Background Most of the Brazilian population relies on public healthcare and stroke is a major cause of disability in this country of continental dimensions. There is limited information about access to rehabilitation after stroke in Brazil. Objective To provide comprehensive information about Access to Rehabilitation After discharge from public hospitals in Brazil (AReA study), up to 6 months after stroke. Methods The present study intends to collect information from 17 public health centers in 16 Brazilian cities in the 5 macroregions of the country. Each center will include 36 participants (n = 612). The inclusion criteria are: age ≥ 18 years old; ischemic or hemorrhagic stroke, from 6 months to 1 year prior to the interview; admission to a public hospital in the acute phase after stroke; any neurological impairment poststroke; patient or caregiver able to provide informed consent and answer the survey. Patients can only be recruited in public neurology or internal medicine outpatient clinics. Outcomes will be assessed by a standard questionnaire about rehabilitation referrals, the rehabilitation program (current status, duration in months, number of sessions per week) and instructions received. In addition, patients will be asked about preferences for locations of rehabilitation (hospitals, clinics, or at home). Trial Status The study is ongoing. Recruitment started on January 31st, 2020 and is planned to continue until June 2022. Conclusion The AReA study will fill a gap in knowledge about access to stroke rehabilitation in the public health system in different Brazilian regions.
Background: Preliminary evidence suggests that access to multidisciplinary rehabilitation is insufficient after hospital discharge of individuals with stroke. Objective: The AReA study intends to collect data about access to rehabilitation in different Brazilian regions. Methods: Seventeen public health centers will participate in the study. Each center will include 36 participants (n = 612). Patients with 6 months and less than oneyear post-ictus, age ≥18 years-old, stroke confirmed by CT or MRI and with any neurological impairment after stroke will be included. In each center, researchers will train the team on the application of the Brazilian versions of the Rankin Modified Scale and the NIH Stroke Scale. The survey consists of the following questions: 1. In the first 6 months after discharge from stroke, were you treated by a Physiatrist /Physiotherapist / Speech / Neurologist / Psychologist / Occupational Therapist?; 2. Has a treatment program been established?; 3. Has this program been or is it being carried out?; 4. On discharge, have you been referred to any rehabilitation service?; 5. Did you look for any service on your own?; 6. Did you receive any guidance about stroke?; 7. Considering that rehabilitation would be indicated for its improvement, how would you like it to be carried out (hospitals, centers, home)? Results: At the moment, 13 centers obtained ethical approval, and three of them started data collection (n=55). Conclusion: The results of this project will be relevant to plan strategies for effective rehabilitation within the Unified Health System in Brazil.
Introduction: Child development is a period of progressive and complex transformations related to growth, maturation, learning, motor skills, and psychosocial issues. Objective: Analyze the influence of obesity on the aspects of motor development and quality of life of children aged three to eight years, and and their mothers’ levels of anxiety and depression. Methods: Cross-sectional descriptive and quantitative approach study with children enrolled and attended at a pediatric endocrinology in Fortaleza, CE, in the period between June and November 2017. The study sample consisted of 24 children from three to eight years of age. We used the anthropometric quantification, the Motor Development Scale, and the Pediatric Quality of Life Inventory (PedsQL™) for children. We applied the Beck anxiety and depression questionnaires for mothers. Results: 16 were female, and 17 were severely obese. Most of the sample showed motor development changes 42,85% classified as “inferior” in the obesity category, and 41.17% in the severely obese category. Both groups revealed”complete right-handed” and “undefined” laterality in around 40% of the individuals. The quality of life had a low mean score. The majority of mothers from both groups presented minimal anxiety and depression. Conclusions: Obesity interferes negatively with the overall motor development, determination of laterality, and quality of life of children, perceiving more severe levels of anxiety and depression in mothers of children severely obesity.
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