Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder

Background: Children with Developmental Coordination Disorder (DCD) have difficulties performing daily activities which reflects negatively on participation, impacting their lives.

Objectives: To examine the effects of the cognitive orientation to daily occupational performance Approach (CO-OP Approach) protocol on occupational performance and satisfaction of Brazilian children who have DCD; to examine whether children could transfer strategies and skills learned during CO-OP to untrained goals.

Methods: A pre-post group comparison design with eight boys aged 6–10 years old. Children participated in 12 CO-OP sessions with their parents twice a week, with an extra session added to the protocol for parents´ orientation. The Canadian Occupational Performance Measure and the Performance Quality Rating Scale were used as outcome measures. The study was registered by the United States Institutes of Health at ClinicalTrials.gov (NCT03112746).

Results: Intervention resulted in higher, clinically and statistically significant, occupational performance measures according to parents, children’s, and external evaluators’ perspectives. All children improved occupational performance on their selected goals and five children could transfer the ability to use cognitive strategies to tasks not addressed in therapy.

Conclusions: This study provides initial directions for future research to investigate the applicability and to implement CO-OP approach on pediatric settings in Brazil.     

Rhizobium response to sole and combined exposure to cadmium and the phytocompounds alpha-pinene and quercetin

Soils can be contaminated with substances arising from anthropogenic sources, but also with natural bioactive compounds produced by plants, such as terpenes and flavonoids. While terpenes and flavonoids have received much less attention from research studies than metals, the effects that phytocompounds can have on soil organisms such as beneficial microorganisms should not be neglected. Herein we report the sole and combined exposure of Rhizobium to cadmium, to the monoterpene alpha-pinene and to the flavanol quercetin. A range of environmentally relevant concentrations of the phytocompounds was tested. Physiological (growth, protein content and intracellular Cd concentration), oxidative damage (lipid peroxidation, protein carbonylation) and antioxidant mechanisms (superoxide dismutase, catalase, glutathione, glutathione-S-transferases, protein electrophoretic profiles) were assessed. Results suggest that exposure to both phytocompounds do not influence Rhizobium growth, but for combined exposure to phytocompounds and Cd, different responses are observed. At low concentrations, phytocompounds seem to relieve the stress imposed by Cd by increasing antioxidant responses, but at high concentrations this advantage is lost and membrane damage may even be exacerbated. Thus, the presence of bioactive phytocompounds in soil may influence the tolerance of microorganisms to persistent toxicants, and may change their impact on the environment.     

Description of Leprosy Classification at Baseline among Patients Enrolled at the Uniform Multidrug Therapy Clinical Trial for Leprosy Patients in Brazil

The uniform multidrug therapy clinical trial, Brazil (U-MDT/CT-BR), database was used to describe and report the performance of available tools to classify 830 leprosy patients as paucibacillary (PB) and multibacillary (MB) at baseline. In a modified Ridley and Jopling (R&J) classification, considering clinical features, histopathological results of skin biopsies and the slit-skin smear bacterial load results were used as the gold standard method for classification. Anti-phenolic glycolipid-I (PGL-I) serology by ML Flow test, the slit skin smear bacterial load, and the number of skin lesions were evaluated. Considering the R&J classification system as gold standard, ML Flow tests correctly allocated 70% patients in the PB group and 87% in the MB group. The classification based on counting the number of skin lesions correctly allocated 46% PB patients and 99% MB leprosy cases. Slit skin smears properly classified 91% and 97% of PB and MB patients, respectively. Based on U-MDT/CT-BR results, classification of leprosy patients for treatment purposes is unnecessary because it does not impact clinical and laboratories outcomes. In this context, the identification of new biomarkers to detect patients at a higher risk to develop leprosy reactions or relapse remains an important research challenge.     

Who is not using condoms among HIV-positive patients in treatment in the largest city in Brazil?

Data on risky sexual behaviors in people living with HIV/AIDS (PLWHA) is still scarce in some populations around the world. The purpose of this study was to assess the factors associated with the use of condoms in a representative sample of PLWHA in outpatient treatment in the city of São Paulo. Six hundred and sixty-seven HIV-positive patients (383 men and 284 women) who were being treated at eight centers participated in this study. Data were collected using a sociodemographic survey, the Beck depression and anxiety inventories, a survey of alcohol and other drugs use, the Alcohol Use Disorders Identification Test, a sexual behavior survey, and the Sexual Risk Behavior Assessment Schedule. The majority of study participants were sexually active (almost 62% of the sample had at least one sexual partner in the last three months), and at least one-fourth engaged in unsafe sex (25.3% did not use condoms during at least one instance of anal and/or vaginal intercourse in the past three months). Multivariate logistic regression showed that engaging in unprotected sex was more likely among females (p < .001), persons with an HIV-positive partner (p < .001), and people using cannabis before sex (p = .002). These findings should stimulate health-care workers to create specific groups for women, seroconcordant couples, and cannabis users to discuss condom use, as they seem to be vulnerable groups.