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Metabolic imprinting refers to lasting metabolic changes from early-life environmental exposures, especially nutritional, that impact adult health and chronic disease risk. We investigated whether metabolic imprinting by small litter size (SL) activates interscapular brown adipose tissue (iBAT) and affects glucose and lipid metabolism, oxidative damage, and insulin resistance (IR) in young rats exposed to a high-sucrose diet (HSD) over eight weeks. Male Wistar rats (n = 48) were assigned to control (eight pups/ dam; CL) and small litter (four pups/ dam; SL) groups. Post-weaning (21 days), they were divided into four dietary groups: (i) standard diet (STD, chow diet) from CL, or (ii) SL; (iii) HSD (30% sucrose) from CL, or (iv) SL, for eight weeks. Afterward, animals were euthanized for analysis of iBAT and serum samples. HSD caused hypertrophy, IR, and oxidative damage in iBAT. However, the SL model attenuated HSD-induced IR by up-regulating p-AKT (Ser 473) and activating iBAT thermogenesis, resulting in decreased PGC1-α expression and up-regulating UCP1 expression, which contributed to iBAT hyperplasia. Additionally, SL reduced PKA activation and free fatty acid (FFA) release, decreasing the lipid oxidative damage observed in HSD-fed iBAT. These findings suggest that SL-induced metabolic imprinting enhances iBAT thermogenesis through p-AKT (Ser 473) and PGC1-α signaling, increases UCP1 expression, and reduces PKA substrates phosphorylation, decreasing FFA levels and oxidative damage following HSD exposure. While our results challenge the existing literature, we propose that the metabolic plasticity from the SL model allows rats to adapt to dietary variations and may protect against HSD-induced IR in adulthood.
The concept of total suffering is widely recognized in palliative care (PC), encompassing a range of interconnected and complex factors that collectively shape the evolving and individualized experience of a patient’s illness journey. Studies on will to live (WtL) in terminally ill patients have demonstrated its variability over time and various factors that influence these changes.
Methods
To objectively investigate the concept of total suffering and WtL; including their fluctuation over time and associations with sociodemographic, clinical, physical, and psychological symptoms in a sample of individuals with life-limiting conditions receiving PC. This multicenter Iberian study involved 3 centers in Portugal and 1 in Spain. A total of 107 individuals with life-limiting conditions consented to participate. To capture the dynamic and multifaceted components of total suffering, we had each participant completed the Edmonton Symptom Assessment Scale (ESAS) along an additional WtL visual analogue once daily over a 30-day period.
Results
WtL demonstrated various patterns over time. While some patterns reflected relative stability, other demonstrated substantive fluctuation during the course of illness. Significant correlations were observed between WtL and all other ESAS items. Moderate positive correlations were found between WtL and total ESAS score and its physical and psychological sub-scores. Spearman’s correlation coefficients between all physical and psychosocial items on the ESAS were statistically significant across all 45 correlations performed, with only 5 showing moderate strength; the remaining correlations were weaker.
Significance of results
Evidence-based understanding of WtL is critical to improving care for patients who experience suffering toward end-of-life and their families. Further research is needed to inform and refine interventions targeting total suffering.
This study aimed to evaluate the association between food addiction (FA), food environment and consumption of ultra-processed foods (UPF) in socially vulnerable women.
Design:
A population-based cross-sectional study was conducted in Favelas and Urban Communities of Maceió-Brazil. The availability of UPF in the food environment was evaluated through the audit of retailers with the support of the AUDITNOVA instrument. The women taking part in the study were interviewed, and a 24-hour food recall was used to assess the proportion of UPF in their diet. The modified Yale Food Addiction Scale 2.0 was also used to determine FA. Association analysis was performed using binary logistic regression and generalised estimation equations.
Participants:
1702 adult women of reproductive age (20–44 years) residents in Favelas and Urban Communities.
Results:
It was found that 14·6 % of the women had FA. The adjusted multivariate association analysis showed that the high availability of UPF in food retail increased the chance of women having FA by up to 47 % (P= 0·02 OR: 1·53; 95 % CI: (1·07, 2·18)). It was also possible to observe that the greater calorific contribution of UPF in the diet increased the chance of women presenting FA by up to 61 % (P< 0·01 OR: 1·39; 95 % CI: (1·48, 1·97)).
Conclusions:
The environment and what is available in it are associated with additive behaviour independent of individual factors, and UPF consumption increases the chance of FA. This demonstrates the need for changes in the food environment in Brazilian favelas, contributing to improving women’s health.
This study aimed to explore combinations of the Brazilian front-of-package nutrition labelling (FoPNL) (high in added sugar, saturated fat or sodium) and/or three specific food additives with cosmetic functions (colourings, flavourings and non-sugar sweeteners) in packaged foods and beverages marketed in Brazil. This approach intends to strengthen the identification of ultra-processed food products (UPFP) by consumers through the information available on their labels. A cross-sectional study was carried out using data from the list of ingredients and the nutrition facts panel on labels of processed foods and UPFP available in Brazilian supermarkets between April and July 2017, totalling 8436 food items assessed, of which 84·0 % were UPFP. Of the total, 62·7 % of the UPFP would have the FoPNL and 65·1 %, 37·9 % and 12·9 % had flavouring, colouring and non-sugar sweeteners, respectively. Combining criteria for the FoPNL with any one of the three cosmetic additives analysed, 45·9 % of the UPFP were identified, and when considering the presence of the FoPNL, flavouring, colouring or non-sugar sweeteners, the identification increased to 89·9 %. Results showed that the current FoPNL in Brazil does not facilitate the identification of UPFP. In this sense, labels that indicate the presence of food additives with cosmetic functions (which are UPFP markers) could be a public health strategy to reduce the consumption of UPFP. Currently, food labelling regulations in Brazil are not aligned with Brazilian Dietary Guidelines recommendations.
Schistosomiasis, a parasitic disease caused by Schistosoma species, remains highly prevalent in tropical regions, where it contributes significantly to hepatic and vascular complications. Despite the well-established role of parasitic eggs in driving inflammation and organ damage, the specific vascular mechanisms remain poorly understood. Given the role of angiogenesis and vascular remodelling in tissue repair, the angiopoietins (ANGs) could be promising biomarkers to evaluate disease progression. This study aims to explore the relationship between ANG levels with parasitic load in patients with schistosomiasis. In this cross-sectional study, 126 schistosomiasis patients were stratified into three groups based on parasitic egg burden: negative, low, and moderate/high. Demographic, clinical, and laboratory data were collected, and serum ANGs were quantified via enzyme-linked immunosorbent assays. Parasitic load was assessed through stool examination, quantifying the number of Schistosoma eggs per gram of faeces. Additional clinical parameters, including liver abnormalities and blood chemistry, were evaluated. The ANG-2 levels and the ANG-2/ANG-1 ratio were significantly elevated in patients with higher egg burdens, particularly in the moderate/high group. The ANG-2/ANG-1 ratio was notably higher in patients with hepatosplenic schistosomiasis. While systemic blood pressure and oxygen saturation showed no significant differences between groups, patients with elevated triglycerides had lower ANG-2 levels. Elevated ANG-2 levels and an increased ANG-2/ANG-1 ratio correlate with higher parasitic burdens, reinforcing their potential as biomarkers for disease severity. These findings underscore the role of egg-induced inflammation in schistosomiasis pathophysiology and suggest that ANGs could aid in early diagnosis and treatment decisions, particularly in populations with high parasitic loads.
Gastroesophageal reflux disease (GERD) is a prevalent condition observed across various medical specialties, including gastroenterology, otorhinolaryngology, surgery and primary care. Despite the routine prescription of proton pump inhibitors, some patients fail to experience adequate symptom relief. This review delves into the multifactorial mechanisms of reflux, which extend beyond hydrochloric acid to include pepsin, bile acids and trypsin. These factors significantly contribute to mucosal injury in GERD and are influenced by dietary composition. Moreover, dietary patterns with anti-inflammatory properties, such as the Mediterranean and dietary approaches to stop hypertension diets, have shown potential in GERD managing, particularly in the context of obesity–an important risk factor.
This study describes a new species of Pharyngodon Diesing, 1961 (Nematoda: Pharyngodonidae) in teiid lizards Ameivula ocellifera (Spix, 1895) (Squamata: Teiidae) from a Caatinga morphoclimatic domain in the state of Pernambuco, Brazil. Pharyngodon ameivulum n. sp., like 11 other species of the genus, features males without spicules, females with truncated eggs, and no tail spines. However, the new species is distinguished by a unique set of morphological characteristics, such as males possessing three pairs of caudal papillae, with the first pair precloacal, the second adcloacal, and the third postcloacal (arrangement 1:1:1), the second pair (adcloacal) of papillae having a bifurcated distal end, and females with lateral body alae. Molecular analysis of the 18S rDNA, 28S rDNA, and 18S + 28S concatenated sequences genes reveals that P. ameivulum n. sp. clusters with representatives of Pharyngodonidae from the genera Skrjabinodon Inglis, 1968 and Spauligodon Skrjabin, Schikhobalova & Lagodovska, 1960, forming a basal clade to the clade composed of Spauligodon spp. and Skrjabinodon trimorphi Ainsworth, 1990. These are the first phylogenetic assays to include a species of Pharyngodon.
To evaluate the relationship between the food environment in favelas and the presence of arterial hypertension and diabetes among women in the context of social vulnerability.
Design:
A cross-sectional and partially ecological population-based study was conducted in a Brazilian capital city. The healthiness and availability of ultra-processed foods in the food environment were assessed through retailer audits using the AUDITNOVA instrument. The presence of diabetes and arterial hypertension was evaluated based on self-reported prior medical diagnosis. Logistic regression models were applied using generalised estimating equations, adjusted for age, education, race/skin colour and poverty status.
Participants:
1882 adult women of reproductive age (20–44 years).
Results:
It was found that 10·9 % of women were hypertensive and 3·2 % had diabetes. The likelihood of having diabetes and arterial hypertension decreases with higher levels of healthiness in the food environment (diabetes (OR: 0·25; 95 % CI: 0·07, 0·97)/arterial hypertension (OR: 0·45; 95 % CI: 0·24, 0·81)) and increases with greater availability of ultra-processed foods in their living area (diabetes (OR: 2·18; 95 % CI: 1·13, 4·21)/arterial hypertension (OR: 1·64; 95 % CI: 1·09, 2·47)).
Conclusions:
These results suggest that characteristics of the consumer food environment have a significant effect on the occurrence of chronic diseases among socially vulnerable women, adding to the existing evidence in the literature and highlighting the need for integrated health care.
Understanding the processes that allow phylogenetically related plant species coexist is important to understand the ecological and evolutionary processes that structure biological communities. In this study, we investigated how the species Erythroxylum simonis, Erythroxylum pauferrense and Erythroxylum citrifolium share ecological niche dimensions according to the abiotic characteristics of their environments of occurrence. To this end, in ten pre-established plots in an Atlantic Forest remnant in northeastern Brazil, we carried out a population survey of the three species and characterised their abiotic niche by measuring light availability, humidity and the physical–chemical properties of the soil. We used generalised linear models to test whether abiotic variables influence species abundance. Our results indicate that the three species coexist along the different environmental gradients, with some level of niche overlap. The species E. simonis is the best competitor, showing generalist behaviour and the highest abundance in all environmental gradients. We emphasise that the adult populations of the species have adapted to various environmental and ecological challenges. Thus, the results reported are influenced by their ability to perform well in terms of physiology, growth and survival in their early-life stages.
Cross-sectional study investigated the association of fresh or minimally processed foods and ultra-processed food consumption with symptoms of depression, anxiety and stress in students from a Brazilian public university. Undergraduate students admitted in 2022 answered an online questionnaire during their first semester. Consumption of 12 subgroups of fresh or minimally processed foods and 13 of ultra-processed foods on the previous day were investigated (affirmative answer for ≥ 5 subgroups was classified as high consumption). Depression, anxiety and stress were investigated using the DASS-21 and mild to extremely severe symptoms were grouped to be compared with individuals without symptoms. Adjusted logistic regression models estimated the Odds Ratio (OR) of the association between symptoms of depression, anxiety and stress (outcomes) and food consumption (exposures), with a significance level of 5%. A total of 924 students were evaluated, of whom 57.7% presented symptoms of depression, 51.9% of anxiety and 59.4% of stress. A high consumption of fresh or minimally processed foods was observed in 80.3% of the students, with a higher frequency among those without symptoms of depression, anxiety, and stress, while 38.9% showed a high consumption of ultra-processed foods, without differences according to symptoms. High consumption of fresh or minimally processed foods was associated with a lower likelihood of symptoms of depression (OR: 0.62; p=0.011), anxiety (OR: 0.58; p=0.003) and stress (OR: 0.69; p=0.043). No association was found between ultra-processed and mental health outcomes. Actions that support and encourage the consumption of healthy food in the university environment can contribute to mental health outcomes.
The aim of this study was to evaluate the production performance and the occurrence of histomorphometric changes in the digestive, hepatic and renal systems of goats fed with a diet containing different contents of 25 and 55% spineless cactus (Nopalea cochenillifera (L.)) and with partial or total restriction of drinking water. A total of 35 castrated male goats were used, with an average initial body weight of 19 + 1.4 kg, an average age of 8 months and distributed into five treatments: control (CON): 0.8 Tifton-85 hay and 0.2 concentrate with access to drinking water; 0.25 spineless cactus with access to drinking water (25ADW); 0.25 spineless cactus without access to drinking water (25NDW); 0.55 spineless cactus with access to drinking water (55ADW) and 0.55 spineless cactus without access to drinking water (55NDW). Ruminal and intestinal morphometry, liver glycogen reserve index, duodenal goblet cell index and liver and kidney histopathology were carried out. In the treatment with 0.25 spineless cactus and 0.55 Tifton-85 hay, dry matter intake increased by 26%. The papilla absorption area showed that the 0.55 spineless cactus content provided a larger area (P < 0.05) compared to the 0.25 content and the control. It can be concluded that spineless cactus (N. cochenillifera (L.)) can be used in the diet of goats at a concentration of up to 0.55, associated with Tifton-85, with or without access to drinking water, without causing losses in animal performance or at ruminal, intestinal, hepatic or renal level.
The article analyses an original database of 177 Latin American women activists killed that had some connection with feminist social movements from 2015 to 2023. A growing body of literature has focused on the killings of socio-environmental activists in Latin America and where they occurred. However, their activisms are under-researched, precisely because feminist social movements and activists have frequently been killed while advocating for women’s rights in the subcontinent. This article focuses on the circumstances, a few reasons portrayed in newspaper events, and the perpetrators of such violence. Based on a literature review, I argue that taking into account the recent narcodynamics of the region, it is possible to understand such violence within the context of drug-related violence, but also—and more likely—to consider those killings as political feminicides. Political feminicides are then examined largely through transfeminicides and peasant/communitarian activists.
The use of forage as a cover crop is an alternative for the sustainable management of conilon coffee (Coffea canephora Pierre ex Froehner) crops. The objective of this study was to evaluate the herbage accumulation and nutritive value of forages used as cover crops and their effect on the productivity and physiology of conilon coffee plants. The inter-row management assessed were 1- Congo grass [Urochloa ruziziensis (R. Germ. & C.M. Evrard) Crins], 2- Mombaça guineagrass [Megathyrsus maximus (Jacq.) B.K. Simon & S.W.L. Jacobs], 3- Marandu palisadegrass [Urochloa brizantha (Hochst. ex A.Rich.) R.D.Webster], 4- weeds, 5- weeding and herbicide application. The experiment was conducted in 2020 and 2021 using a randomized block design (split-plot) with four replications and a plot size of 24 m2. Herbage accumulation of Congo grass, Mombaça guineagrass and Marandu palisadegrass (1.12 to 3.81 t/ha) were higher than weeds (0.18 to 1.95 t/ha) in seven periods evaluated. Mombaça guineagrass had the highest average herbage accumulation (1.47 to 3.81 t/ha). The forage cover crops did not differ among themselves for dry matter concentration, crude protein and C:N ratio in three periods evaluated. The inter-rows management with cover crops did not reduce productivity, grain/fruit ratio, grain size, vegetative vigour and physiology of the coffee plants compared to the management with weeding and herbicide in 2021. In 2022, they stagnated or reduced productivity by up to 49%, with changes in plant physiology. Adjustments in the management of cover crops are needed for the development of competitive and sustainable coffee crops.
This study aimed to assess hemoglobin concentration and its association with oral contraceptive (OC) use, food insecurity (FI) and dietary iron availability (DIA) in adult women of reproductive age (20–44 years). This is a population-based cross-sectional study that analysed 505 women living in favelas and urban communities in a capital city in northeastern Brazil. Hemoglobin concentration was determined using capillary blood samples. FI and DIA were assessed using the Brazilian Food Insecurity Scale and the 24-h food recall, respectively. Association analysis was carried out using logistic regression. A directed acyclic graph (DAG) was designed to illustrate the causal paths between hemoglobin concentration and DIA. A significance level of 5 % was adopted. Low hemoglobin concentrations (11·2 g/dl: (1·79)) and a high prevalence of anaemia (64·0 %) were observed; 28·7 % used OC (28·7 %) and 76·4 % were in FI. An average energetic intake of 1495 kcal/d (482·0) and 0·46 mg/d (0·27) of DIA were also observed. In the DAG-guided multivariable analysis, it was observed that hemoglobin concentrations ≥ 12 mg/dl were directly associated with higher DIA (OR: 1·67; 95 % CI (1. 08, 2·59)) and OC use (OR: 1·67; 95 % CI (1·10, 2·55)) and inversely associated with mild FI (OR: 0·60; 95 % CI (0·37, 0·96)) or severe FI (OR: 0·37; 95 % CI: (0·18, 0·76)). Women taking OC and with a higher DIA were less likely to have low hemoglobin concentrations, while those in the context of FI were in the opposite situation.
Over the last few years, during the pandemic, the Brazilian population has suffered several problems, ranging from health to socioeconomic impacts. When we consider Brazilian science, there has been an undeniable scientific delay generated by the pandemic, especially in areas that are not related to the coronavirus. In this context, with the aim of fostering collaboration among researchers in the field of Developmental Origins of Health and Diseases (DOHaD) and enhancing the potential for implementing public health strategies to prevent noncommunicable chronic diseases, the Brazilian Association of Developmental Origins of Health and Diseases (DOHaD Brazil) was established in 2020. In this narrative, we explore the effects of the COVID-19 pandemic in Brazil, focusing on its impacts on scientific research conducted in universities. Additionally, we underscore the significance of the DOHaD Brazil Association, particularly from the perspective of young researchers engaged in DOHaD research in Brazil.
Individuals with mental health disorders often lack access to appropriate care, including psychosocial rehabilitation programs, which are considered essential for their recovery. In 2019, as part of the intervention by the Community and Mental Health Service, at Hospital de Magalhães Lemos, we initiated a psychoeducational group for patients with psychotic spectrum disorders, with the purpose of providing our patients with comprehensive information about their condition and effective management strategies. Our 8-week program consisted of 16 sessions, including icebreaker activities, discussion of certain themes, sharing of experiences and practice of stress management techniques.
Objectives
The aim of this study was to assess and quantify the impact of our 2023 program.
Methods
Out of a total of 20 patients interviewed for our program in 2023, 16 began the program and 12 completed it. The program’s evaluation was based on several assessment tools, including a sociodemographic questionnaire, a knowledge assessment questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Insight and Treatment Attitudes Questionnaire (ITAC), the World Health Organization Quality of Life (WHOQOL), and the Medication Adherence Rating Scale (MARS). We also created a health agenda to organize an individual plan of care.
Results
Our findings indicated an improvement in insight and attitudes towards treatment by 8.6%, an enhancement in treatment adherence by 5%, and an increase in knowledge by 11.9%. In terms of quality of life, we observed a slight improvement in the psychological domain by 0.6% and in the social domain by 1.2%. Regarding the impact on psychotic symptomatology, there was an average decrease in 4 points in the negative subscale and in 3 points in the general psychopathology subscale, whereas the positive subscale remained unchanged. None of the patients required hospitalization during this period.
Conclusions
Our study revealed some improvement in nearly all the evaluated parameters. There was an improvement of the therapeutic relationship, which we believe has contributed to lower scores in the negative symptoms and general psychopathology subscale. As for the study limitations, we acknowledge that we will need to expand our sample through additional programs in the next years, to include it in early intervention psychosis programs and to re-evaluate our patients’ outcomes after a more extended follow-up period, particularly if they continue to participate in our monthly mutual support group. Additionally, we must consider potential study biases, including the subjectivity of PANSS evaluations and the influence of other confounding factors, such as changes in treatment regimens during the program.
The aim of this study is to assess the effects of substituting soybean meal with extruded urea in the diet of crossbred Texel x no defined racial pattern lambs under continuous grazing on Brachiaria ssp., focusing on both their productive and nutritional performance. 60 Texel crossbred lambs (12 animals for each treatment) were used, with an average initial weight of 20.7 ± 0.87 kg and an average age of 2.5 ± 0.70 months, fed treatments with increasing levels of UE (Urea extruded Amireia® 200S): 0; 6; 12; 18 and 24 grams of EU 100/kg of body weight, with trial period was 5 months, using the multivariate technique. The data were subjected to principal component and canonical discriminant analysis to check possible differences between the evaluated treatments and identify the variables that best discriminate and use these variables to create a discriminant function that represents the differences between treatments. Of the 12 variables initially used, we observed that 9 were used by the main components, but 6 were those that presented the greatest discriminatory power for the study. Main component 1 was characterized by biometric measurements and showed the greatest power of variation in the study (60%), followed by main component 2, represented by slaughter weight and empty body weight (13%). These correlations indicate that biometric measurements can serve as reliable indirect indicators for estimating carcass traits in sheep, offering a practical alternative to visual assessments.
Sucrose yield in sugarcane is a complex process regulated by both environmental and endogenous factors. However, the metabolic balance driving vegetative growth and sucrose accumulation remains poorly understood. Herein, we carried out a comprehensive assessment of carbohydrate dynamics throughout the crop cycle in two sugarcane varieties varying in biomass production, evaluating the carbon metabolism in both leaves and stalks. Our data revealed that the decline in photosynthetic rates during sugarcane maturation is associated not only to accumulation of sugars in leaves but also due to stomatal and non-stomatal limitations. We found that metabolic processes in leaves and stalks were intrinsically linked. While IACSP94-2094 had higher stalk sucrose concentration than IACSP95-5000, this latter produced more biomass. Compared to IACSP95-5000, IACSP94-2094 showed higher sucrose phosphate synthase (SPS) activity in leaves and stalks, along with lower soluble acid invertase (SAI) activity in leaves during the maximum growth stage. Interestingly, IACSP94-2094 also exhibited higher stalk SPS activity and lower stalk SAI activity than IACSP95-5000 during maturation. High biomass production by IACSP95-5000 was associated with higher sucrose synthase (SuSy) and SAI activity in leaves and higher SuSy and soluble neutral invertase (SNI) activity in stalks when compared to IACSP94-2094 during the maximum growth. Despite the contrasting strategies, both varieties displayed similar total sucrose yield, a balance between sucrose concentration and biomass production. This phenomenon implies the presence of a compensatory mechanism in sugarcane, with high biomass production compensating low sucrose accumulation and vice versa.
Immersive technologies have the potential to control cognitive and behavioural symptoms in people with dementia. A safe environment can be designed through a specific interactive scenario, according to the preferences and experiences of each user.
Objective:
Mapping neuro-emotional responses during the interactive scenario therapy experience in a case study, with dementia, using electroencephalography (EEG).
Methods:
A participant, 78 years old and diagnosed with moderate to severe Alzheimer's disease (female; Mini Mental State Examination score of 17 points; frontal assessment battery score of 8 points), underwent EEG analysis (EMOTIV EPOC X) using a protocol with interactive scenarios tailored to the participant's needs and preferences, the scenarios were designed from reminiscence strategies. The protocol included a stimulus that alternated between motor and cognitive activities (3 minutes), and breath-centered relaxation (1 minute). The scenarios used in this study were: setting up a living room; composing a cake recipe; shopping in the market to make a cake; looking for objects in the park; organizing a birthday party. These variables are provided, on a scale of 0 to 100, after processing by the algorithms of the EmotivPRO v3.0 software.
Results:
The values found in the EEG analysis will be described without stimulus and with stimulus respectively. Thus, engagement (68.57 to 71.86); arousal (57.86 to 49.86), focus (61.57 to 57.00), interest (54.86 to 49.57), relaxation (33.86 to 30.86), and stress (53.71 to 43.00). The EEG data showed an increase in engagement when the patient was stimulated (68.57 to 71.86). Relaxation also increased (30.86 to 33.86) when the stimulus was removed. The stress level, as analysed by the EEG, was also higher in the period without stimulus and reduced in the period with the stimulus (53.71 to 43).
Conclusion:
During a stimulus period in interactive therapy, there was an increase in engagement, which was related to an increasing focus during the stimulus. Lower values were observed compared to the period without stimulus, indicating a period of recovery after a period of concentration/arousal. Therefore, therapy with an interactive and familiar scenario, using a circuit of stimulus-breathing exercises, promotes a positive and adequate neuro-emotional response in a person with dementia.