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- Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A SurveyPublication . Řasová, Kamila; Freeman, Jenny; Cattaneo, Davide; Jonsdottir, Johanna; Baert, Ilse; Smedal, Tori; Romberg, Anders; Feys, Peter; Alves-Guerreiro, José; Habek, Mario; Henze, Thomas; Santoyo-Medina, Carme; Beiske, Antonie; Asch, Paul Van; Bakalidou, Daphne; Salcı, Yeliz; Dimitrova, Erieta; Pavlíková, Markéta; Štětkářová, Ivana; Vorlíčková, Jana; Martinková, PatriciaBackground: Guidelines and general recommendations are available for multiple sclerosis rehabilitation, but no specific guidance exists for physical therapists. Describing aspects of physical therapy content and delivery in multiple sclerosis and its determinants and analysing whether general recommendations connected with physical therapy are implemented in practice is important for interpreting clinical and research evidence. Methods: An online cross-sectional survey of physical therapists specialized in multiple sclerosis (212 specialists from 26 European countries) was used. Results: There was distinct diversity in service delivery and content across Europe. Perceived accessibility of physical therapy varied from most accessible in the Western region, and least in the Southern region. Sixty-four physical therapists adjusted their approach according to different disability levels, less so in the Eastern region. Duration, frequency and dose of sessions differed between regions, being highest in Southern and Western regions. “Hands on treatment” was the most commonly used therapeutic approach in all apart from the Northern regions, where “word instruction” (providing advice and information) prevailed. Conclusions: The content and delivery of physical therapy differs across Europe. Recommendations concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice.
- Should Children Drink Water with Very Low Mineral Content? Implications of the Global Expansion of Water Filtration Systems and Relevance of Consumption of Water with Higher Mineralization LevelsPublication . Pereira, Cidália D.; Martins, Maria JoãoThe consumption of water with very low mineral content (W-VLMC; water with total dissolved solids below 50 mg/L), despite limited and inconsistent evidence and the resulting knowledge gaps, has not been associated with health risks for the general population. However, certain population subgroups (those eating very unbalanced diets or avoiding certain foods, engaged in prolonged periods of fasting, and/or doing prolonged or strenuous exercise as well as pregnant or breastfeeding women) should be mindful of maintaining sufficient intake of all essential minerals through their food if regularly using this type of water as their main beverage. The rapid expansion of water filtration systems—often producing W-VLMC—creates a timely and valuable opportunity to advance research on the health implications of W-VLMC intake. As these systems become increasingly common in educational settings and homes, children represent a subgroup experiencing rising exposure to W-VLMC. Additional studies are needed to assess the health effects of such exposure from early childhood. A complementary yet contrasting perspective is that the use of water intended for human consumption—with stringent quality control standards—and natural mineral waters—inherently pure, thus eliminating the need for filtration—with higher mineralization in both types of water, may provide an additional dietary source of essential minerals, especially for all the population subgroups mentioned above.