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To investigate the influence of climate on hospitalizations of sickle cell anemia (SCA) adults and children, we analyzed the health and meteorological parameters from a metropolis (1999-2018). 1462 hospitalizations were coded for SCA patients in crisis (M:F = 715:747) and 1354 hospitalizations for SCA patients without crisis (M:F = 698:656) [age = 22.9 vs 15.2 years and duration of hospitalization (DoH) = 5.7 vs 4.4 days, respectively,]. More hospitalizations were for adults than children in crisis, and for children than adults without crisis. More children and adults were hospitalized in winter andspring than in summer and autumn Hospitalizations correlated positively with humidity (lag −5), maximum pressure (lag −2), mean pressure (lag −2), and thermal amplitude (lag −2), and negatively with maximum temperature (lag −3). DoH positively correlated with minimum temperature (lag −4). Understanding these complex associations would induce attitudinal/behavioral modifications among patients and their caregivers. [ABSTRACT FROM AUTHOR]

This study examined the within- and between-day variability of time-segmented sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) in adolescents. The sample comprised 154 adolescents (11–16 years old) from two public schools in Florianópolis, Brazil. The proportion of time spent in SB, LPA, and MVPA was measured using Actigraph GT3X+ accelerometers for the following weekday time segments: before school (07:00–07:59), school time (08:00–11:59), after school (12:00–12:59), afternoons (13:00–17:59), and evenings (18:00–23:00). Participants were more active during commuting-related time segments. Females showed lower MVPA than males during school time, afternoons, and evenings, but not before school and after school. Higher age was associated with higher SB and lower LPA during school time, afternoons, and evenings, and slightly lower MVPA during afternoons. The variability of SB, LPA, and MVPA for all time segments was mainly explained by within-participant day-to-day variations rather than between-participant differences of daily-averaged estimates. [ABSTRACT FROM AUTHOR]

The Human Immunodeficiency Virus (HIV) is considered one of the greatest public health challenges given its impact on morbidity and mortality, and there is currently no vaccine available. The costs for any vaccine have to be weighed against current preventative measures as well as its impact in reducing future infections. This was the rationale behind conducting a willingness to pay (WTP) study to guide future funding decisions. A cross-sectional study was conducted involving residents of Northern Brazil regarding their WTP for a hypothetical vaccine against HIV with 70% effectiveness. 634 individuals were interviewed and 94% accepted to use this hypothetical vaccine. The WTP was US$47.54 (200.00BRL). We believe these findings can contribute to decision-making about pricing once a HIV vaccine becomes available in Brazil and in discussions with its acceptability. [ABSTRACT FROM AUTHOR]

This study aims to describe and compare the phonological characteristics of European Portuguese and Brazilian Portuguese preschool and school age children with Speech Sound Disorders (SSD). Speech samples for the European Portuguese Group (EPG) (n = 13) were collected using Subteste Fonético e Fonológico of Teste Fonético e Fonológico Avaliação da Linguagem Pré-Escolar. For the Brazilian Portuguese Group (BPG) (n = 13) Prova de Nomeação de Fonologia of Teste de Linguagem Infantil ABFW was applied. Different phonological measures were considered. Groups were matched according to sex, age, and percentage of correct consonants (revised). EPG presented more weak syllable deletion (p =.00); absolute index and relative index had a higher number of omissions (p =.003). BPG had more substitutions (p =.004). Intragroup analysis showed differences between groups in the occurrence of phonological processes (p ≤ 0.00). The most occurring was gliding of liquids, cluster reduction and devoicing in both groups; for the absolute index and relative index, the EPG presented differences in omission (p =.003), and the BPG in substitution (p =.002). Results suggested differences between groups in phonological processes occurrence and a relation with the most frequent type of error. These findings may occur due to the variation of phonetic and phonological characteristics between European Portuguese and Brazilian Portuguese in the two phonological tests. Linguistic variations had not directly influenced the measures studied, which characterized SSD. European Portuguese and Brazilian Portuguese children with SSD demonstrated similar characteristics as to the type of errors and phonological processes. [ABSTRACT FROM AUTHOR]

Background: Knee pain during stair managing is a common complaint among individuals with PFP and can negatively affect their activities of daily living. Gait modification programs can be used to decrease patellofemoral pain. Immediate effects of a stair descent distal gait modification session that intended to emphasize forefoot landing during stair descent are described in this study. Objectives: To analyze the immediate effects of a distal gait modification session on lower extremity movements and intensity of pain in women with patellofemoral pain during stair descent. Method: Nonrandomized controlled trial. Sixteen women with patellofemoral pain were allocated into two groups: (1) Gait Modification Group (n = 8); and 2) Control Group (n = 8). The intensity of pain (visual analog scale) and kinematics of knee, ankle, and forefoot (multi-segmental foot model) during stair descent were assessed before and after the intervention. Results: After the gait modification session, there was an increase of forefoot eversion and ankle plantarflexion as well as a decrease of knee flexion. An immediate decrease in patellofemoral pain intensity during stair descent was also observed. Conclusion: The distal gait modification session changed the lower extremity kinetic chain strategy of movement, increasing foot and ankle movement contribution and decreasing knee contribution to the task. An immediate decrease in patellofemoral pain intensity during stair descent was also observed. To emphasize forefoot landing may be a useful intervention to immediately relieve pain in patients with patellofemoral pain during stair descent. Clinical studies are needed to verify the gait modification session effects in medium and long terms. [ABSTRACT FROM AUTHOR]

Aim: We compared the efficacy of hand-arm bimanual intensive training (HABIT) in two doses (90 vs. 45 hours) and two schedules of the same dose (90 vs. 2 × 45 hours) on hand and daily functioning. Method: Eighteen children with unilateral cerebral palsy were randomized to receive 6 hours of daily training over 3 weeks, totaling 90 hours (Group 90, n = 9) or receive 6 hours of daily training over 1.5 weeks, totaling 45 hours (Group 2 × 45, n = 9). After 6 months, Group 2 × 45 received an additional 45 hours. Hand (Jebsen-Taylor Test of Hand Function, Assisting Hand Assessment) and daily functioning tests (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory) were administered before, immediately after, and 6 months after interventions. Results: Both groups demonstrated significant improvements in hand and daily functioning after 90 hours (Group 90) or the first 45 hours (Group 2 × 45), without differences between groups. However, more children from Group 90 obtained smallest detectable differences in the Assisting Hand Assessment. The addition of the second bout of 45 hours (Group 2 × 45) did not lead to further improvements. Conclusions: As this study was powered to test for large differences between groups, future investigations on larger samples will be needed to compare differences at the two dosage levels. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the characteristics of the asymmetries in the dominant and non-dominant limbs when kicking stationary and rolling balls. Ten experienced Brazilian amateur futsal players participated in this study. Each participant performed kicks under two conditions (stationary ball vs. rolling ball) with the dominant and non-dominant limbs (five kicks per condition per limb). We analysed the kicking accuracy, ball and foot velocities, angular joint displacement and velocity. The asymmetry between the dominant and non-dominant limbs was analysed by symmetry index and two-way repeated measures ANOVA. The results did not reveal any interaction between the condition and limb for ball velocity, foot velocity and accuracy. However, kicking with the dominant limb in both kicks showed higher ball velocity (stationary ball: dominant – 24.27 ± 2.21 m · s‒1and non-dominant – 21.62 ± 2.26 m · s‒1; rolling ball: dominant – 23.88 ± 2.71 m · s‒1and non-dominant – 21.42 ± 2.25 m · s‒1), foot velocity (stationary ball: dominant – 17.61 ± 1.87 m · s‒1and non-dominant – 15.58 ± 2.69 m · s‒1; rolling ball: dominant – 17.25 ± 2.26 m · s‒1and non-dominant – 14.77 ± 2.35 m · s‒1) and accuracy (stationary ball: dominant – 1.17 ± 0.84 m and non-dominant – 1.56 ± 1.30 m; rolling ball: dominant – 1.31 ± 0.91 m and non-dominant – 1.97 ± 1.44 m). In addition, the angular joint adjustments were dependent on the limb in both kicks (the kicks with non-dominant limb showed lower hip external rotation than the kicks with the dominant limb), indicating that the hip joint is important in kick performance. In conclusion, the kicks with the non-dominant limb showed different angular adjustments in comparison to kicks with the dominant limb. In addition, kicking a rolling ball with the non-dominant limb showed higher asymmetry for accuracy, indicating that complex kicks are more asymmetric. [ABSTRACT FROM PUBLISHER]

Anabolic-androgenic steroids (AAS) are used to enhance physical performance and/or appearance. The aim of this study was to evaluate the influence of the concomitant use of alcohol, tobacco, cocaine, and AAS on blood lipid profiles of 145 asymptomatic male bodybuilders from the Northeast region of Brazil. Interviews, clinical exams, and serological evaluations were performed on all participants between 2007 and 2009. All subjects' self-reported use of testosterone or its derivatives, 118 individuals reported alcohol intake, 27-reported cigarette smoking, and 33 confirmed cocaine use. Four subjects were users of all drugs at the same time. Higher levels of total cholesterol and LDL-cholesterol were observed among concomitant users of alcohol, tobacco, cocaine, and AAS. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the validity (Study 1) and reliability (Study 2) of a novel intermittent running test (Carminatti's test) for physiological assessment of soccer players. In Study 1, 28 players performed Carminatti's test, a repeated sprint ability test, and an intermittent treadmill test. In Study 2, 24 players performed Carminatti's test twice within 72 h to determine test–retest reliability. Carminatti's test required the participants to complete repeated bouts of 5 × 12 s shuttle running at progressively faster speeds until volitional exhaustion. The 12 s bouts were separated by 6 s recovery periods, making each stage 90 s in duration. The initial running distance was set at 15 m and was increased by 1 m at each stage (90 s). The repeated sprint ability test required the participants to perform 7 × 34.2 m maximal effort sprints separated by 25 s recovery. During the intermittent treadmill test, the initial velocity of 9.0 km · h−1 was increased by 1.2 km · h−1 every 3 min until volitional exhaustion. No significant difference (P > 0.05) was observed between Carminatti's test peak running velocity and speed at VO2max (v-VO2max). Peak running velocity in Carminatti's test was strongly correlated with v-VO2max (r = 0.74, P < 0.01), and highly associated with velocity at the onset of blood lactate accumulation (r = 0.63, P < 0.01). Mean sprint time was strongly associated with peak running velocity in Carminatti's test (r = −0.71, P < 0.01). The intraclass correlation was 0.94 with a coefficient of variation of 1.4%. In conclusion, Carminatti's test appears to be avalid and reliable measure of physical fitness and of the ability to perform intermittent high-intensity exercise in soccer players. [ABSTRACT FROM PUBLISHER]

Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's motor severity level and their elaborateness of play with conventional-imaginative and symbolic play materials and a number of object substitutions in symbolic play. This indicated that children with greater motor limitations had diminished play ability. In this sample, 35%% of the children showed typical play styles, identified by good scores in elaborate pretend play actions, number of object substitutions, and ability to self-initiate play, whereas 65%% showed delay in their play. Implications: The type of pretend play deficits that might be expected in children with cerebral palsy were described. Furthermore, suggested directions for therapeutic intervention to enhance pretend play performance in cerebral palsy children were proposed. [ABSTRACT FROM AUTHOR]

A high incidence of waterborne diseases is observed worldwide and in order to address contamination problems prior to an outbreak, quantitative microbial risk assessment is a useful tool for estimating the risk of infection. The objective of this paper was to assess the probability of Giardia infection from consuming water from shallow wells in a peri-urban area. Giardia has been described as an important waterborne pathogen and reported in several water sources, including ground waters. Sixteen water samples were collected and examined according to the US EPA (1623, 2005). A Monte Carlo method was used to address the potential risk as described by the exponential dose response model. Giardia cysts occurred in 62.5% of the samples (<0.1-36.1 cysts/l). A median risk of 10-1 for the population was estimated and the adult ingestion was the highest risk driver. This study illustrates the vulnerability of shallow well water supply systems in peri-urban areas. [ABSTRACT FROM AUTHOR]

Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-α) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-α were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-α (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56–7.56), non-bacteraemic typical bacterial (1.47; 0.24–4.07), atypical bacterial (0.18; 0.06–1.03) and only viral (0.65; 0.11–2.22) subgroups was significant ( p = 0.02). PCT was ≥2 ng/ml in 52 (33%) cases. The presence of IFN-α was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT ≥2 ng/ml was 95% (89–100%), 89% (78–100%), 93% (85–100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49–68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-α was uncommonly detected. [ABSTRACT FROM AUTHOR]