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Duchenne muscular dystrophy (DMD) is a disease that primarily affects males and causes a gradual loss of muscle strength. This results in a deterioration of motor skills and functional mobility, which can impact the performance of various occupations. Individuals with DMD often rely heavily on caregivers to assist with daily activities, which can lead to caregiver burden. A case study was conducted to explore and describe potential variations in the performance of a young adult diagnosed with DMD and his caregivers resulting from the integration of smart speakers (SS)-controlled Internet of Things (IoT) devices in the home environment. The study also examined the potential of SS as an environment control unit (ECU) and analysed variations in caregiver burden. Smart devices and SS were installed in the most frequently used spaces, namely, the bedroom and living room. The study employed WebQDA software to perform content analysis and Microsoft Excel to calculate the scores of the structured instruments. The implementation of the IoT-assisted environment compensated for previously physical tasks, resulting in a slight increase in independent performance and reduced demands on caregivers.

Background: Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors' clinical practices concerning the promotion of patients' physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors' physical activity level and sedentary behaviours., Methods: A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors' attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables., Results: A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients' physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p < 0.001): working in primary healthcare settings (p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients' physical activity promotion in healthcare settings (p < 0.001), being approached by patients to address physical activity (p < 0.001), and having higher levels of physical activity (p = 0.001)., Conclusions: The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors' own physical activity levels., (© 2022. The Author(s).)

Purpose: The present study seeks to survey information and training needs of informal caregivers related to the use of assistive technologies at home, so as to, in the near future, try to meet them. Therefore, the full aim of this study is to contribute to reducing technology abandonment and to enhancing its use in the family setting by children with cognitive and/or motor limitations., Materials and Methods: Content analysis of a set of ten interviews with informal caregivers of children and youngsters with cognitive and/or motor disabilities., Results: Assistive technologies open a wide range of opportunities, mostly to students whose learning skills diverge from standard development. They promote communication, independence as well as inclusion of children with cognitive and/or motor disabilities. Despite the human and material resources available, the implementation of assistive technologies in many family settings is still a struggling task. The results reveal a perspective on (i) the interaction between those caregivers and their children, (ii) children's skills in using assistive technology, (iii) caregivers' digital literacy and (iv) their training needs., Conclusions: The present paper highlights the fact that carrying out interviews with informal caregivers leads to obtaining significant data for a diagnosis of the use of assistive technologies in the family setting and to assess the needs of informal caregivers. From this study, the need to provide caregivers with further training on assistive technologies emerges as preponderant, and to improve caregivers' skills in the search for and access to practical information.Implication for RehabilitationCognitive and/or motor disabilities impact on communication, independence and also on the full inclusion of children, especially when efforts developed at school do not have any follow up at home.Endowing informal caregivers with the knowledge and skills to use assistive devices with their children is a step forward to their full development.Interviews conducted with informal caregivers are a means to gaining insights into understanding the reasons behind assistive technology abandonment at home.

Introduction: Obstructive sleep apnea is a clinical entity that is associated with an increase in morbidity and mortality and it is estimated that it is significantly undiagnosed. The objective of this study was to assess the risk of undiagnosed obstructive sleep apneain obese individuals., Material and Methods: A descriptive and analytical cross-sectional study; the risk of obstructive sleep apnea's was assessed over a period of 11 months by applying the STOP-Bang questionnaire to all individuals who attended a family health unit who were aged ≥ 18 years and had body mass index of ≥ 30 kg/m2 and who had not yet been diagnosed with obstructive sleep apnea and agreed to participate; the risk of an undiagnosed moderate to severe obstructive sleep apnea was considered for any STOP-Bang score of ≥ 3., Results: The risk of undiagnosed obstructive sleep apnea was assessed in 888 individuals (59.3% females) with an average age of 59.6 ± 14.68 years and a mean body mass index 33.6 ± 3.43 kg/m2; the mean STOP-Bang score was 3.5 ± 1.74, 70.9% scored ≥ 3; the frequency of all STOP-Bang questionnaire parameters was higher (p < 0.004) within the group with score ≥ 3., Discussion: The studied population is one of the main strengths, since it is in obese people that the incidence of this disease is higher. There are some limitations related to this sample coming from a single family health unit, as well as the patients' follow-up being carried out throughout routine appointments for diseases that are closely related with obstructive sleep apnea., Conclusion: The level of underdiagnosis of obstructive sleep apnea's in obese individuals can be significantly high and a large proportion of them may have the disease at a moderate to severe stage; Family Physicians can have a very important role in screening and diagnosis.

Background: Older adults experience physical and psychological declines affecting independency. Adapted and structured combined interventions composed of cognitive stimulation and physical exercise contribute to comorbidities' reduction. Methods: Multicenter single-blinded two-arm cluster randomized controlled trial conducted to assess effectiveness of a combined intervention (CI), composed of a cognitive stimulation program (CSP) and a physical exercise program (PEP), on psychological and physical capacities of frail older adults as to on their activities of daily living. Were recruited 50 subjects from two elderly end-user organizations. Of these, 44 (65.9% females, mean age of 80.5 ± 8.47 years) were considered eligible, being randomly allocated in experimental (EG) or control group (CG). Data collected at baseline and post-intervention. EG received CI three times a week during 12 weeks. CG received standard care. Non-parametric measures were considered. Results: At baseline, groups were equivalent for study outcomes. The comparison of pre- and post-intervention data revealed that subjects receiving CI reduced depressive symptomatology and risk of fall based on gait and balance, and improved gait speed. Simultaneously, in the CG a significant decline on activities of daily living was observed. Significant results were found among biomechanical parameters of gait (BPG). EG' effect size revealed to be small (0.2 ≤ r < 0.5). CG' effect size was also small; but for activities of daily living there was an evident decrease. Conclusion: The CI is effective on managing older adults' psychological and physical capacities.

Therapeutic communities emerged to respond to individuals with substance use disorders. The studies carried out emphasize the importance of the Occupational Therapist in the process of constructing occupational meaning. However, there is a paucity of studies addressing the relevance of this profession in this specific context. To understand the intervention of Occupational Therapy in the Therapeutic Community "Clínica do Outeiro - Portugal", describing the perception of individuals with substance use disorders, Occupational Therapists and other team members. Descriptive-exploratory study with a qualitative approach, by means of a case study research. We used interviews with clients and Occupational Therapists and focus group with the multidisciplinary team to collect data. Occupational Therapy is characterized by the greater proximity it establishes with users, as well as by the dynamism, creativity and motivation it infuses, playing a preponderant role in the (re) structuring of routines, performance of ADL and IADL, leisure and social participation of individuals with substance use disorders. The OT emerges as essential in this community, as a professional who is dedicated to the work of adapting and including the individual in the therapeutic community through the acquisition of the necessary occupational performance skills essential for everyday life in society.

Introduction: Cervix cancer is the fourth most common female cancer and the second most frequent in women aged 15 to 44 years. The infection by the human papillomavirus is a necessary condition in almost all of cervix cancer cases; it is a sexually transmitted disease and all women sexually active are at risk of being infected. There are currently three vaccines against human papillomavirus, and despite of the efficacy being well proven in woman aged up to 25 years, it is not well established in older ages., Material and Methods: It was performed a literature review of the current evidence about the efficacy of the vaccines against human papillomavirus in women older than 24 years in the cervix cancer prevention, and was assessed the evidence quality by the GRADE system., Results: Two randomized controlled trials were identified with a total of 9,571 participants - 4,792 vaccinated and 4,779 at the control group and reported data of 48 months period follow-up. The relative risk reduction was 41% (95% CI: 29 a 50%) - for the vaccinated group. There were no differences in safety and tolerability between the two groups - vaccine and control., Conclusion: The actual evidence shows that the vaccines against human papillomavirus 16 and/or 18 in women older than 24 until 45 years have an important efficacy at reducing the risk of having persistent infection and/or to acquire cervix cancer precursor lesions.

Objective: To evaluate the feasibility and validity of great auricular nerve preservation during parotidectomy., Methods: Thirty patients with parotid tumors were randomized to 2 groups. Sixteen patients (group A) underwent classic parotidectomy with sacrifice of the great auricular nerve. The surgeon tried to spare the nerve in the 14 patients (group B). Tactile sensitivity, pain sensitivity, and tactile discrimination were evaluated preoperatively and at 7 days, 30 days, 6 months, and 12 months after surgery. The regions examined were the superior helix, lobule, and infra-auricular and posterior auricular regions., Results: After surgery, both groups showed lower levels of sensitivity, mainly in the lobule and in the infra-auricular region. These alterations were less pronounced in group B. Both groups showed improvement over time. In group B the tactile sensitivity reached preoperative levels by 6 months after surgery. The recuperation in group A was partial and stabilized at 6 months after surgery., Conclusion: Great auricular nerve preservation is technically feasible during parotidectomy, with a decrease of the sensitivity alterations in the early postoperative period and avoidance of the permanent sequelae that occur when the nerve is sacrificed.