Repositório RCAAP

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Parkinson's disease is a progressive pathology of the motor system caused by poor dopamine production and is characterized by difficulty in coordination, potency, endurance and muscle control. Given the neuromotor nature of the disease, the oral phase of swallowing is affected, , in which multiple soft and bony structures act, including the tongue that plays an important role, both in the formation of the bolus and in the propulsion to the pharynx. Although numerous studies have focused their efforts on the analysis of the phenomenon of food transit, it is still necessary to deepen the knowledge in this area. Based on this premise, this study aimed to analyze the effects of a strength and resistance intervention program for the tongue in subjects with Parkinson's Disease. This research was approved by the Ethics Committee of the Federal University of Santa Maria and the Speech Therapy Clinic of the University of Talca, in Chile, where the collections were carried out. Two groups were formed with subjects with Parkinson's Disease. Both performed conventional tongue exercises and one with the addition of the Iowa Oral Performance Instrument during training. The electrical activity of the suprahyoid muscles and tongue pressure were pre-intervention, over 4 and 8 weeks of training, as well as in the 12th week, investigating detraining. Quality of life related to swallowing was measured before and after the intervention. It was found that all participants had lower tongue strength and endurance than those found in studies with healthy individuals. Subjects in more advanced stages of the disease had lower tongue strength. After the training, a significant increase in the electrical activity of the suprahyoid musculature and lingual strength was found in the group that performed the speech-language intervention associated with the Iowa Oral Performance Instrument compared to the control. Likewise the quality of life related to swallowing improved in the experimental group.

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The Kangaroo Mother Care (KMC) is considered a natural, cost-effective, evidence-based intervention, and is recommended as a standard of care for preterm neonates. The full-time presence of the mother in the kangaroo unit, by encouraging breastfeeding, can reduce the difficulties for oral feeding, which are frequent in preterm neonates, since sucking at the breast contributes to the development of the functions and structures of the stomatognathic system. This research aimed to verify the effects of KMC on oral skills, breastfeeding and introduction of complementary feeding in preterm neonates throughout the first year of life. This is a longitudinal observational, prospective and analytical study. The sample comprised 46 preterm neonates with gestational age at birth ≤ 34 weeks, allocated to the Kangaroo Neonatal Intermediate Care Unit (UCINCa) and the Conventional Neonatal Intermediate Care Unit (UCINCo) of a university hospital in southern Brazil. After neonatal discharge, participants were followed-up by telephone calls at 4, 6 and 12 months of corrected age. In preterm neonates who attended the UCINCa the maturation process of oral skills was faster, which translated into fewer days to make the transition from tube feeding to full oral feeding (4.5 days versus 10 days, for UCINCa and UCINCo, respectively, p=0.041). There was no influence on length of stay, although there was a reduction of 4 days in the length of stay, counted from the release of the oral route, in preterm neonates in the UCINCa. The KMC favored exclusive breastfeeding at hospital discharge, and significantly, at 4 months of corrected age, when 35% of preterm neonates were still on exclusive breastfeeding, and only 8.3% of children exiting the UCINCo. At 6 and 12 months of corrected age the rates of breastfeeding did not differ between units. The introduction of complementary feeding was reported in 45% and 42.3% of the infants in the UCINCa and UCINCo, respectively, at 4 months of corrected age. It was concluded that admission to the UCINCa accelerated the maturation process of oral skills in preterm neonates, shortening the time of transition from tube feeding to full oral feeding. In addition, it provided a significant increase in exclusive breastfeeding rates at neonatal discharge and at 4 months of corrected age. Participation in KMC was not protective on breastfeeding rates from the 6th month of corrected age, nor to avoid early introduction of complementary feeding.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

The death of the spouse generates immediate and long-term changes, being significant for the reorganization of the family system and for the experience of parenting, however, there are still few studies related to male single parenting in the face of widowhood. Thus, the present study sought to understand the perception of men about the paternal role in the process of family adaptation to grief. Four widowed parents aged between 33 and 54 years old and with children up to 12 years old were interviewed. The research used the Collective Case Study design, with a qualitative approach, and the data were analyzed through thematic content analysis. The results were presented in the format of a scientific article: " Paternal tasks before family grieving for mother’s death". Despite the suffering associated with the death of the wife, the parents' efforts to continue the family routine, meaning the loss as a driver to prioritize the children's quality of life. Performing parenthood, assuming the responsibility of raising children represented the greatest investment of parents, resulting in an important reorganization of the family system. The relevance of expanding knowledge about male single parenting in the face of widowhood in families with young children is highlighted, understanding that the challenges arising from this reality are many, not only in relation to the creation and maintenance of the children's mental health and the experience of mourning healthy family, but also to the rescue of that father as a man, with his needs and expectations for the future remade.

International law, in addition to promoting the socioeconomic development of the states of the global North, served as a propelling and legitimizing instrument for various injustices, especially those related to the oppression of cultural diversity and identities, which have a strong relationship with colonization. In this scenario, several critical readings and institutions of contemporary international law have proposed strategies to try to alleviate these historical injustices, which were and are strongly committed against the indigenous peoples of Latin America, and these institutions and readings have recently been grouped as a regime of the international recognition law (DIR). Emmanuelle Jouannet's seminal critical reading, which systematizes the DIR, proposes to understand it from its three approaches: the legal protection of difference, the positivization of specific rights for specific populations and the repair of historical damages. Thus, this research investigates the role of the Inter-American Court of Human Rights (IACHR) in applying the international law of recognition in sentences referring to the oppression of cultural diversity and the identities of indigenous peoples in Latin America. The delimitation of the research field considered the temporal criterion, to select the sentencing sentences handed down from 2005 to April 2020, since in 2005 the UNESCO Convention for the Protection of Cultural Diversity was published, an international document that organized the international legal regime protecting cultural and identity diversity. This work answers the following research problem: how does the international law of recognition, based on the approaches proposed by Emmanuelle Jouannet, appear in the foundation of the IACHR's judgments on the rights of indigenous peoples? To this end, the work empirically investigates the sentences of the IACHR that analyze indigenous issues, using the dialectic approach as the research method and, as a technique, the bibliographic and documentary review, in addition to the quantitative and qualitative analyzes of the selected sentencing sentences. As a result, 18 (eighteen) sentences were selected in which states were sentenced to reparation measures related to both the recognition of the cultural and identity diversity of indigenous peoples but also to the preservation of memory for present and future generations, giving concreteness, in reality Latin America, the DIR's action fronts as proposed by Jouannet. This work highlights and discusses the findings about the contributions of the IACHR's work to strengthen the DIR. It can be seen that the jurisprudence of the IACHR plays a crucial role in preserving the cultural diversity and identities of indigenous populations, and this work highlights and discusses the discoveries about its contributions to strengthen the DIR.

The occupational therapist is the professional who holds expertise in the fields of health, education, culture, and social assistance. Research on the involvement of this professional in health actions and services is essential to understand their participation in the Sistema Único de Saúde (SUS). This study aims to identify the insertion of these professionals in the health care network of the SUS, in the health macro-regions of the state of Rio Grande do Sul, between the years 2015 and 2020. For this, a cross-sectional and descriptive research was carried out, with data obtained from the database of the Departmento de Informatica do SUS (DATASUS), about the vacancies filled by professionals working in the SUS. It was possible to analyze the region of each Coordenadoria Regional de Saúde (CRS) of the state, verify the establishments that are affiliated to the SUS, and examine the characteristics of the vacancies. It was verified that the 2nd CRS has the largest number of vacancies, and the 18th CRS has the highest rate of vacancies, 8.8 per 1000 inhabitants. The establishments that offer vacancies, in the majority, were maintained (54.0%) of municipal management (74.7%), without teaching activity (76.5%) and with spontaneous and referenced demand (62.8%). As for the professionals who filled the vacancies, they predominantly worked 3 shifts (66.1%), under contract (74.1%), were not self-employed (86.7%), were legal entity (98.8%) and SUS professionals (89.2%). An increase in the offer of vacancies was observed during the study period, reaching the highest number (700) in 2020. In this study, it was possible to identify the growth of the profession, presenting, on a larger scale, in services that are located in the capital, in the beach region or close to the training centers of these professionals. The results of this research collaborate with the qualification of information about the occupational therapist in the state and provides information subsidies that can guide the implementation of public policies for the insertion and training of the occupational therapist for work in Rio Grande do Sul.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

The sound stimulus is transformed into an electrical stimulus by the internal hair cells of the cochlea and conducted to the auditory cortex by means of neural synapses. These, in turn, are evaluated by the Hearing Evoked Potentials, responsible for informing about the integrity and functionality of the central auditory pathway. Among the potentials, the Long Latency Auditory Evoked Potential (LLAEP) investigates the auditory perception of the sound stimulus, as well as abilities such as attention and memory, covering subcortex and cortex structures. Frequency Following Response (FFR) is responsible for the evaluation of the entire central auditory pathway, exposing the coding of verbal sounds by the system. Accordingly, the objective of this study is to correlate and associate the findings of LLAEP and FFR in normal6hearing young adults, taking into account the latency values of the potentials. It is a prospective, cross6sectional, quantitative and qualitative study with a sample of convenience involving normalized or normal adults. The individuals underwent anamnesis, meatoscopy, threshold and vocal audiometry, acoustic immittance measurementsj Digits Dichotic Test (TDD) and Randon Gap Detection Test (RGDT)j Brainstem Auditory Evoked Potential (BAEP) for sample composition. As research procedures, the Frequency Following Response (FFR) and Long Latency Auditory Evoked Potential (LLAEP) were performed. Two expert judges performed the analysis of the examinations. The significance used was 5%. The sample consisted of 32 individuals (20 women and 12 men) normal6hearing adults, with a mean age of 22.5 years (18 and 32 years) with normality in BAEP, RGDT and TDD. Positive correlation between VA complex and P1 wave with values from to de r=0,52(p6 value=0,007) e A/P1 de r=0,64(p6value=0,001) and negative with N2 being V/N2 r=60,47(p6 value=0,015) e A/N2 r=60,44(p6value=0,023) and still positive correlation of C with N2 with values of r=0,43(p6value=0,036) statistically significant was observed. There was no significant association between normal and altered individuals in the tests in general and when associated by components. In conclusion, FFR presents correlation with some LLAEP waves, which reinforces the hypothesis that there is contribution of different cortical areas to the formation of FFR waves. No association was observed between the qualitative results of the tests, demonstrating the impartiality of each test.

The present dissertation comprises reports of two scientific studies with the main theme of acute ST-segment elevation myocardial infarction (STEMI). The first was a cohort study that aimed to evaluate the prevalence of reperfusion therapy (RT), the clinical variables associated with non-RT, and the in-hospital outcomes of individuals with STEMI treated at a university hospital in southern Brazil. Data were collected through interviews during hospitalization between September, 2016 and February, 2020. The individuals were dichotomized in groups according to the reperfusion strategy (with and without RT). The univariate and multivariate analyses were performed to determine predictors of non-RT. It was also analyzed the impact of non-RT on in-hospital outcomes, compared to those who underwent RT. The total sample was 268 patients. The rate of non-RT was x (27.6%). Individuals with non-anterior wall STEMI and longer symptom onset had a higher probability of not undergoing RT. The non-RT was also associated with higher mortality and prolonged hospitalization. In conclusion, we observed that a significant percentage of individuals with STEMI did not receive RT, leading to worse outcomes. The second study aimed to evaluate the applicability of using the SAGE score in predicting elevated pulse wave velocity (PWV) (≥ 10m/s) for individuals who have experienced STEMI. A cross-sectional study was performed. The PWV was analyzed an oscillometric technique and to estimate the SAGE score. Data were collected between September, 2019 and February, 2021. Statistical analyses included obtaining the Youden's J statistic and receiver operating characteristic (ROC) curve to estimate the ideal cutoff SAGE score; binary logistic regression was also used to assess the correlation of SAGE score and PWV. Of the 39 individuals included in this study, 20.5% had a PWV ≥ 10 m/s. The SAGE scores distinguished individuals with high PWV with the ideal cutoff score estimated as ≥ 8 points. It is concluded the SAGE score showed adequate applicability in the identification of individuals with elevated PWV after STEMI.

Introduction: The higher education system offers health care students high standards of hard skills in the field. However, we do not know how much this contributes to soft skills and moral skills that are also becoming a crucial prerequisite for better health care performance. Good clinical communication skills correlate with better health care outcomes. In pediatric oncology, we need take care, since the diagnosis is already committed to the future and the quality of life from then on. Objectives: Observe the soft skills between doctors who work with children hospitalized or being followed up in the pediatric oncology service of a tertiary hospital in the south of Brazil with perspective of pediatric patients with their responsible family members and health staff. Materials and methods: This is a cross-sectional study with a quantitative approach. The data collection period comprised six months. Evaluated all subjects who were hospitalized in the meantime and their respective family members; the professionals who are part of the medical and multiprofessional team in the hospitalization sector at the Center for the Treatment of Children and Adolescents with Cancer (CTCriAC) and in the outpatient sector Centro do Convivência Turma do IQUE. They were presented to the semi-structured questionnaire, divided into blocks of questions that were later analyzed by the SPSS® software version 21. Results and discussion: The links between doctors, the health team, patients, and family members are important. It is necessary to develop tools for communication. This occurs from the transmission of the diagnosis of a chronic and/or potentially fatal disease to all complications that involve adherence and treatment of pediatric oncological disease. Altogether, the sample studied was 51 subjects, of these, 14 were pediatric patients, 13 family members, five pediatric oncologist doctors and 19 health team professionals. There was a statistically significant association between physicians treating patients and family members with respect and courtesy and listening carefully to their complaints and ease of understanding the information in an easy-to-understand manner and consequently between the ease of dialogue related to the treatment offered. In addition, there was an association between the good quality of hospital information and the satisfaction of the medical support provided, as well as between the appearance and comfort of the hospital. Conclusion: The medical school must incorporate since the graduation the concepts of soft and moral skills. To improve the bond between the medical and multiprofessional team and the patient and his family, since the role of the doctor cannot understand only in diagnosing and treating the patient, avoiding, applying the concept of empathy, and listening if the patient has anything to say to improve adherence to his treatment.

Autobiographical memory and reminiscence are the bases on which personal narratives are built, communicative resources that fulfill functions associated with the Self, but also coordinate and enrich interactions with others. In turn, projecting the future time reinforces our purposes and vital determinations. The objective of this research was to explain the subjectivity of future prospecting (a precept of the social world) based on autobiographical narratives (reminiscences) produced by the elderlies after participating in a cognitivecommunicative stimulation program. This research assumed a mixed methodology in its course; since initially evidence was obtained of the effect on global cognitive efficacy and subjective well-being of a cognitive-communicative stimulation program based on reminiscence (PECC-R); subsequently, a proposal for an autobiographical interview was developed and the reason for its content validity was obtained, highlighting the clinical projections that this instrument has for the Speech and Language practice with the elderly population. Finally, from a qualitative perspective, the phenomenology of the relationship between reminiscence and prospection in the aging of typical older people was studied through autobiographical narratives. Theoretically, the paradigm of Interpretative Phenomenological Analysis is adhered to for these purposes since it was sought to explain a precept of the social world (prospection) from autobiographical narratives (reminiscences). The usefulness of reminiscence as a valid tool for the analysis and interpretation of the future perspectives developed by the elderly is evident. It is expected that, based on the data produced, the designs of Speech and Language interventions will be restructured and rethought, incorporating this new knowledge to the evaluative and therapeutic actions, rescuing the intersubjectivity inherent to aging to facilitate the interaction with this age people, their groups and/or with other members of the health team interested in them.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

The present research described reference values for the electrophysiological thresholds of the frequency specific Auditory Brainstem Response (ABR) with the NB CE-Chirp® LS and NB iChirp stimuli in hearing infants and compared the minimum level of responses, latency and amplitude of both stimuli (Article 1). Also, it sought to analyze the correlation between the electrophysiological thresholds, with the same stimuli, and the behavioral ones of children with hearing loss (Article 2). The time of testing for both stimuli were compared. 74 hearing infants and 21 hearing impaired children participated in this study. The frequencies investigated were 500Hz, 1000Hz, 2000Hz and 4000Hz, by air conduction with the NB CE-Chirp® LS stimulus in the Eclipse equipment, and with the NB iChirp in the SmartEP. The hearing impaired children were also submitted to behavioral auditory assessment. The electrophysiological thresholds for the hearing infants were obtained in the same session, in natural sleep, and in most participants, unilaterally. As for the hearing impaired children, the research was performed in both ears, in half of the sample at 500Hz and 2000Hz and at 1000Hz and 4000hz in the rest, this choice was made by draw. For both groups, the minimum levels of response were researched, i.e. the lower intensity at which the wave V was visualized, and the time of testing was clocked. All exams were evaluated by judges with experience in ABR, after being tabulated and statistically analyzed. In regard to the thresholds of hearing infants, the minimum levels of response and the latency at 500Hz and 1000Hz showed a statistically significant difference between the stimuli, with lower thresholds and higher latencies for the NB iChirp. Higher amplitudes were obtained with the NB iChirp stimulus. The average time of testing for the threshold investigation at the four frequencies was 40 minutes for each ear. For children with hearing loss, there was a strong correlation between the two stimuli and also between electrophysiological and behavioral thresholds at the frequencies of 1000Hz, 2000Hz and 4000Hz. The mean differences between the electrophysiological and behavioral thresholds were below 6dBnHL and the time of testing was similar between the equipment. From these data, the study made it possible to estimate reference values for the electrophysiological thresholds with the NB CE-Chirp® LS and NB iChirp for hearing infants and found that with the NB iChirp the latency of responses is influenced by frequency and that this stimulus provides better amplitudes when compared to the NB CE-Chirp® LS. Additionally, it was possible to evidence that the NB CE-Chirp® LS and the NB iChirp similarly measure the electrophysiological thresholds of children with hearing loss and accurately estimate the behavioral auditory thresholds of this population. There was no difference in the time of testing between the stimuli for both normal-hearing infants and hearing impaired children.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES