kits and submitted to RT-qPCR, using E, N1, and N2 gene targets of SARS-CoV-2. Only 7% (3/41) samples from public fountains were positive, with a mean viral load (VL) of SARS-CoV-2 RNA of 5.02 × 101 gc/l (2.41~8.59 × 101 gc/l), while the streams had average VL of 7.43 × 105 gc/l (Pampa), 7.06 × 105 gc/l (Luiz Rau), 2.01 × 105 gc/l (Dilúvio), and 4.46 × 105 cg/l (WWTP). The results showed varying levels of viral presence in different sample types, with a demonstrated correlation between environmental viral load and clinical COVID-19 cases. These findings contribute to understanding virus persistence and transmission pathways in the environment. Continuous monitoring, especially in less developed regions, is crucial for early detection of vaccine resistance, new variants, and potential COVID-19 resurgence.

Remote cognitive rehabilitation of attention: a case series pilot study with post-stroke patients.

Cognitive deficits are highly prevalent following a stroke, with memory, attention, and psychomotor speed being among the most affected functions. Prior research indicates that cognitive rehabilitation for stroke patients yields substantial improvements in cognitive performance and concurrently exerts a positive influence on reducing depressive symptoms. Objective: The goal of this study was to provide a description and assessment of the influence of cognitive rehabilitation on the attentional performance and depressive symptoms of individuals diagnosed with stroke. Methods: Participants underwent a neuropsychological assessment both prior to and following a 15-week remote cognitive rehabilitation intervention. This intervention involved the implementation of various cognitive tasks aimed at rehabilitating attentional skills. Results: The outcomes of the individualized descriptive assessment revealed a no table inclination towards enhanced attentional performance. The comparative results indicated that the cognitive rehabilitation intervention for stroke patients proved effective in facilitating a substantial reduction in depressive symptoms and enhancing participants' alternating attention. While it is acknowledged that certain individuals may still exhibit deficiencies in various facets of attentional performance, cognitive rehabilitation contributed to the clinical amelioration of these individuals. Conclusion: Clinical improvement holds profound significance in the day-to-day existence of these individuals, bolstering their autonomy and fortifying their sense of self-efficacy, as attested by their personal perceptions and self-reports.

Os déficits cognitivos são altamente prevalentes após um acidente vascular cerebral (AVC), sendo a memória, a atenção e a velocidade psicomotora algumas das funções mais afetadas. Pesquisas anteriores demonstram que a reabilitação cognitiva em pacientes com AVC resulta em melhorias substanciais no desempenho cognitivo e exerce simultaneamente uma influência positiva na redução dos sintomas depressivos. Objetivo: O objetivo deste estudo foi fornecer uma descrição e avaliação da influência da reabilitação cognitiva no desempenho da atenção e de sintomas depressivos de indivíduos diagnosticados com AVC. Métodos: Os participantes foram submetidos a uma avaliação neuropsicológica antes e depois de uma intervenção de reabilitação cognitiva remota de 15 semanas. Essa intervenção envolveu a implementação de várias tarefas cognitivas destinadas à reabilitação das habilidades de atenção. Resultados: Os resultados da avaliação descritiva individualizada revelaram notável tendência para o aprimoramento do desempenho da atenção. Os resultados comparativos revelaram que a intervenção de reabilitação cognitiva para pacientes com AVC se mostrou eficaz na facilitação de uma redução substancial nos sintomas depressivos e no aprimoramento da atenção alternada dos participantes. Embora seja reconhecido que certos indivíduos ainda podem apresentar prejuízo no desempenho atencional, a reabilitação cognitiva contribuiu para a melhora clínica desses indivíduos. Conclusão: A melhora clínica possui profunda significância na existência cotidiana desses indivíduos, fortalecendo sua autonomia e reforçando sua sensação de autoeficácia, como atestado por suas percepções pessoais e relatos próprios.

EFFECTS OF VITAMIN D SUPPLEMENTATION DURING PREGNANCY ON NEWBORNS AND INFANTS: AN INTEGRATIVE REVIEW.

OBJECTIVE: To identify the effects of vitamin D supplementation during pregnancy on newborns and infants. DATA SOURCES: The present study is an integrative review of literature based on clinical trials published in journals indexed in the PubMed and Web of Science databases. Two searches were carried out, starting with the association (and) of the health term "vitamin D" with "pregnancy". In the search for information, selection criteria were established, and there was no language limitation and year of publication. DATA SYNTHESIS: The final selection resulted in 44 clinical trials, most of which were randomized and double blind, which were carried out in outpatient clinics, referral hospitals and universities, mainly in Europe. The samples studied were predominantly of newborns. In these 44 trials, 23 types of different doses of vitamin D during pregnancy, with different doses, regimens and times of use, and 14 different outcomes were studied in newborns (NB) and infants. Of the 44 studies performed, 35 showed statistically significant beneficial effects of vitamin D supplementation during pregnancy on newborns and infants compared to control groups. CONCLUSIONS: Vitamin D supplementation during pregnancy for at least three months before delivery has the potential of positively influencing calcium metabolism, physical growth and immune system development in newborns and infants. However, there is insufficient knowledge to define the optimal dose and to guarantee the absence of possible long-term adverse effects.

Determinants of Time to Care for Children and Adolescents With Disabilities.

Time use studies uncover the organization of daily routine of families of children with disabilities. The objective of this study is to identify determinants of time spent caring for children/adolescents with cerebral palsy (CP), autism spectrum disorder (ASD), and typical development (TD). Participants were caregivers of children/adolescents with/without disability. Structural equation modeling tested a proposed model of time spent in child care. The variables in the model were as follows: questionnaire (families' socioeconomic status [SES]), children's functioning (The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test [PEDI-CAT]); hours of care (daily diaries), number of adaptations used, and help with child care (parents' report). Distinct variable combinations explained 78% of the variation in the time to care (TD model), followed by 42% (ASD) and 29% (CP). Adaptations indirectly affected time to care through its effect on functioning (CP); family's SES affected functioning through its effect on adaptation use (ASD). In conclusion, knowledge of factors affecting caregivers' time spent on children's care help occupational therapists implement family-centered strategies.

Early Identification of IgA Anti-SARSCoV-2 in Milk of Mother With COVID-19 Infection.

INTRODUCTION: Human milk cannot currently be considered a major source of COVID-19 infection. On the other hand, it can contain specific antibodies that could modulate a possible newborn infection by SARS-CoV-2. MAIN ISSUE: A 32-year-old pregnant woman, gestational age 37 and 3/7 weeks, was admitted with a flu-like syndrome caused by COVID-19. The female newborn was appropriate for gestational age, with a birth weight of 2,890 g, length 48 cm, and head circumference 34 cm. MANAGEMENT: The mother-infant dyad remained in the rooming-in unit during hospitalization, exclusively breastfeeding and following World Health Organization recommendations for contact and airway precautions. On the 3rd day after delivery, two mother's milk samples (3 and 5 mL) were collected by hand expression. The samples were centrifuged for 10 min twice consecutively to separate fat, which was removed, and the remaining material was transferred to another tube to determine anti-SARS-CoV-2 Immunoglobulin A and Immunoglobulin G (ELISA, Kit EUROIMMUN AG, Luebeck, Germany). Anti-SARS-CoV-2 Immunoglobulin A was detected in the two samples evaluated, whose values were 2.5 and 1.9, respectively. No anti-SARSCoV-2 immunoglobulin G was detected. The exclusively-breastfed infant remained well through 45 days of age. CONCLUSION: The presence of SARS-CoV-2 Immunoglobulin A in the milk of mothers infected with COVID-19 may be related to protection against the transmission and severity of the disease in their infants.

Proposed protocol for post COVID-19 cognitive rehabilitation for attention and memory / Proposta de protocolo de reabilitação cognitiva pós-COVID-19 para atenção e memória

ABSTRACT Since the beginning of the COVID-19 pandemic, many people suffered from Long Covid Syndrome, in which affected individuals do not recover immediately after the end of the infectious and inflammatory process caused by the virus. The most common neuropsychological symptoms of this syndrome are: memory decline, lack of attention, anxiety and depression. Objective: The purpose of this study was to develop a proposed cognitive rehabilitation protocol for post-COVID individuals with cognitive symptoms. Methods: A rehabilitation proposed protocol focusing on attention and memory was developed, based on the tests used in the neuropsychological evaluation of affected patients. Researchers held weekly sessions for six months, each lasting 60 minutes. Homework activities were also assigned and corrected in the following session. The attention and memory sessions were conducted with activities based on the applied tests. Results: Despite the methodological separation of attention and memory, the activities indirectly affect other cognitive functions and abilities, such as executive function, language, reasoning, execution strategies, and cognitive flexibility. A computer, a sheet of paper, and a pen were used to present the slides for the activities. Attention training included all types of attention: sustained, alternating, selective and divided. Memory training sessions included activities that stimulated both short-term and long-term memory. With each session, the difficulty of the activities was gradually increased. Conclusion: Cognitive rehabilitation already has more consolidated evidence about its effectiveness for the treatment of other pathologies, so it can be thought that it will also be a promising strategy for COVID-19 too.

RESUMO Desde o início da pandemia de COVID-19, muitas pessoas sofreram com a síndrome da COVID longa, em que os indivíduos afetados não se recuperam após o término do processo infeccioso e inflamatório causado pelo vírus. Os sintomas neuropsicológicos mais comuns dessa síndrome são: declínio da memória, falta de atenção, ansiedade e depressão. Objetivo: Desenvolver uma proposta de protocolo de reabilitação cognitiva para indivíduos pós-COVID com sintomas cognitivos. Métodos: Foi desenvolvida uma proposta de protocolo de reabilitação com foco na atenção e na memória, baseada nos testes utilizados na avaliação neuropsicológica dos pacientes afetados. Os pesquisadores realizaram sessões semanais durante seis meses, cada uma com duração de 60 minutos. As atividades de lição de casa também foram atribuídas e corrigidas na sessão seguinte. As sessões de atenção e memória foram realizadas com atividades baseadas nos testes aplicados. Resultados: Apesar da separação metodológica entre atenção e memória, as atividades afetam indiretamente outras funções e habilidades cognitivas, como função executiva, linguagem, raciocínio, estratégias de execução e flexibilidade cognitiva. Foram utilizados computador, folha de papel e caneta para a apresentação dos slides das atividades. O treinamento da atenção incluiu todos os tipos de atenção: sustentada, alternada, seletiva e dividida. As sessões de treinamento de memória incluíram atividades que estimularam memória de curto e longo prazo. A cada sessão, a dificuldade das atividades foi aumentando gradativamente. Conclusão: A reabilitação cognitiva já possui evidências mais consolidadas sobre a sua eficácia para o tratamento de outras patologias, pelo que se pode pensar que na COVID-19 será também uma estratégia promissora.

Predictors of Subjective Well-Being of Expatriates on Mission in Brazil / Preditores de Bem-Estar Subjetivo em Expatriados em Missão no Brasil / Predictores del Bienestar Subjetivo de Expatriados en Misión en Brasil

Abstract Expatriation for work presents several challenges before departure, during expatriation, and on the return to the country of origin that can impact the subjective well-being of these professionals. This study evaluated sociodemographic, labor, cultural distance, and intercultural efficacy variables as possible predictors for Subjective Well-being in 238 expatriates on mission in Brazil. The instruments used were a sociodemographic and labor questionnaire, The Satisfaction with Life Scale, The Scores of Cultural Distance, and the Multicultural Personality Questionnaire. The results, analyzed via Stepwise multiple linear regression, revealed a predictor model of SWB consisting of the variables: having children, cultural empathy, social initiative, and emotional stability. The results indicate the need for interventions focusing on subjective well-being aimed at adapting expatriates in Brazil.

Resumo A expatriação por trabalho apresenta vários desafios, antes da partida, durante a expatriação e no retorno ao país de origem, que podem impactar no bem-estar subjetivo dos profissionais. Este estudo teve por objetivo avaliar as variáveis sociodemográficas, laborais, a distância cultural e a eficácia intercultural como preditoras para o bem-estar subjetivo em 238 expatriados em missão no Brasil. Os instrumentos utilizados foram um questionário sociodemográfico e laboral, a Escala de Satisfação com a Vida, os escores de Distância Cultural, a Escala de afetos positivos e negativos e o Questionário de Personalidade Multicultural. Os resultados, examinados por meio da Análise de Regressão Linear, revelaram um modelo preditor de bem-estar subjetivo constituído pelas variáveis ter filhos, empatia cultural, iniciativa social e estabilidade emocional. Os resultados, ainda, indicaram a necessidade de intervenções com foco no bem-estar subjetivo visando à adaptação dos expatriados no Brasil.

Resumen La expatriación por trabajo presenta varios desafíos antes de la salida, durante la expatriación y en el regreso al país de origen que pueden impactar en el bienestar subjetivo de estos profesionales. Este estudio tuvo como objetivo evaluar variables sociodemográficas y laborales, distancia cultural y efectividad intercultural como predictores de bienestar subjetivo en 238 expatriados en misión en Brasil. Los instrumentos utilizados fueron un cuestionario sociodemográfico y laboral, la Escala de Satisfacción con la Vida, los puntajes de Distancia Cultural, la Escala de Afectos Positivos y Negativos y el Cuestionario de Personalidad Multicultural. Los resultados se evaluaron desde un Análisis de Regresión Lineal y revelaron un modelo predictivo del bienestar subjetivo constituido por las variables tener hijos, empatía cultural, iniciativa social y estabilidad emocional. Los resultados indican la necesidad de intervenciones enfocadas en el bienestar subjetivo dirigidas a la adaptación de los expatriados en Brasil.

Remote cognitive rehabilitation of attention: a case series pilot study with post-stroke patients / Reabilitação cognitiva remota da atenção: um estudo piloto de séries de casos com pacientes pós-AVC

ABSTRACT Cognitive deficits are highly prevalent following a stroke, with memory, attention, and psychomotor speed being among the most affected functions. Prior research indicates that cognitive rehabilitation for stroke patients yields substantial improvements in cognitive performance and concurrently exerts a positive influence on reducing depressive symptoms. Objective: The goal of this study was to provide a description and assessment of the influence of cognitive rehabilitation on the attentional performance and depressive symptoms of individuals diagnosed with stroke. Methods: Participants underwent a neuropsychological assessment both prior to and following a 15-week remote cognitive rehabilitation intervention. This intervention involved the implementation of various cognitive tasks aimed at rehabilitating attentional skills. Results: The outcomes of the individualized descriptive assessment revealed a no table inclination towards enhanced attentional performance. The comparative results indicated that the cognitive rehabilitation intervention for stroke patients proved effective in facilitating a substantial reduction in depressive symptoms and enhancing participants' alternating attention. While it is acknowledged that certain individuals may still exhibit deficiencies in various facets of attentional performance, cognitive rehabilitation contributed to the clinical amelioration of these individuals. Conclusion: Clinical improvement holds profound significance in the day-to-day existence of these individuals, bolstering their autonomy and fortifying their sense of self-efficacy, as attested by their personal perceptions and self-reports.

RESUMO Os déficits cognitivos são altamente prevalentes após um acidente vascular cerebral (AVC), sendo a memória, a atenção e a velocidade psicomotora algumas das funções mais afetadas. Pesquisas anteriores demonstram que a reabilitação cognitiva em pacientes com AVC resulta em melhorias substanciais no desempenho cognitivo e exerce simultaneamente uma influência positiva na redução dos sintomas depressivos. Objetivo: O objetivo deste estudo foi fornecer uma descrição e avaliação da influência da reabilitação cognitiva no desempenho da atenção e de sintomas depressivos de indivíduos diagnosticados com AVC. Métodos: Os participantes foram submetidos a uma avaliação neuropsicológica antes e depois de uma intervenção de reabilitação cognitiva remota de 15 semanas. Essa intervenção envolveu a implementação de várias tarefas cognitivas destinadas à reabilitação das habilidades de atenção. Resultados: Os resultados da avaliação descritiva individualizada revelaram notável tendência para o aprimoramento do desempenho da atenção. Os resultados comparativos revelaram que a intervenção de reabilitação cognitiva para pacientes com AVC se mostrou eficaz na facilitação de uma redução substancial nos sintomas depressivos e no aprimoramento da atenção alternada dos participantes. Embora seja reconhecido que certos indivíduos ainda podem apresentar prejuízo no desempenho atencional, a reabilitação cognitiva contribuiu para a melhora clínica desses indivíduos. Conclusão: A melhora clínica possui profunda significância na existência cotidiana desses indivíduos, fortalecendo sua autonomia e reforçando sua sensação de autoeficácia, como atestado por suas percepções pessoais e relatos próprios.

Effects of vitamin d supplementation during pregnancy on newborns and infants: an integrative review / Efeitos da suplementação de vitamina d durante a gestação no recém-nascido e lactente: uma revisão integrativa

ABSTRACT Objective: To identify the effects of vitamin D supplementation during pregnancy on newborns and infants. Data sources: The present study is an integrative review of literature based on clinical trials published in journals indexed in the PubMed and Web of Science databases. Two searches were carried out, starting with the association (and) of the health term "vitamin D" with "pregnancy". In the search for information, selection criteria were established, and there was no language limitation and year of publication. Data synthesis: The final selection resulted in 44 clinical trials, most of which were randomized and double blind, which were carried out in outpatient clinics, referral hospitals and universities, mainly in Europe. The samples studied were predominantly of newborns. In these 44 trials, 23 types of different doses of vitamin D during pregnancy, with different doses, regimens and times of use, and 14 different outcomes were studied in newborns (NB) and infants. Of the 44 studies performed, 35 showed statistically significant beneficial effects of vitamin D supplementation during pregnancy on newborns and infants compared to control groups. Conclusions: Vitamin D supplementation during pregnancy for at least three months before delivery has the potential of positively influencing calcium metabolism, physical growth and immune system development in newborns and infants. However, there is insufficient knowledge to define the optimal dose and to guarantee the absence of possible long-term adverse effects.

RESUMO Objetivo: Identificar os efeitos da suplementação de vitamina D durante a gestação no recém-nascido e lactente. Fontes de dados: Revisão integrativa da literatura baseada em ensaios clínicos publicados em revistas indexadas nas bases de dados PubMed e Web of Science. Foi realizada uma busca em cada base de dados, que partiu da associação (and) dos descritores de saúde vitamin D e pregnancy. Na busca pelas informações, foram estabelecidos critérios de seleção e não houve limitação de idioma nem de ano de publicação. Síntese de dados: A seleção final resultou em 44 ensaios clínicos - a maioria randomizada e duplo-cego -, que foram realizados em ambulatórios, hospitais de referência e universidades sobretudo da Europa. As amostras estudadas foram predominantemente de recém-nascidos. Nesses 44 ensaios, foram testadas 23 formas de suplementação de vitamina D na gestação, com diferentes doses, regimes e tempos de uso, e estudaram-se 14 desfechos diferentes nos recém-nascidos e lactentes. Dos 44 estudos, 35 demonstraram efeitos benéficos da suplementação de vitamina D durante a gestação nos recém-nascidos e lactentes de forma estatisticamente significante, quando comparados aos do grupo controle. Conclusões: A suplementação de vitamina D na gestação, por no mínimo três meses antes do parto, potencialmente influencia de forma positiva o metabolismo do cálcio, o crescimento físico e o desenvolvimento do sistema imunológico dos recém-nascidos e lactentes, entretanto não há conhecimento suficiente para a definição da dose ideal nem para garantir a inexistência de possíveis efeitos adversos em longo prazo.

Eficácia do Nintendo Wii em desfechos funcionais e de saúde de indivíduos com doença de Parkinson: uma revisão sistemática / Eficacia del Nintendo Wii en resultados funcionales y de salud de individuos con enfermedad de Parkinson: una revisión sistemática / Effectiveness of Nintendo Wii in functional and health outcomes of individuals with Parkinson's disease: a systematic review

RESUMO O objetivo deste estudo foi revisar sistematicamente a literatura sobre a eficácia do Nintendo Wii na melhora de desfechos funcionais e de saúde de indivíduos com doença de Parkinson. A revisão foi desenvolvida seguindo o PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), com buscas nas bases de dados MEDLINE, SciELO, LILACS e PEDro mediante estratégia de busca composta pela combinação dos termos "Wii", "Doença de Parkinson", "reabilitação" e "fisioterapia", seguida de busca manual. Os critérios de inclusão foram: estudos experimentais ou quase-experimentais relacionados a intervenções envolvendo o uso do Nintendo Wii para melhora de desfechos funcionais em indivíduos com doença de Parkinson, publicados até fevereiro de 2016, sem restrição de idioma. A qualidade metodológica dos estudos foi avaliada pela escala PEDro. Dos 701 estudos encontrados, foram selecionados sete que atenderam aos critérios de inclusão, a maioria (57,14%) apresentava qualidade metodológica ruim e era do tipo quase-experimental. Os resultados sugerem que o uso do Wii parece eficaz para melhora de desfechos funcionais (equilíbrio, mobilidade, desempenho motor e independência) e de saúde (diminuição do risco de quedas), sendo mais consistentes os resultados para melhora do equilíbrio. São necessários estudos com melhor qualidade metodológica para o estabelecimento das evidências e, ainda, padronizações sobre os tipos de jogos, intensidade e frequência adequados para cada tipo de paciente com DP.

RESUMEN El objetivo de este estudio ha sido el de revisar sistemáticamente la literatura sobre la eficacia del Nintendo Wii en la mejora de resultados funcionales y de salud de individuos con enfermedad de Parkinson. La revisión sistemática de la literatura ha sido desarrollada siguiendo el PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), con búsquedas en las bases de datos MEDLINE, SciELO, LILACS y PEDro de acuerdo con la estrategia de búsqueda compuesta por la combinación de los términos "Wii", "Enfermedad de Parkinson", "rehabilitación" y "fisioterapia", seguida de búsqueda manual. Los criterios de inclusión han sido: los estudios experimentales o casi-experimentales relacionados a las intervenciones involucrando el uso del Nintendo Wii para la mejora de resultados funcionales en los individuos con enfermedad de Parkinson, publicados hasta febrero de 2016, sin restricción de idioma. La cualidad metodológica de los estudios ha sido evaluada por la escala PEDro. De los 701 estudios encontrados, han sido incluidos siete que atendieron a los criterios de inclusión, la gran parte (el 57,14%) con cualidad metodológica mala y del tipo casi-experimental. Los resultados sugieren que el uso del Wii parece eficaz para la mejora de resultados funcionales (el equilibrio, la movilidad, el desempeño motor y la independencia) y de salud (disminución del riesgo de caídas), siendo más consistentes los resultados para la mejora del equilibrio. Son necesarios estudios con mejor cualidad metodológica para el establecimiento de las evidencias. Todavía son necesarias estandarizaciones sobre los tipos de juegos, intensidad y frecuencia adecuados para cada tipo de paciente con EP.

ABSTRACT The objective of this study was to conduct a systematic review of the literature on the effectiveness of Nintendo Wii in the improvement of functional and health outcomes of individuals with Parkinson's disease. A systematic review of the literature was developed following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), with research in MEDLINE, SciELO, LILACS, PEDro through a search strategy that combined the terms Wii, Parkinson's Disease, rehabilitation, and physical therapy, followed by manual search. Inclusion criteria were: experimental studies or quasi-experiments related to interventions involving the use of Nintendo Wii to improve functional outcomes in individuals with Parkinson's disease, published until February 2016, without language restriction. The methodological quality of the studies was assessed with the PEDro scale. Of the 701 studies found, we included seven that met the inclusion criteria - most of the articles (57.14%) had bad methodological quality and were quasi-experiments. The results suggest that the use of Wii seems effective to improve functional outcomes (balance, mobility, motor performance and independence) and health (reducing the risk of falls), being more consistent the results for the improvement of balance. Studies with better methodological quality are needed for the establishment of evidence. Standardization on the types of games, intensity and frequency suitable for each type of patient with PD are still required.

As representações sociais dos discentes e egressos sobre a terapia ocupacional / The social representations about occupational therapy by students and graduates / Las representaciones sociales de los estudiantes y egresados de la carrera de terapia ocupacional

O presente estudo se propõe a identificar as representações sociais dos estudantes e egressos do curso de Terapia Ocupacional (TO), da Universidade Federal de Minas Gerais (UFMG), sobre sua profissão, buscando verificar diferentes estágios de constituição dessas representações ao longo do processo de formação, atuação e construção da identidade profissional. Participaram do estudo, acadêmicos e discentes (n = 100) divididos em três subgrupos (inicias, finais e egressos). Para a coleta de dados, foi aplicado um questionário de evocação livre de palavras, e as informações foram posteriormente processadas pelos softwares EVOC2005 e CHIC®. Os resultados mostraram que, entre as palavras que compõem o núcleo central, somente "autonomia" e "independência" apresentaram alta representatividade nos três subgrupos. Durante toda a sequência da análise dos dados, esse binômio se destaca, como observado também na árvore hierárquica. Conclui-se que os acadêmicos e discentes, ao representarem a profissão, priorizam o fazer profissional, que pode estar relacionado com a dificuldade em definir e criar uma identidade profissional.

This study aims at identifying the social representations by students and graduates in the Occupation Therapy program at the Federal University of Minas Gerais (UFMG) about their profession. It also aims to identify different stages of establishing such representations throughout the training process, performance and construction of the professional identity. Students and graduates participated in the study (n = 100), which was divided into three subgroups (initial, final and graduates). A questionnaire was used for data collection which was then subsequently processed by EVOC2005 and CHIC® software. The results showed that among the words that make up the core, only autonomous and independent exhibited high representation in the three subgroups. This binomial stands out throughout the following data analysis, as observed in the hierarchical tree. We conclude that students and graduates who represent the profession prioritize professional action (doing), which may be related to the difficulty in defining and creating a professional identity.

El presente estudio tiene como finalidad identificar las representaciones sociales sobre la profesión de los estudiantes y egresados de la carrera de Terapia Ocupacional de la Universidad Federal de Minas Gerais, buscando verificar las diferentes etapas de la constitución de estas representaciones a lo largo del proceso de formación, ejercicio y construcción de la identidad profesional. En este estudio participaron estudiantes y egresados (n=100) divididos en tres subgrupos (nuevo ingreso, próximos a graduarse y egresados). Para la recolección de los datos se aplicó un cuestionario de evocación libre de palabras, posteriormente, estos fueron procesados por los programas EVOC2005 y CHIC ®. Los resultados mostraron que de entre las palabras que componen el núcleo central, solamente autonomía e independencia presentaron una alta representatividad en los tres grupos; durante toda la secuencia de análisis de datos, este binomio destaca, pudiéndose observar esto de igual manera en el árbol jerárquico. Se concluye que los estudiantes y egresados, al momento de representar su profesión, priorizan el ejercicio profesional, lo que puede estar relacionado con la dificultad en definir y crear una identidad profesional.

Avaliação fisioterapêutica da cicatrização de lesões por queimaduras: revisão bibliográfica / Evaluación fisioterapéutica de cicatrización en lesiones de quemaduras: revisión de la literatura / Physiotherapeutic evaluation of burn wound healing: a literature review

Introdução: As queimaduras muitas vezes ocasionam um grande impacto a longo prazo na vida dos que sofreram o trauma, afetando a funcionalidade física e sua condição psciológica, decorrente das cicatrizes provocadas pela lesão. A fisioterapia dentro da equipe multidisciplinar colabora na prevenção e na reeducação funcional do indivíduo, sempre buscando mimizar as cicatrizes. Por sua importância clínica e de prognóstico ao tratamento, a avaliação fisioterapêutica da cicatrização da lesão por queimaduras é um dos assuntos que ainda está a ser esclarecido. Objetivo: Analisar a literatura científica produzida nos últimos 10 anos sobre avaliação fisioterapêutica da cicatrização de lesões por queimaduras. Método: Busca de artigos no período compreendido de dez anos, entre 2005 e 2015, nos acervos de refencial bibliográfico científico “PubMed” e “Scholar Google” em língua inglesa. Resultados: Foram encontrados dez artigos, dentro dos critérios de busca adotados, sendo poucos os dados na literatura que relatam a avaliação da cicatrização por fisioterapeutas. Evidencia-se que a abordagem dos estudos dentro do conceito de cicatrização é ampla, passando da fase aguda da lesão às cicatrizes ambulatoriais, sendo diferente a forma de avaliação do processo de cicatrização de cada um deles, não detendo-se somente às escalas de avaliação da cicatriz. Conclusões: Embora exista uma grande variação da lesão referente à profundidade e origem das queimaduras, localização, idade do paciente, entre outras condições clínicas, ainda há a necessidade de se encontrar protocolos e ferramentas que apresentem padronização e confiabilidade para uma avaliação da cicatrização reproduzível e com acurácia.

Introduction: Burns often cause a long-term impact in the lives of those who suffered trauma, affecting their physical functionality and psychological condition, due to wound scars. Physiotherapy within the multidisciplinary team collaborates on prevention and functional rehabilitation always aiming to minimize scars. Because of its clinical significance and prognosis for treatment, physiotherapeutic assessment of burn wounds is one of the issues still to be clarified. Objective: To analyze the scientific literature produced in the last 10 years of physiotherapeutic assessment of burns wound healing. Method: Articles were searched in the period of ten years between 2005 and 2015, in the scientific literature data basis “PubMed” and “Google Scholar” in the English language. Results: There were ten articles found within the established search criteria, with a few data reporting the evaluation of the healing by physical therapists. It is evident that broad studies based on scar concepts, considering its initial acute phase is not restricted to outpatients scars as there are particular differences for scar assessments which are not restrained to scar scale assessment. Conclusions: Although there is a wide variation of lesion related to the depth and origin of burns, location, patient’s age, among other medical conditions, there is still the need to find out protocols and tools that have standardization and reliability for burn wound healing assessment with reproducibility and accuracy.

Introducción: Las quemaduras muchas vezes causan un gran impacto a largo plazo en la vida de aquellos que han sufrido un trauma, que afecta a la funcionalidad física y su condición psciológica, como resultado de cicatrices causadas por la lesione. La fisioterapía dentro del equipo multidisciplinar ayuda en la prevención y la rehabilitación funcional del individuo siempre buscando minimizar las cicatrices. Por su importancia clínica y en el pronóstico del tratamiento, la evaluación fisioterapéutica de la cicatrización de las quemaduras es una de las cuestiones aún por esclarecer. Objetivo: Analizar la literatura científica producida en los últimos 10 años al respecto de la evaluación fisioterapéutica de la cicatrización en quemaduras. Método: Busca por artículos del período de diez años entre 2005 y 2015, en la literatura científica y colecciones referencial on line “PubMed” y “Google Scholar” en Inglés. Resultados: Fueron encontrados diez artículos dentro de los criterios de búsqueda adoptados, con pocos datos en la literatura que informaron la evaluación de la cicatrización por los fisioterapeutas. Es evidente que el enfoque de los estudios dentro del concepto de cicatrización és amplio, , pasando de fase aguda de la lesión a las cicatrizes en ambulatorio, siendo diferente la forma de evaluación del proceso de cicatrización de cada proceso, no deteniéndose sólo las escalas de evaluación de la cicatriz. Conclusiones: Aunque hay una amplia variación de lesiones relacionadas con la profundidad y el origen de las quemaduras, la ubicación, la edad del paciente, entre otras condiciones médicas, todavía existe la necesidad de encontrar los protocolos y herramientas estandarizadas y con fiabilidad para una evaluación de la cicatrización y reproducible con exactitud.

Perfil epidemiológico, sociodemográfico e clínico de idosos institucionalizados / Perfil epidemiológico, sociodemografico y clinico de ancianos institucionalizados / Epidemiological, sociodemographic and clinical profile of institutionalized elderly

Determinar o perfil epidemiológico, sociodemográfico e clínico de idosos institucionalizados, bem comoas enfermidadesprevalentes e medicamentos utilizados. Tratou-se deum estudo descritivo de abordagem quantitativa, realizado em umaInstituição de Longa Permanência para Idosos (ILPI) em um município de Minas Gerais. A análise dos dadosfoi realizada apartir da comparação de achados da literatura com os dados identificados através do questionário utilizado. A idade médiados idosos foi de 77,3 anos, sendo a maior parte dosexo feminino, analfabeta, solteira e sem filhos.A maioria morava naILPI há mais de um ano e foi institucionalizada poralgum familiar por indisponibilidade para cuidar. Amédia de ingestãode medicamentos por idoso foi de 2,87. Os mais utilizados foram os neurológicos, anti-hipertensivos eos hipoglicemiantes.As doenças com maior prevalência distribuíram-se como endocrinológicas, cardiovasculares e neuropsiquiátricas. Osresultados deste trabalho contribuem na determinação da tipologia dos idosos institucionalizados nestemunicípio e sugerea necessidade de uma política de qualidade de cuidados em ILPI, de forma que o Setor Público exerça seupapel deregulador, fiscalizador e executor das ações dessasinstituições, avaliando as condições de seu funcionamento e dosserviços ofertados.

The objective of this study was to determine the epidemiological, clinical and sociodemographicprofile of institutionalized elderly people, as well as the prevalent diseases and medications used bythem. This was adescriptive study using a quantitative approach conducted in an institution of Long permanence of Elderly Care in a countyof Minas Gerais State, Brazil. Data analysis was performed by comparing the findings obtained throughaquestionnaire with data from the literature. The average age of the elderly people was 77.3 years, andmost ofthem were female, illiterate, widowers and had no children. Most were residents for over one year andhad beeninstitutionalized by the family mainly due to inability to care of them. The use of medication was of2.87 pils per elderly.The most widely used were neurological, antihypertensive and hypoglycemic. The most prevalent diseasesweredistributed as endocrine, cardiovascular and neuropsychiatric. The results of this study contribute indetermining the typeof institutionalized elderly in this municipality and suggest the need for a policy of quality of carein long-stay institutions,so that the Public Sector exerts its role as regulator, supervisor and executor of actions of such institutions, assessing theconditions of its operation and offered services.

Delinear el perfil epidemiológico, sociodemográficoy clínico de ancianos institucionalizados,así como las enfermedadesprevalentes y los medicamentos utilizados por ésos.Se trata de un estudio descriptivo de abordaje cuantitativo realizadoenuna institución de Larga Estadía para Ancianos en unmunicipio de Minas Gerais. Los análisis de datos sehan dado apartir de la comparación de hallazgos de la literatura con los datos identificados a través del cuestionario utilizado.Laedad media de los ancianos es 77,3 años, con prevalencia de género femenino, analfabetos, viudos y sinhijos. La mayoríason residentes durante más de uno año y han sido institucionalizados por algún familiar, cuyo principal motivo fue laindisponibilidad a cuidar de ésos. El número promedio de medicamentos por individuo fue de 2,87. Los más utilizados sonneurológicos, antihipertensivos e hipoglucemiantes.Las enfermedades más prevalentes fueron distribuidas comoendocrino, cardiovascular y neuropsiquiátricos. Losresultados de este estudio contribuyen en la determinación detipología de los ancianos institucionalizados en este municipio y sugiere la necesidad de una política de calidad decuidados en instituciones de larga estadía, para que el sector público ejerza su papel de regulador, fiscalizador y ejecutorde las acciones de dichas instituciones, evaluandolas condiciones de su funcionamiento y de los servicios ofrecidos.