Sao Paulo, Brazil

City University of Sao Paulo
Sao Paulo, Brazil
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The purpose of this article is to discuss the routine of children in early childhood education, especially of those aged zero to four years, focusing on the moments of rest and feeding. At this stage of educational service, the dialogical relationships between adults and children and the integration between care and education are fundamental assumptions for a quality early childhood education, a condition to ensure the fundamental rights of babies and very young children. This qualitative investigation consisted of a case study of ethnographic nature, conducted in 2010 and 2011, in a Centro de Educação Infantil (CEI - Early Childhood Education Center) of the public school system of São Paulo city, Brazil, which serves children aged from 0 to 4 years. The methodological procedures included participant observation, documentary analysis and semi-structured interviews with the CEI team and children's families. The investigation involved literature review, and the main references were Barbosa, Batista, Coutinho, Guimarães, Korczak, Tristão, and Wallon. The results evidenced that the emotions expressed by children at the times of meals and rest are, to a great extent, disregarded. I have also found contradictions between the propositions of integrating care and education included in the pedagogical project and teachers' discourses and practices with the children. The study concluded that it is essential to include the topics of care of the body - food, hygiene, rest, and health - as part of continuing teacher education and the weekly planning conducted in institutions of early childhood education.

Ortolan F.,State University of Rio Grande do Sul | Steel C.J.,City University of Sao Paulo
Comprehensive Reviews in Food Science and Food Safety | Year: 2017

The use of vital wheat gluten in the baking industry and wheat flour mills aims to improve the rheological characteristics of flour considered unsuitable to obtain products such as sliced bread, French bread, high-fiber breads, and other products that require strong flours. To improve characteristics such as flour strength, dough mixing tolerance, and bread volume, vital wheat gluten is added to flour at levels that can vary from 2% to 10% (flour basis), with 5% being a commonly used dosage. However, the vital wheat gluten commercialized in the market has few quality specifications, especially related to the characteristics of the proteins that constitute it and are responsible for the formation of the viscoelastic gluten network. Information on protein quality is important, because variations are observed in the technological quality of vital wheat gluten obtained from different sources, which could be associated to damage caused to proteins during the obtainment process. Several tests, either physical-chemical analyses, or rheological tests, are carried out to establish gluten quality; however, they are sometimes time-consuming and costly. Although these tests give good answers to specify gluten quality, flour mills, and the baking industries require fast and simple tests to evaluate the uses and/or dosage of vital gluten addition to wheat flour. This review covers the concepts, uses, obtainment processes, and quality analysis of vital wheat gluten, as well as simple tests to help identify details about protein quality of commercial vital wheat gluten. © 2017 Institute of Food Technologists®.

Correa J.B.,City University of Sao Paulo | Costa L.O.P.,City University of Sao Paulo | Costa L.O.P.,The George Institute for Global Health | de Oliveira N.T.B.,City University of Sao Paulo | And 2 more authors.
Experimental Brain Research | Year: 2015

Quantitative sensory testing is widely used in human research to investigate the state of the peripheral and central nervous system contributions in pain processing. It is a valuable tool to help identify central sensitization and may be important in the treatment of low back pain. The aim of this study was to evaluate changes in local and segmental hypersensitivity and endogenous pain inhibition in people with chronic nonspecific low back pain. Thirty patients with chronic low back pain and thirty healthy subjects were studied. Pressure pain thresholds (PPTs) were measured from the lumbar region and over the tibialis anterior muscle (TA). A cold pressor test was used to assess the activation of conditioned pain modulation (CPM), and PPTs in the lumbar region were recorded 30 s after immersion of participant’s foot in a bucket with cold water. People with chronic low back pain have significantly lower PPT than controls at both the lumbar region [89.5 kPa (mean difference) 95 % CI 40.9–131.1 kPa] and TA [59.45 kPa (mean difference) 95 % CI 13.49–105.42 kPa]. During CPM, people with chronic low back pain have significantly lower PPT than controls in lumbar region [118.6 kPa (mean difference) 95 % CI 77.9–159.2 kPa]. Women had significantly lower PPTs than men in both lumbar region [101.7 kPa (mean difference) 95 % CI 37.9–165.7 kPa] and over the TA [189.7 kPa (mean difference) 95 % CI 14.2–145.2 kPa]. There was no significant difference in PPTs in men between healthy controls and those with low back pain, suggesting the significant differences are mediated primarily by difference between women. © 2015, Springer-Verlag Berlin Heidelberg.

Duarte M.,University of Sao Paulo | Freitas S.M.S.F.,City University of Sao Paulo
Revista Brasileira de Fisioterapia | Year: 2010

Background: The maintenance of balance and body orientation in humans is guaranteed by the adequate functioning of the postural control system. The investigation of this control has awakened the interest of professionals from several fields such as Physical Therapy, Physical Education, Engineering, Physics, Medicine, Psychology, and others. Objectives: The purposes of this study are to revise the methods of data analysis used to investigate the postural control in human beings and to demonstrate the computational algorithms of the main measures used in the postural control evaluation. Conclusion: The experimental procedures and measures used in postural control evaluation presented in this review can help in the standardization of postural control investigation. © Revista Brasileira de Fisioterapia.

Chronic nonspecific low back pain is a significant health condition with high prevalence worldwide and it is associated with enormous costs to society. Clinical practice guidelines show that many interventions are available to treat patients with chronic low back pain, but the vast majority of these interventions have a modest effect in reducing pain and disability. An intervention that has been widespread in recent years is the use of elastic bandages called Kinesio Taping. Although Kinesio Taping has been used extensively in clinical practice, current evidence does not support the use of this intervention; however these conclusions are based on a small number of underpowered studies. Therefore, questions remain about the effectiveness of the Kinesio Taping method as an additional treatment to interventions, such as conventional physiotherapy, that have already been recommended by the current clinical practice guidelines in robust and high-quality randomised controlled trials. We aim to determine the effectiveness of the addition of the use of Kinesio Taping in patients with chronic nonspecific low back pain who receive guideline-endorsed conventional physiotherapy. One hundred and forty-eight patients will be randomly allocated to receive either conventional physiotherapy, which consists of a combination of manual therapy techniques, general exercises, and specific stabilisation exercises (Guideline-Endorsed Conventional Physiotherapy Group) or to receive conventional physiotherapy with the addition of Kinesio Taping to the lumbar spine (Conventional Physiotherapy plus Kinesio Taping Group) over a period of 5 weeks (10 sessions of treatment). Clinical outcomes (pain intensity, disability and global perceived effect) will be collected at baseline and at 5 weeks, 3 months, and 6 months after randomisation. We will also collect satisfaction with care and adverse effects after treatment. Data will be collected by a blinded assessor. All statistical analysis will be conducted following the principles of intention to treat, and the effects of treatment will be calculated using Linear Mixed Models. The results of this study will provide new information about the usefulness of Kinesio Taping as an additional component of a guideline-endorsed physiotherapy program in patients with chronic nonspecific low back pain.

STUDY DESIGN:: Correlation and agreement analysis OBJECTIVES:: The objective of this study was to compare the Brazilian Portuguese versions of the ÖMPSQ-short and the SBST-Brazil in patients with low back pain and to verify their correlation with disability, kinesiophobia, and pain. SUMMARY OF BACKGROUND DATA:: The Örebro Musculoskeletal Pain Screening Questionnaire Short-Form (ÖMPSQ-short) and the STarT Back Screening Tool (SBST) were designed to identify patients at risk of developing pain and disability related to psychosocial factors. METHODS:: We assessed 130 patients, who answered the ÖMPSQ-short, SBST-Brazil, Roland-Morris disability questionnaire, Tampa scale of kinesiophobia, and Pain Numerical Rating scale. The total scores of the ÖMPSQ-short and the SBST-Brazil were correlated with the other questionnaires. Cross tabulation and Cohenʼs kappa were used to analyze the agreement between the ÖMPSQ-short and the SBST-Brazil for participant classification as low- or high-risk for involvement of psychosocial factors. RESULTS:: The ÖMPSQ-short and the SBST-Brazil presented good correlation between total scores (r=0.73), good correlation with disability (ÖMPSQ-short: r?=?0.72; SBST-Brazil: r?=?0.76) and kinesiophobia (ÖMPSQ-short: r?=?0.68; SBST-Brazil: r?=?0.60) and moderate correlation with pain in the last episode (ÖMPSQ-short: r?=?0.39; SBST-Brazil: r?=?0.48), in last two weeks (ÖMPSQ-short: r?=?0.39; SBST: r?=?0.43), and current pain (ÖMPSQ-short: r?=?0.39; SBST-Brazil: r?=?0.31). Participant classification as high or low risk by the two questionnaires showed moderate agreement (k?=?0.49). 83% of participants were classified correctly by the two questionnaires. CONCLUSION:: The ÖMPSQ-short and the SBST-Brazil showed good correlation between total scores and moderate agreement for patient classification in relation to the presence of psychosocial factors.Level of Evidence: 3 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Padula R.S.,City University of Sao Paulo
Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) | Year: 2012

Systematic reviews are considered the best design to synthesize all existing information of a given research topic. To date, there is no study that investigated the quality of reporting of systematic reviews relevant to physical therapy published in Portuguese. Objective: To analyse the quality of reporting of systematic reviews in the field of physical therapy published in Portuguese by using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist. All systematic reviews published in Portuguese that were indexed on PEDro database up to August 2011 were included. The quality of reporting of the eligible papers was analysed by using the PRISMA checklist. Each quality assessment was performed by two independent reviewers with arbitration of a third reviewer if necessary. A total of 37 systematic reviews were identified. These studies were published between 2003 and 2010. Less than 30% of the PRISMA checklist items were satisfied, being most of the items related to the introduction and discussion sections. No improvements over time were observed. Most of the studies did not satisfy the items from the PRISMA Checklist. It seems that most of authors did not know the existence of this checklist. The implementation of reporting statements such as the PRISMA statement by Portuguese-written journals is likely to help authors to write their systematic reviews in a more transparent and clear way.

Saragiotto B.T.,City University of Sao Paulo | Yamato T.P.,City University of Sao Paulo | Lopes A.D.,City University of Sao Paulo
Journal of Orthopaedic and Sports Physical Therapy | Year: 2014

STUDY DESIGN: Qualitative study based on semi-structured interviews.OBJECTIVES: To describe the beliefs and opinions of runners about risk factors associated with running injuries.BACKGROUND: Despite the health benefits of running, a high prevalence of injury has been reported in runners. Preventive strategies for running injuries may be more successful with a better knowledge of runners' beliefs.METHODS: A semi-structured interview of recreational runners was based on the question, "What do you think can cause injuries in runners?" Analysis of the interviews was performed in 3 steps: (1) organizing the data into thematic units, (2) reading and reorganizing the data according to frequency of citation, and (3) interpreting and summarizing the data. The runner interviews were continued until no new beliefs and opinions of runners regarding injuries were being added to the data, indicating saturation of the topic.RESULTS: A total of 95 recreational runners (65 men, 30 women) between the ages of 19 and 71 years were interviewed. Of those interviewed, the average running experience was 5.5 years and approximately 45% had experienced a running-related injury in the past. The factors suggested by the runners were divided into extrinsic and intrinsic factors. The most cited extrinsic factors were "not stretching," "excess of training," "not warming up," "lack of strength," and "wearing the wrong shoes." For the intrinsic factors, the main terms cited were "not respecting the body's limitations" and "foot-type changes.CONCLUSION: Recreational runners mainly attributed injury to factors related to training, running shoes, and exceeding the body's limits. Knowing the factors identified in this study may contribute to the development of better educational strategies to prevent running injuries, as some of the runners' beliefs are not supported by the research literature. Copyright © 2014 Journal of Orthopaedic & Sports Physical Therapy. All rights reserved.

Freitas S.M.S.F.,City University of Sao Paulo | Duarte M.,Federal University of ABC
Gait and Posture | Year: 2012

How aging affects body sway and joint coordination during quiet standing was investigated under two visual feedback conditions provided on a monitor screen: fixed and moving cursor representing the center of pressure (COP) position measured by a platform. The across-time joint motion variance of ankle, knee, hip, mid-trunk, and cervical spine leading to COP displacement was analyzed using the uncontrolled manifold approach. The body sway was assessed by the COP displacement. Young and older adults showed greater ankle joint contribution to COP displacement than the other joints. However, older adults showed larger variability of knee and mid-trunk joint motions than young adults. During the moving condition, the ankle joint contribution decreased and hip joint contribution increased for both groups, but the COP displacement increased only for the older adults. We conclude that joint coordination and body sway during quiet standing can be modified by providing COP visual feedback and that joint coordination is affected by aging. © 2011 Elsevier B.V.

Saragiotto B.T.,City University of Sao Paulo
Spine | Year: 2016

STUDY DESIGN.: Systematic review. OBJECTIVE.: To evaluate the effectiveness of motor control exercise in patients with non-specific low back pain. SUMMARY OF BACKGROUND DATA.: Motor control exercise (MCE) is a common form of exercise used for managing low back pain (LBP). MCE focuses on the activation of the deep trunk muscles and targets the restoration of control and coordination of these muscles, progressing to more complex and functional tasks integrating the activation of deep and global trunk muscles. METHODS.: We conducted electronic searches of CENTRAL, MEDLINE, EMBASE, five other databases and two trials registers from their inception up to April 2015. Two independent review authors screened the search results, assessed risk of bias and extracted the data. A third reviewer resolved any disagreement. We included randomised controlled trials comparing MCE with no treatment, another treatment or as a supplement to other interventions in patients with non-specific LBP. Primary outcomes were pain intensity and disability. We assessed risk of bias using the Cochrane Back and Neck (CBN) Review Group 12-item criteria. We combined results in a meta-analysis expressed as mean difference and 95% confidence interval. We assessed the overall quality of the evidence using the GRADE approach. RESULTS.: We included 32 trials (n?=?2,628). Most included trials had low risk of bias. For acute LBP, low to moderate quality evidence indicates no clinically important differences between MCE and spinal manipulative therapy or other forms of exercise. There is very low quality evidence that the addition of MCE to medical management does not provide clinically important improvements. For recurrence at one year, there is very low quality evidence that MCE and medical management decrease the risk of recurrence. For chronic LBP, there is low to moderate quality evidence that MCE is effective for reducing pain compared with minimal intervention. There is low to high quality evidence that MCE is not clinically more effective than other exercises or manual therapy. There is very low to low quality evidence that MCE is clinically more effective than exercise and electrophysical agents (EPA) or telerehabilitation for pain and disability. CONCLUSION.: MCE is probably more effective than a minimal intervention for reducing pain, but probably does not have an important effect on disability, in patients with chronic LBP. There was no clinically important difference between MCE and other forms of exercises or manual therapy for acute and chronic LBP.Level of Evidence: 1 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

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