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Introduction: Basketball referees are the authorities responsible for ensuring that rules and regulations are followed and for making decisions. The ability of referees to respond to the physical and physiological demands imposed during the game is essential for good performance on the court. Objective: To understand the context in which health problems faced by basketball referees occur and to outline the epidemiological profile of musculoskeletal injuries. Methods: A prospective cohort study was conducted in which basketball referees were evaluated using a standardized form. The participants were monitored online weekly for 12 weeks using the Oslo Sports Trauma Research Center questionnaire to assess health problems, such as diseases (affecting the respiratory, cardiovascular, digestive or neurological systems) or musculoskeletal injuries (acute or from overuse). Results: The study sample consisted of 78 referees with a mean age of 36.5 (±9.8) years. Most referees (97.4%) found it important to implement a preventive program. In relation to the health problems reported during follow-up, there was an incidence rate of 23.7 injuries per 1000 hours of play (95% CI 19.5 - 27.9) and the mean weekly prevalence of diseases was 3.2 (95% CI 0.4 – 6.0) and of injuries was 17.4 (95% CI 16.5 – 18.3). Conclusion: Through this study, it was possible to conclude that there was an incidence rate of 23.7 injuries per 1000 hours of play (95% CI 19.5 - 27.9) and a mean prevalence of diseases of 3.2 (95% CI 0.4 - 6.0) and musculoskeletal injuries of 17.4 (95% CI 16.5 - 18.3). The most common health problems that affected basketball referees were musculoskeletal overuse injuries of the lower limbs. Level of evidence I; Prospective cohort study .

Background Throwing athletes present alterations in shoulder rotation range of motion (ROM), but not much is known about the relationship between these alterations and performance measurements in volleyball practitioners. # Purpose To compare the passive ranges of motion of internal rotation (IR), external rotation (ER), and total rotation motion (TRM) of the shoulder in dominant and nondominant limbs of young volleyball athletes and to investigate their relationship with ball speed during serves with and without precision (inside and outside court, respectively). The possible association of anthropometrics and competitive practice time with these velocities was also investigated. # Study Design Cross-sectional study. # Methods Fifty-seven male volleyball athletes (mean age 17.11 ± 1.88 y; weight 74.68 ± 9.7 kg; height 1.87 ± 0.09 cm) were evaluated for shoulder IR and ER with a bubble goniometer and serve speed inside and outside court was measured with a radar gun. Simple and multiple regression analyses were applied to investigate associations of ROM, anthropometrics, and competitive practice time with serve speed. # Results Dominant shoulders had diminished IR ROM compared to nondominant shoulders (59.1º ± 16.7º vs 66.4º ± 16.9º; *p* < 0.001) as well as diminished TRM (173.5º ± 31.8º vs 179.1º ± 29.9º; *p* < 0.001). Simple regression showed negative association between dominant ER and serve speed outside the court (*p* = 0.004). Positive associations existed between age and serve speed in both conditions (*p* < 0.001), BMI and speed inside (*p* = 0.009) and outside the court (*p* = 0.008), and between competitive practice time and speed inside (*p* = 0.008) and outside court (*p* = 0.003). However, multiple analysis confirmed only age (*p* < 0.001) and BMI to be associated with ball velocities (inside court *p* = 0.034; outside court *p* = 0.031). # Conclusion The results of this study demonstrated that young volleyball athletes presented lower IR and TRM of the shoulder in the dominant upper limb. Age and BMI were directly associated with ball velocities when serving. Passive rotation ROM did not have a relationship with this performance measurement. # Level of Evidence 3b

Background: Morphological changes characteristic of femoroacetabular impingement (FAI) are common in soccer players. However, the clinical relevance of such anatomical variations is still not well-defined. Hypothesis: We hypothesized that high alpha angle values and/or acetabular retroversion index (ARI) are correlated with rotational range of motion (ROM) of the hip and that there are clinical-radiological diferences between the dominant lower limb (DLL) and nondominant lower limb (NDLL) in professional soccer players. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: A total of 59 male professional soccer players (average age 25.5 years, range 18-38 years) were evaluated in the preseason. As main outcome measures, we evaluated the alpha angle and the ARI and hip IR and ER ROM with radiographic analysis. Results: The measurements taken on DLL and NDLL were compared and a significant difference was found between the sides in the ER ( P = 0.027), where the DLL measures were 1.54° (95% CI, 0.18-2.89) greater than the NDLL. There were no significant differences between the sides in the measures of IR ( P > 0.99), total ROM ( P = 0.07), alpha angle ( P = 0.250), and ARI ( P = 0.079). The correlations between the rotation measurements and the alpha angle in each limb were evaluated and the coefficient values showed no correlation; so also between the ARI and rotation measures. Conclusion: Morphological changes of the femur or acetabulum are not correlated with hip IR and ER ROM in male professional soccer players. ER on the dominant side was greater than on the nondominant side. There was no significant difference in the other measurements between sides. Clinical Relevance: In clinical practice, it is common to attribute loss of hip rotational movement to the presence of FAI. This study shows that anatomical FAI may not have a very strong influence on available hip rotational movement in professional soccer athletes.

Rhipicephalus microplus, popularly known as the cattle tick, is the most important tick of livestock as it is responsible for significant economic losses. The use of chemical acaricides is still the most widely used control method despite its known disadvantages. Vaccination would be a safe alternative for the control of R. microplus and holds advantages over the use of chemical acaricides as it is environmental-friendly and leaves no residues in meat or milk. Two vaccines based on the Bm86 protein were commercialized, TickGARD® and Gavac®, with varying reported efficacies in different countries. The use of other vaccines, such as Tick Vac®, Go-Tick®, and Bovimune Ixovac® have been restricted to some countries. Several other proteins have been analyzed as possible antigens for more effective vaccines against R. microplus, including peptidases, serine proteinase inhibitors, glutathione S-transferases, metalloproteases, and ribosomal proteins, with efficacies ranging from 14% to 96%. Nonetheless, more research is needed to develop safe and efficient tick vaccines, such as the evaluation of the efficacy of antigens against other tick species to verify cross-reactivity and inclusion of additional antigens to promote the blocking of the infection and spreading of tick-borne diseases. This review summarizes the discoveries of candidate antigens for R. microplus tick vaccines as well as the methods used to test their efficacy.

As startups, geralmente precisam de financiamento para crescer e estes novos empreendimentos frequentemente se voltam a investidores anjos como opção de capital. Investidores anjo são indivíduos com grande disponibilidade de recursos financeiros que decidem investir em negócios de risco trazendo frequentemente não somente capital, mas também conhecimento e experiência. O objetivo deste estudo é compreender melhor o processo decisório de investimento anjo em startups, identificando e analisando quais são os critérios de investimento priorizados pelos investidores anjo brasileiros em seus investimentos em startups. O ambiente principal de pesquisa deste trabalho foi a Gávea Angels, a mais antiga associação de anjos do Brasil, e de forma secundária, os investidores da rede de contatos dos pesquisadores. Em linha com grande parte dos estudos internacionais sobre o assunto, os resultados demonstraram que a despeito da importância dos critérios ligados ao mercado, produto e dados financeiros, os critérios priorizados foram aqueles ligados ao empreendedor e seu time de gestão, conforme segue: (1) confiabilidade/honestidade do empreendedor; (2) entusiasmo/comprometimento do empreendedor; (3) time de gestão; (4) expertise de domínio do empreendedor. Os critérios ?resiliência? e ?paixão do time? foram os atributos mais importantes na análise particular do ?time de gestão?

Objective: To create and validate a handbook for the prevention of peristomal skin complications. Methods: For the elaboration of the handbook, a literature review was conducted in the following databases: Cochrane Library, SciELO, LILACS, and MEDLINE. The handbook “Preventing and treating the complications of intestinal peristomal skin” was elaborated in nine steps. The first step addressed the concepts of ostomy, stoma type, and ostomy classification. In the second step, the following were described: definition of the collection equipment, type of collection equipment, and technique of changing one- and two-piece equipment. In the third step, the peristomal skin cleansing technique was described. In the fourth step, the types of complications of the peristomal skin were listed. In the fifth step, preventive approaches to avoid complications with the peristomal skin were described. In the sixth step, the therapeutic approaches in the treatment of aforementioned peristomal skin complications were addressed. In the seventh step, the handbook layout was created by an Information Technology professional. In the eighth step, the handbook was validated by 25 nurses. In the ninth step, the final version of the instrument was laid out. Results: The final version of the “Preventing and treating the complications of intestinal peristomal skin” handbook has 37 pages. It was registered in the International Standard Book Number: 978-85-67647-46-3, standard format size (21 cm high by 15 cm wide), totaling 50 illustrations. In the first evaluation, the evaluators assessed the manual as partially adequate to completely adequate. In the first evaluation, the content validity index ranged between 0.88 to 1.0; no 100% agreement was observed among the evaluators' answers. In the second evaluation, as an agreement was observed in all items, the content validity index was 1.0. Conclusion: The handbook “Preventing and treating the complications of intestinal peristomal skin” was elaborated based on scientific principles and had its content, language, and design validated by specialists in the field. Resumo: Objetivo: Construir e validar um manual para a prevenção das complicações da pele periestoma. Método: Para a construção do manual, realizou-se uma revisão nas bases: Biblioteca Cochrane, SciELO, LILACS e MEDLINE. O manual “Prevenindo e tratando das complicações da pele periestoma intestinal” foi elaborado em nove etapas. A primeira etapa abordou os conceitos de estomia, tipo de estoma, classificação de estomia. Na segunda etapa, foram elaborados: definição de equipamento coletor, tipo de equipamentos coletores, técnica da troca do equipamento de uma e duas peças. Na terceira etapa, definiu-se a técnica de limpeza da pele periestoma. Na quarta etapa, foram descritos os tipos de complicações da pele periestoma. Na quinta etapa, enfocaram-se as condutas preventivas para evitar as complicações com a pele periestoma. Na sexta etapa, foram descritas as condutas terapêuticas no tratamento das complicações da pele periestoma citadas acima. Na sétima etapa, foi realizada a diagramação do manual por um profissional da área de Tecnologia da Informação. Na oitava etapa, validação do manual por 25 enfermeiros. A nona etapa correspondeu à diagramação da versão final do instrumento. Resultados: A versão final do manual denominado “Prevenindo e tratando das complicações da pele periestoma intestinal” contém 37 páginas. Foi registrado no International Standard Book Number: 978-85-67647-46-3, tamanho padrão de formatação com 21 cm de altura por 15 cm de largura, totalizando 50 ilustrações. Na primeira avaliação, os juízes avaliaram o manual como parcialmente adequado a totalmente adequado. O Índice de validade de conteúdo na primeira avaliação foi entre 0,88 a 1,0; não tendo ocorrido 100% de concordância das respostas dos juízes; na segunda avaliação, tendo havido concordância dos juízes em todos os itens, o índice de validade de conteúdo foi 1,0. Conclusão: O manual intitulado “Prevenindo e tratando das complicações da pele periestoma intestinal” foi construído com embasamento científico, validado quanto ao conteúdo, à linguagem e à aparência por especialistas na área. PALAVRAS-CHAVE: Estomia, Dermatite, Cuidados de enfermagem, Manual, Keywords: Ostomy, Dermatitis, Nursing care, Handbook

Study Design Clinical measurement study. Background Ankle sprain is a common condition. Therefore, translated, culturally adapted, and clinimetrically tested instruments for measuring the ankle are needed. Objectives To translate and cross-culturally adapt the Sports Athlete Foot and Ankle Score (SAFAS) and the global rating of change (GROC) into Brazilian Portuguese. This study also aimed to test the measurement properties of the SAFAS, the GROC, and the existing Brazilian-Portuguese versions of the numeric pain-rating scale (NPRS) and the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) in a group with ankle sprain. Methods The SAFAS and GROC instruments were cross-culturally adapted into Brazilian Portuguese and pretested in this population (n = 18). The measurement properties of the SAFAS, GROC, NPRS, and AOFAS (internal consistency, ceiling and floor effects, construct validity, reproducibility, and responsiveness) were tested in a test-retest design in patients with ankle sprain at baseline (n = 63) and at follow-up periods of 48 to 72 hours (n = 53) and 4 weeks (n = 43) after baseline. Results The SAFAS, GROC, NPRS, and AOFAS yielded considerable internal consistency (Cronbach alpha ranging from .76 to .97), moderate reliability (intraclass correlation coefficient model 2,1 ranging from 0.59 to 0.80), and dubious agreement (percentage of the standard error of measurement ranging from 13% to 22.43%). The highest correlations on construct validity were observed among the 4 SAFAS subscales (Pearson r = 0.75 to 0.86, P.01), but statistically significant values appeared in the intercorrelation of instruments. There were no observed floor or ceiling effects in any of the instruments. All of their scores of change showed moderate correlation with the GROC (r = -0.48 to 0.30, P.05) and could be classified as responsive. Conclusion The Brazilian-Portuguese versions of the SAFAS, GROC, NPRS, and AOFAS had acceptable measurement properties in high-performing athletes. J Orthop Sports Phys Ther 2016;46(12):1042-1050. Epub 8 Nov 2016. doi:10.2519/jospt.2016.6218.

Background Shoulder dislocation is a common injury among young athletes, especially those who play contact sports. Objective The aim of this systematic review is to investigate the return to preinjury sporting activities in patients who have undergone a conservative treatment with immobilisation after a primary anterior shoulder dislocation. Data sources We conducted electronic searches without restriction of language on the EMBASE and PUBMED databases, using the term ‘shoulder dislocation’ for each database. Study selection All prospective studies that have evaluated the role of immobilisation for first-time shoulder dislocation were included in this review. Synthesis methods and risk of bias Author9s name, year of publication, design of study, population, sample size, follow-up times, immobilisation method, and the rate of patients9 return to preinjury sporting activities were extracted from the selected articles. The instrument used for assessing the risk of bias of the included articles was the PEDro scale. Results A total of 7397 studies were found. From the four studies included in this review four of them used external rotation (ER) as treatment for three weeks. A total of 214 participants were recruited for ER and 169 for internal rotation (IR). On average, 58.9% (95% CI 51.1% to 64.7%) for immobilisation in ER and 42.6% (95% CI 34.5% to 49.8%) for immobilisation in IR returned to preinjury sports activities. PEDro scores for the included studies ranged from 3 to 6. Conclusions On the basis of the best available evidence that the studies reported, on average

Human milk oligosaccharide (HMO) composition varies throughout lactation and can be influenced by maternal characteristics. This study describes HMO variation up to three months postpartum and explores the influences of maternal sociodemographic and anthropometric characteristics in a Brazilian prospective cohort. We followed 101 subjects from 28&ndash, 35 gestational weeks (baseline) and throughout lactation at 2&ndash, 8 (visit 1), 28&ndash, 50 (visit 2) and 88&ndash, 119 days postpartum (visit 3). Milk samples were collected at visits 1, 2 and 3, and 19 HMOs were quantified usinghigh-performance liquid chromatography with fluorescence detection (HPLC-FL). Friedman post-hoc test, Spearman rank correlation for maternal characteristics and HMOs and non-negative matrix factorization (NMF) were used to define the HMO profile. Most women were secretors (89.1%) and presented high proportion of 2&rsquo, fucosyllactose (2ꞌFL) at all three sample times, while lacto-N-tetraose (LNT, 2&ndash, 8 days) and lacto-N-fucopentaose II (LNFPII, 28-50 and 88-119 days) were the most abundant HMOs in non-secretor women. Over the course of lactation, total HMO weight concentrations (g/L) decreased, but total HMO molar concentrations (mmol/L) increased, highlighting differential changes in HMO composition over time. In addition, maternal pre-pregnancy body mass index (BMI) and parity influence the HMO composition in healthy women in this Brazilian cohort.

The purpose of this study was to investigate the effectiveness of adding photobiomodulation therapy and neuromuscular electrical stimulation (NMES) to volleyball athletes’ training, focusing on muscle strength and jumping skills. Thirty-six athletes were randomly placed into three groups: control, photobiomodulation therapy, and NMES. The athletes trained to improve their muscle strength and jumping skills. The athletes in the photobiomodulation therapy group were submitted to photobiomodulation therapy (850 nm, continuous, energy density 0.8 J/cm2, radiant energy per point 6 J, total radiant energy 36 J) before undergoing strength and plyometric training. The NMES group additionally underwent NMES-based quadriceps femoris muscle strength training (base frequency 1 kHz, frequency modulation 70 Hz, intensity maximum tolerable). The variables analyzed were muscle strength, jumping ability, global impression, and jump frequency; they were measured at baseline and during follow-ups at 6 and 8 weeks. The statistical analysis was conducted on an intention-to-treat basis. The between-group differences and their respective 95% CIs were calculated using linear mixed models by using group, time, and group-versus-time interaction terms. Dominant lower limb strength improved the most in the NMES group compared to the control group (mean difference = 1.4, 95% CI = .5 to 2.4). Non-dominant lower limb strength increased in both the photobiomodulation therapy group (mean difference = 1.1, 95% CI = .3 to 2) and the NMES group (mean difference = 1.9, 95% CI = 1.1 to 2.8) compared to the control group, but the NMES group improved more than the photobiomodulation therapy group (mean difference = 0.8, 95% CI = 0.1 to 1.7). The NMES group had the greatest improvement in global perceived effect scale compared to the control group (mean difference = 1.1, 95% CI = 1 to 2.2). Dominant lower limb strength improved in the NMES group compared to the control group. Non-dominant lower limb strength increased in both the photobiomodulation therapy group and the NMES group compared to the control group, but the NMES group improved significantly more than the photobiomodulation therapy group; the NMES group also improved in the global perceived effect scale compared to the control group. This study found that, for volleyball athletes, photobiomodulation therapy and NMES both promoted benefits in terms of muscle-strength gain. In addition, these benefits were maintained for 2 weeks even after training was interrupted. Dominant lower limb strength improved in the NMES group compared to the control group. Non-dominant lower limb strength increased in both the photobiomodulation therapy group and the NMES group compared to the control group, but the NMES group improved significantly more than the photobiomodulation therapy group; the NMES group also improved in global impression of jumps compared to the control group.

Objective: To compare the performance and effectiveness of a hydrocolloid dressing (HD) and a transparent polyurethane film (PF) in preventing pressure ulcer (PU) development. Method: The study was conducted in the intensive care unit, coronary care unit and medical clinic of the Holy House of Mercy of Passos, Brazil. Data were collected 48 hours after admission and during hospitalisation. The Braden scale was used for PU risk assessment. Consecutive eligible patients without PUs were randomly assigned by lottery to the two groups, either the HD or PF group. Results: Of the 160 eligible patients, significant between-group differences were found in the mean total number of dressing changes (HD, 6.09 ± 1.655 changes; PF, 5.59 ± 2.036 changes; p=0.010), and mean number of dressing changes in the sacral region (HD, 2.50 ± 0.871; PF, 2.05 ± 0.825; p=0.001), with the PF group requiring significantly fewer changes than the HD group. The most common reasons for changing dressings in both groups were moisture (PF 51.1%; HD 47.9%) and shear (HD 43%; PF 38.9%), with a significant difference in shear between groups. The incidence of PUs was significantly lower (p=0.038) in the PF group (8.7%) compared with that in the HD group (15%). Conclusion: The results suggest that the transparent polyurethane film had a better performance and was more effective than the hydrocolloid dressing in preventing PU development.

The need to insert the durability factor on dimensioning concrete structures has been stimulating the development of new models to predict the service life of those structures. Among those new models, the use of data from Non-Destructive Testing (NDT) is recommended. It is known that electrical resistivity is a parameter related with permeability and, in consequence, with the resistance of the concrete against the intrusion of aggressive agents. Electrical resistivity may be monitored with time by a NDT method, by a low cost and easy execution technique. However, some parameters of this essay need to be further discussed in the literature aiming to standardize this technique. Thus, this study had the goal to verify the influence of test specimen’s shape in measurements of electrical resistivity. In order to that, cylindrical and prismatic test specimens have been molded from a same type of concrete and electrical resistivity was monitored during a period of 120 days. Results show significant differences between the values obtained. Test specimens in cylindrical shape had the higher results. A good correlation between factors was found with R2 higher than 0.94.

RESUMO: Tayassu tajacu, popularmente conhecido como cateto, é uma espécie silvestre encontrada em quase todo o continente Americano, sendo abundante em seus locais de ocorrência. O trabalho objetivou conhecer a fauna helmintológica, bem como os indicadores de infecções, de catetos (T. tajacu) procedentes da Amazônia Brasileira. Para tanto, foram utilizados cinco animais adultos (três machos e duas fêmeas), capturados no município de Araguaína, estado do Tocantins, com auxílio de armadilhas. Os catetos foram tranquilizados, contidos quimicamente e eutanasiados segundo o Guia Brasileiro de Boas Práticas para Eutanásia em Animais do Conselho Federal de Medicina Veterinária. As espécies encontradas foram identificadas e os indicadores de infecção foram determinados (percentual de infecção, abundância, intensidade média e variação da intensidade). Foi coletado um total de 1394 helmintos, sendo nove espécies de nematódeos: Eucyathostomum dentatum, Cruzia brasiliensis, Monodontus semicircularis, Monodontus aguiari, Spiculopteragia tayassui, Texicospirura turki, Parabronema pecariae, Physocephalus sexalatus, Cooperia punctata. Os helmintos com maiores percentuais de infecção foram Physocephalus sexalatus, Parabronema pecariae e Monodontus aguiari, encontrados em 100% dos animais examinados, sendo este último o mais abundante (164), com maior intensidade média (164) e com maior número total de helmintos (820). Em contrapartida, Spiculopteragia tayassui foi a espécie que obteve menores indicadores, sendo encontrada apenas uma fêmea neste estudo. Foi relatada, neste trabalho, a primeira ocorrência de Cruzia brasiliensis parasitando catetos (T. tajacu) no Brasil, espécie até então descrita e encontrada apenas parasitando suínos domésticos. ABSTRACT: Tayassu tajacu, popularly known as collared peccary, is a wildlife species found throughout the American continent, being abundant in their places of occurrence. This study aimed to describe the helminthological fauna, as well as the infection indicators, of the collared peccary (T. tajacu) coming from the Brazilian Amazon. Five adult peccaries (three males and two females) were captured in the Araguaína region, Tocantins, Brazil, with the aid of traps. The collared peccaries were reassured, chemically restrained and euthanized according to the Brazilian Good Practice Guide for Animal Euthanasy of the Federal Board of Veterinary Medicine. The species found were identified and the infection indicators were determined (infection rate, abundance, mean intensity and intensity variation). A total of 1394 helminths of nine nematode species were collected: Eucyathostomum dentatum, Cruzia brasiliensis, Monodontus semicircularis, Monodontus aguiari, Spiculopteragia tayassui, Texicospirura turki, Parabronema pecariae, Physocephalus sexalatus and Cooperia punctata. Helminths with higher percentages of infection were Physocephalus sexalatus, Parabronema pecariae and Monodontus aguiari found in 100% of the examined animals; the latter was the most abundant (164) and had a highest mean intensity (164) and total number of helminths (820). In contrast, Spiculopteragia tayassui presented lower indicators, found only one female in this study. In this studythe the first occurrence of Cruzia brasiliensis parasitizing collared peccary (T. Tajacu) in Brazil was reported, specie hitherto described and only found parasitizing domestic pigs.

Background Several forms of conservative treatment have been the focus of many recent studies in knee osteoarthritis (OA). Among these techniques, the application of pulsed shortwave (PSW) treatment has been widely used, but the optimal dose and application time have not been well established. Objective The purposes of this study were: (1) evaluate the effect of PSW treatment in different doses and (2) to compare low-dose and high-dose PSW groups with control and placebo groups. Design This was a randomized clinical trial. Setting The study was conducted in the physical therapy department of 2 large urban hospitals. Patients One hundred twenty-one women (mean age=60 years, SD=9) with a diagnosis of knee OA participated in the study. Intervention and Measurements Participants were distributed randomly into 4 groups: 35 participants did not receive any treatment (control group), 23 received a placebo treatment, 32 received low-dose PSW treatment (power of 14.5 W, treatment duration of 19 minutes, and total energy of 17 kJ), and 31 received high-dose PSW treatment (power of 14.5 W, treatment duration of 38 minutes, and total energy of 33 kJ). An 11-point numerical pain rating scale and the Knee Osteoarthritis Outcome Score were used to assess pain and function in 3 stages: at initial evaluation (pretreatment), immediately after treatment, and at 12-month follow-up. Results The 4 groups were homogeneous prior to treatment with respect to demographics, pain, and functional scale data. The results demonstrated the short-term effectiveness of the PSW at low and high doses in patients with knee OA. Both treatment groups showed a significant reduction in pain and improvement in function compared with the control and placebo groups (effect size: range=20.0–23.4 for the low-dose PSW group and range=15.7–16.5 for the high-dose PSW group). There were no differences in results between PSW doses, although a low dose of PSW appeared to be more effective in the long term. Limitations These results were achieved without physical exercise, which could have positively influenced the results. Conclusions Pulsed shortwave treatment is an effective method for pain relief and improvement of function and quality of life in the short term in women with knee OA. On the basis of the results, application of PSW treatment is recommended in the female population with knee OA. However, conclusions regarding the 12-month follow-up should be analyzed carefully due to the high dropout rate.

Esta revisão de literatura sobre aprendizagem organizacional aponta cinco principais desafios enfrentados por pesquisadores desse campo. Os desafios identificados foram de caráter teórico, conceitual e metodológico e merecem atenção especial no momento de planejamento de projetos de pesquisa nessa área. A primeira constatação do levantamento bibliográfico é que inexiste uma teoria da aprendizagem organizacional e, portanto, os pesquisadores enfrentam o desafio de erigir teoria relativa a esse fenômeno complexo e multifacetado. Já o segundo desafio refere-se à análise multinível de um processo que ocorre em nível individual e transcende o grupo, a organização e outras organizações, exigindo um modelo de análise adequado. O tema vem sendo estudado por diversas disciplinas sob perspectivas distintas, representando a terceira constatação da pesquisa e o desafio de construir pontes interdisciplinares para o desenvolvimento de uma teoria abrangente e útil em diversos campos da ciência. Esse desafio se torna ainda mais complexo diante da constatação da multiplicidade de conceitos e construtos de pesquisa relacionados diretamente com o mesmo processo de geração e operação de conhecimento para adaptação e performance organizacional. Por fim, o quinto desafio refere-se às metodologias de pesquisa sobre aprendizagem organizacional, com possibilidades pouco exploradas e uma hegemonia dos instrumentos de percepção individual. This literature review on organizational learning points out five main challenges faced by researchers from this field. The challenges identified had a theoretical, conceptual, and methodological nature and they deserve a special attention at the time of planning research projects in this area. The first finding of the bibliographical survey is that there is not a theory of organizational learning and, therefore, researchers face the challenge of building theory related to this complex and multifaceted phenomenon. In turn, the second challenge refers to multilevel analysis of a process that takes place at the individual level and goes beyond the group, the organization, and other organizations, requiring a suitable analytical model. The theme has been studied by several disciplines from different perspectives, representing the third research finding and the challenge of building interdisciplinary bridges to develop a comprehensive and useful theory in various fields of science. This challenge becomes even more complex given the verification of the multiplicity of research concepts and constructs directly related to the same processes of generating and operating knowledge for organizational adaptation and performance. Finally, the fifth challenge refers to research methodologies on organizational learning, with barely explored possibilities and hegemony of instruments of individual perception.

STUDY DESIGN: Clinical measurement study.OBJECTIVES: To cross-culturally adapt the Anterior Knee Pain Scale (AKPS), the Functional Index Questionnaire (FIQ), and the Pain Severity Scale (PSS) for patellofemoral pain syndrome (PFPS) into Brazilian Portuguese. This study also aimed to test the measurement properties of the AKPS, the FIQ, and the PSS, and the existing Brazilian Portuguese versions of the numeric pain rating scale (NPRS) and the Global Perceived Effect scale in a group with PFPS.BACKGROUND: PFPS is a common condition. Therefore, translated, culturally adapted, and clinimetrically tested instruments for measuring PFPS are needed.METHODS: the AKPS, FIQ, and PSS instruments were cross-culturally adapted into Brazilian Portuguese. the measurement properties of the AKPS, FIQ, PSS, NPRS, and Global Perceived Effect scale (internal consistency, ceiling and floor effects, and construct validity) were tested in 83 patients with PFPS. the reproducibility and responsiveness were tested in 52 patients with PFPS in a test-retest design, with follow-up testing at 48 to 72 hours and at 4 weeks after baseline.RESULTS: the AKPS, the FIQ, and the PSS yielded adequate internal consistency (Cronbach alpha ranging from .75 to .87) and excellent reliability (intraclass correlation coefficients [model 2,1] ranging from 0.90 to 0.97). the AKPS and the PSS yielded very good agreement (standard error of measurement, 2.9% and 3.5%, respectively). the highest correlations were observed among the AKPS, the FIQ, and the PSS (Pearson r>0.60, P

Clinical measurement.To translate, adapt, and test the measurement properties of the Brazilian Portuguese version of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire.It is important to objectively measure symptoms and functional limitations related to patellar tendinopathy using outcome measures that have been validated in the language of the target population. Cross-cultural adaptations are also useful to enhance the understanding of the measurement properties of an assessment tool, regardless of the target language.The VISA-P questionnaire was translated into Brazilian Portuguese, culturally adapted, and titled VISA-P Brazil. It was then administered on 2 occasions with a 24- to 48-hour interval between them, and a third time after a month of physical therapy treatment. The following measurement properties were analyzed: internal consistency, test-retest reliability, agreement, construct validity, floor and ceiling effects, and responsiveness.The VISA-P Brazil had high internal consistency (Cronbach α = .76; if item deleted, Cronbach α = .69-.78), excellent reliability and agreement (intraclass correlation coefficient = 0.91; 95% confidence interval: 0.85, 0.95; standard error of measurement, 5.2 points; minimal detectable change at the 90% confidence level, 12.2 points), and good construct validity (Pearson r = 0.60 compared to Lysholm). No ceiling and floor effects were detected for the VISA-P Brazil, and the responsiveness, based on 32 patients receiving physical therapy intervention for 1 month, demonstrated a large effect size of 0.97 (95% confidence interval: 0.68, 1.25).The VISA-P Brazil is a reproducible and responsive tool and can be used in clinical practice and research to assess the severity of pain and disability of patients with patellar tendinopathy.

Background This study was designed to analyze spirometric parameters and cytokine (interferon [IFN] gamma and IL-5) levels in induced sputum from patients with asthma or allergic rhinitis (AR) and nonatopic subjects. Methods Thirty-three subjects aged 18–60 years were enrolled in the present study. Eight patients had asthma without AR symptoms, 16 had AR without asthma symptoms or history, and both groups had positive skin-prick test (SPT) to aeroallergens. The nine remaining subjects were healthy nonatopic subjects with negative SPT to aeroallergens. Spirometry was performed by evaluating the forced vital capacity (FVC), forced expiratory volume in the 1st second (FEV 1 ), and forced expiratory flow between 25 and 75% (FEF 25–75 ) of FVC before and after bronchodilator use. Induced sputum samples were also collected for measuring cytokine (IFN-gamma and IL-5) levels by enzyme-linked immunosorbent assay. Results Significant pre- and postbronchodilator change was observed only for FEV 1 with higher variation values in asthmatic subjects compared with patients with AR (p < 0.05) and nonatopic subjects (p < 0.01). There was no significant difference in pre- and postbronchodilator spirometric parameters among the three groups, although asthmatic patients showed lower prebronchodilator FEF 25–75 values (p = 0.065). IL-5 levels were higher in induced sputum from patients with asthma and AR compared with nonatopic subjects (p = 0.020 and p = 0.032, respectively), but IFN-gamma levels showed no significant difference between the groups. Conclusion Spirometric measurements were not able to show any occurrence of bronchial constriction in patients with AR, but predominant IL-5 levels in induced sputum from these patients reinforce the role of Th2-type immune response in lower respiratory airways that could contribute to the concept of “one airway, one disease.”

Blomia tropicalis, Dermatophagoides pteronyssinus and D. farinae are prevalent house dust mites. Concanavalin A-binding components derived from B. tropicalis (Bt-ConA extract) are highly immunogenic in allergic diseases. The aim of the present study was to evaluate the humoral and cellular immune responses to B. tropicalis in mite-sensitized patients. A total of 137 patients with allergic rhinitis with/without asthma and 109 non-atopic subjects were selected and analyzed by the skin prick test, and for total serum IgE and specific IgE levels to both Bt-total and Bt-ConA extracts, their proliferative response and cytokine (IFN-gamma and IL-5) production by peripheral blood mononuclear cells (PBMC) stimulated with both extracts. Skin prick test showed that 70% of the patients were sensitized to Bt (Bt+) and similar levels of specific IgE to Bt-total and Bt-ConA extracts were demonstrable in Bt+ patients. Significant PBMC proliferation was observed in response to Bt-total extract in Bt+, but not in Bt- patients and non-atopic subjects (P0.001). Bt-ConA extract induced increased proliferative responses in all patient groups compared to medium alone (P0.05), but these responses were significantly decreased in the presence of the mannopyranoside ConA inhibitor (P0.05). Significant IFN-gamma production was observed after Bt-ConA stimulation of Bt+ patients (P0.05), while Bt-total extract had no effect. IL-5 production was consistently detected in Bt+ patients after allergen-specific stimulation or with no stimulus, indicating that PBMC from allergic patients are prone to produce Th2 profile cytokines, spontaneously or inductively by allergen restimulation. These data showed that ConA-binding components isolated from B. tropicalis may contain relevant antigens that are involved in both humoral and cellular immune responses. However, without an additional purification procedure to eliminate the residual contamination with ConA, its use in immunotherapeutic procedures cannot be recommended.

OBJETIVO: Conhecer o perfil de sensibilização dos pacientes com diagnóstico de doenças alérgicas atendidos no Ambulatório de Alergia do Hospital de Clínicas da Universidade Federal de Uberlândia. MÉTODOS: Foi realizado um estudo retrospectivo por meio da análise de prontuários de pacientes atendidos no serviço, que foram submetidos ao teste cutâneo de puntura (TCP) para os alérgenos de Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t), Canis familiaris (Can f), Felis domesticus (Fel d), Blattella germanica (Bla g) e Alternaria alternata, e respondido corretamente ao questionário ISAAC. RESULTADOS: Foram analisados 212 prontuários de pacientes que preenchiam os critérios de inclusão. A rinite alérgica isoladamente foi a maior causa de atendimento (32%), seguida das associações asma e rinite (29,7%) e asma, rinite e eczema (9,4%). Pacientes com asma isoladamente perfizeram apenas 1,9% dos atendimentos. A sensibilização dos pacientes observada foi de 73,5%, sendo de 61,7% para Der p, 59,9% para Der f, 54,7% para Blo t, 45,7% para Bla g, 38,2% para Can f, 33,3% para Fel d e 9,9% para Alternaria. Não houve diferenças significantes entre as patologias encontradas e os perfis de sensibilização. CONCLUSÃO: Os principais alérgenos sensibilizantes determinados pelo TCP foram os ácaros, com predomínio de Der p e Der f, chamando a atenção a elevada prevalência de sensibilização ao último. Ainda foi observada elevada sensibilização aos alérgenos de B. germanica, superior aos estudos anteriores realizados no País. OBJECTIVE: To evaluate allergens among patients with allergic respiratory disease attended at the Allergy Clinic of the University Hospital - Federal University of Uberlândia. METHODS: A retrospective study was performed using medical records. Patients were included if their ISAAC questionnaires were correctly filled out and their skin prick tests were positive to at least one of the allergens from Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t), Canis familiaris (Can f), Felis domesticus (Fel d), Blattella germanica (Bla g) and Alternaria alternata. RESULTS: Two-hundred and twelve medical records fulfilled the inclusion criteria. Allergic rhinitis was the main clinical diagnosis (32%), followed by concomitant manifestation of asthma and rhinitis (29.7%), and asthma, rhinitis and atopic dermatitis (9.4%). Asthma alone was found only in 1.9% of patients. The total sensitization observed was 73.5%, of which 61.7%, 59.9%, 54.7%, 45.7%, 38.2%, 33.3%, 9.9% were sensitized to Der p, Der f, Blo t, Bla g, Can f, Fel d and Alternaria, respectively. No significant difference was found between allergic disease types and source of allergen sensitization. CONCLUSION: The highest sensitization in allergic patients under study was to dust mites, especially Der p and Der f. It is noteworthy that the number of patients sensitized to cockroach extract was uncommonly high when compared to previous studies.

Blomia tropicalis (Bt) and Dermatophagoides pteronyssinus (Dp) are the prevalent house dust mites in tropical countries and are associated with allergic diseases. Glycosylated antigens are highly immunogenic and involved in different pathologies. We evaluated the presence of IgE, IgG1, and IgG4 to concanavalin A-binding antigens (Bt-Con-A) isolated from Bt-total extract in sera of allergic and non-allergic subjects. Bt-total and Bt-Con-A extracts were evaluated by SDS-PAGE and ELISA for reacting with IgE, IgG1, and IgG4 in sera of 121 patients with allergic rhinitis and 36 non-allergic individuals. All subjects were skin prick tested with Bt-total extract and inhibition tests were performed for IgE, IgG1, and IgG4 using both extracts (Bt-total and Bt-Con-A). Skin prick test showed that 58% of the patients were sensitized to Bt (Bt+), with 52% reactive to both mites (Bt and Dp) and 6% to Bt only. A broad spectrum of proteins (14-152 kDa) was visualized in Bt-total and components >27 kDa for the Bt-Con-A extract. ELISA showed a similar profile of IgE, IgG1 and IgG4 levels in response to Bt-total and Bt-Con-A extracts in different groups, although Bt+ patients showed a lower IgG4 reactivity to Bt-Con-A extract. Specific IgG1 levels were higher in Bt+ patients than in control subjects, and IgG4 levels showed no significant difference among groups. ELISA inhibition showed a partial IgE and total IgG1 and IgG4 cross-reactivity with Dp extract for Bt-total and Bt-Con-A extracts. We conclude that Con-A-binding components isolated from Bt constitute major allergens and are involved in both allergen sensitization (IgE response) and homeostasis maintenance (IgG1 and IgG4 responses).

SUMMARY OBJECTIVE To evaluate pain, functional capacity, and quality of life of patients with non-specific chronic low back pain, after home-based exercise therapy with different kinds of supervision. METHOD Thirty individuals of both gender, between 18 and 65 years old, performed the proposed exercises three times a week, for eight weeks. Group A (N = 17) performed the exercises after a single supervised session. Group B (N = 13) was supervised once a week at the rehabilitation center. Both groups received a booklet with instructions, and questionnaires to evaluate pain, functional capacity and quality of life; during the initial evaluation, after four and eight weeks. RESULTS There was an improvement in pain and functional capacity between the initial evaluation and week 4, and the initial evaluation and week 8 in both groups (p 0,05). CONCLUSION Home-based exercise therapy, when performed in a period of eight weeks, using the booklet, was effective for improving level of pain, functional capacity, and quality of life in patients with non-specific chronic low back pain. The weekly supervision did not significantly influence the final outcome between the groups. RESUMO OBJETIVO Avaliar dor, capacidade funcional e qualidade de vida de pacientes com dor lombar crônica inespecífica após terapia por exercícios domiciliares, com diferentes maneiras de supervisão. MÉTODO Trinta indivíduos de ambos os sexos, com idade entre 18 e 65 anos, apresentando dor lombar crônica inespecífica, realizaram os exercícios propostos três vezes por semana, durante oito semanas. Indivíduos do Grupo A (N=17) realizaram os exercícios após única sessão supervisionada. Já os indivíduos do Grupo B (N=13) foram supervisionados uma vez por semana no centro de reabilitação. Ambos receberam cartilha com orientações e questionários para avaliar dor, capacidade funcional e qualidade de vida; durante avaliação inicial, após quatro e oito semanas. RESULTADOS Houve melhora da dor e capacidade funcional entre as avaliações inicial e semana 4, e inicial e semana 8 nos dois grupos (p0,05). CONCLUSÃO A terapia por exercícios domiciliares, quando realizada num período de oito semanas, com auxílio da cartilha, foi eficaz para melhora da dor, capacidade funcional e qualidade de vida, em pacientes com dor lombar crônica inespecífica. A supervisão semanal não influenciou de forma significativa o resultado final quando comparados os grupos.