Evaluation of the effect of melatonin in patients with Burning mouth syndrome: a double-blind, placebo-controlled randomized clinical trial

Abstract The present study was carried out to evaluate the effect of Melatonin and Placebo in the patient with the Burning mouth (BMs). This double-blind, placebo-controlled randomized clinical trial study was carried out on 30 patients who were suffering from BMS. During this period patients were divided into 2 study and control groups. The study group used four 3 mg Melatonin daily and the control group received a placebo. Then the severity of the burning sensation was measured by the physician Sleep quality was measured using the VAS scale using the Petersburg questionnaire. Data in the application Enter SPSS 20 and then using T test or equivalent Nonparametric was analyzed, mean sleep score and mean severity of oral irritation before and after treatment in two the group was evaluated using T-test Independent. Level significance was considered 0.05. The results of the present study show that the use of melatonin and a placebo in patients with BMS reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study severity of burning was 4.93±2.56 after treatment in the study group and 6.93±2.12 in the control group, which was statistically significant (P =0.036). No significant difference was observed between the two groups in the sleep quality score (P-value = 0.43). Using Melatonin can be a reliable way to treat pain for which there is no standard treatment to date. Although evidence suggests an association between sleep disorders and BMS, melatonin was not superior to a placebo in reducing BMS-induced burning in the present study. Identification of stressors and the ways to struggle with them, further studies with larger samples and higher oral doses, extended follow-up periods and control of psychological factors, and measurement of body mass index that may affect pharmacokinetics are recommended.

Patient safety culture from the perspective of employees in a university hospital

Abstract Safety culture is a product of values, attitudes, skills, and behavioral patterns, and it determines the commitment of the management to a secure organization. The evaluation of safety culture in hospitals helps to identify and manage the relevant patient safety issues in hospital routines and working conditions proactively. Thus, this study is aimed to evaluate patient safety culture in all the departments of a university hospital of medium complexity. This study employed a cross-sectional and analytical design employed in the Portuguese version of the Hospital Survey on Patient Safety Culture. A sample of all hospital staff participated in this study, which was conducted from December 2016 to May 2017. The percentage of positive responses was calculated to identify the strong and weak areas in patient safety. Of the 413 questionnaires distributed, 368 valid responses were returned. The response rate was, therefore, 89%. The overall percentage of positive responses was 50.3%. The "Supervisor/manager expectations and actions promoting patient safety" dimension obtained the highest percentage of positive responses (67.1%). The "Nonpunitive response to error" dimension was considered the weakest for safety culture, with only 22.9% positive responses. Furthermore, most professionals (70.6%) did not report any events in the previous 12 months. Nevertheless, 69.5% of participants considered patient safety within their unit/work area as "very good" or "great." The results showed that the employees' perception of patient safety diverged from the reality within the institution. Therefore, efforts should be made to promote an acceptable safety culture in all hospital areas.

[Patient owner surveys in small animal medicine - importance, benefits and pitfalls in planning, execution and analysis]. / Patientenbesitzerbefragungen in der Kleintiermedizin ­ Bedeutung, Nutzen und Fallstricke bei Planung, Durchführung und Auswertung.

OBJECTIVE: In the present study, the benefits and difficulties of planning and conducting patient surveys in veterinary medicine were examined using 2 examples. One focus was placed on the comparison of the subjective assessment and perception of patient owners with regard to long-term investigation of disease progression. STUDY POPULATION: An owner survey was conducted in dogs with chronic enteropathy (CE) and degenerative mitral valve disease (DMVD). In both surveys, the case system of the Clinic for Small Animals of the University of Veterinary Medicine Hannover was used to identify suitable cases based on appropriate diagnoses. Owners were contacted and invited to complete (digitally or postally) a multipart questionnaire on their dogs. The results of the survey were evaluated regarding their agreement with literature data. Based on the results of this evaluation, the study design, reliability of owner perception and the benefit of the survey were examined critically. RESULTS: The search in the clinic's case system provided 125 suitable cases for CE and 145 for DMVD. A total of 81 (CE, response rate 64.8 %) and 72 (DMVD, response rate 49,7 %) owners answered the questionnaire. The owners provided considerably different information concerning the diagnostic examination of their animals. While the statements on the course and forms of disease in CE corresponded to the information from the literature, this was not always the case with DMVD. CONCLUSION AND CLINICAL RELEVANCE: Patient owner surveys may provide important information about disease progression from the owner's perspective. This is particularly valuable in chronic diseases, the management of which requires good owner compliance. An identical approach to patient selection may lead to results differing in their informative value depending on the disease.

Content analysis of clinical questions from Australian general practice which are prioritised for answering: identifying common question types and perceived knowledge gaps.

Perceived knowledge gaps in general practice are not well documented but must be understood to ensure relevant and timely evidence for busy general practitioners (GPs) which reflects their diverse and changing needs. The aim of this study was to classify the types of questions submitted by Australian GPs to an evidence-based practice information service using established and inductive coding systems. We analysed 126 clinical questions submitted by 53 Australian GPs over a 1.5-year period. Questions were coded using the International Classification of Primary Care (ICPC-2 PLUS) and Ely and colleagues' generic questions taxonomy by two independent coders. Inductive qualitative content analysis was also used to identify perceived knowledge gaps. Treatment (71%), diagnosis (15%) and epidemiology (9%) were the most common categories of questions. Using the ICPC-2 classification, questions were most commonly coded to the endocrine/metabolic and nutritional chapter heading, followed by general and unspecified, digestive and musculoskeletal. Seventy per cent of all questions related to the need to stay up-to-date with the evidence, or be informed about new tests or treatments (including complementary and alternative therapies). These findings suggest that current guideline formats for common clinical problems may not meet the knowledge demands of GPs and there is gap in access to evidence updates on new tests, treatments and complementary and alternative therapies. Better systems for 'pulling' real-time questions from GPs could better inform the 'push' of more relevant and timely evidence for use in the clinical encounter.

Reclassification of the work-related stress questionnaires scales based on the work system model: A scoping review and qualitative study.

BACKGROUND: Given the wide variety of factors affecting work-related stress, a work system approach could be adopted in order to better identify factors that impact individual stress. OBJECTIVES: To provide a scoping review of the available work-related stress questionnaires and to reclassify their scales on the basis of the five elements included in the work system model using a content analysis method. METHODS: The main available work-related stress questionnaires used in previous studies in the time range of 1975 to 2017 were collected through a search in several indexing and citation databases. To reclassify the scales of these questionnaires, a qualitative content analysis was used and then reclassified in accordance with the five components of work system model: job (tasks), organizational condition, individual characteristics, technology and tools, and physical environmental. RESULTS: In total, 22 questionnaires met the conditions required to be entered into the final stage of the study. Emphasis of these questionnaires was on measuring job-related factors and organizational condition-related factors. 22.7% of them had considered no scales to measure the individual characteristics-related factors. CONCLUSIONS: The results of the reclassification can help organizations select areas that encompass their own specific problems. Practical implications are also discussed.

Identifying and Classifying Quality of Life Tools for Assessing Neurogenic Bowel Dysfunction After Spinal Cord Injury.

Objectives: To identify and classify tools for assessing the influence of neurogenic bowel dysfunction (NBD) on quality of life (QoL) after spinal cord injury (SCI). Methods: In this systematic review, MEDLINE/PubMed, CINAHL, and PsycInfo were searched to identify studies assessing the influence of NBD on QoL (or related construct) after SCI. Two independent reviewers screened titles and abstracts, and both reviewers classified tools as subjective or objective according to Dijkers' theoretical QoL framework. Results: Seventy-two studies were identified, and 35 studies met the inclusion criteria. Five objective measures assessed the influence of NBD on QoL, which were validated for use in SCI, but no measure was condition-specific to NBD. Eight measures were classified as subjective tools; two had an established reliability and validity for SCI while six had some psychometric evidence for use in the SCI population. Five subjective measures (NBD score, Burwood QoL Questionnaire, Impediments to Community Integration [ICI] Scale, SCI-QoL Bowel Management Difficulties, and Survey of Neurogenic Bowel Characteristics) were developed specifically for SCI. The NBD score showed sensitivity to the influence of NBD on QoL in experimental trials. Conclusion: Thirteen tools assessed the influence of NBD on QoL in SCI. Although not developed specifically for SCI, the Health Utility Index (HUI-III) was the only tool identified that provided data on "QoL as utility" on the impact of NBD. The validated NBD score was the only condition-specific tool to assess QoL as "subjective well-being." Further validation of existing tools could help to inform practice and policy related to resource allocation for bowel care post SCI.

Comfort assessment of running footwear: Does assessment type affect inter-session reliability?

Assessing comfort of running footwear reliably is challenging. The purpose of this study was to compare the intra-rater reliability between different assessment types, to calculate intra-individual reliability scores and to evaluate the effect of rater selection based on individual reliability scores on group level reliability. Three assessment types: ranking, Visual Analogue Scale (VAS), and Likert Scale (LS) were provided twice in six separate sessions among 30 participants, who assessed comfort of five shoes after treadmill running. Spearman's rho provided an evaluation of inter-session relative reliability and typical error as a measure of absolute reliability for each assessment type. Ranking (r = 0.70, 95% confidence interval [CI] 0.61-0.78) yielded the highest relative reliability for overall comfort, followed by VAS (r = 0.67, 95% CI 0.56-0.75) and LS (r = 0.63, 95% CI 0.52-0.72), with large-scale overlaps of CIs between assessment types. The same order of assessment types was found for the percentage of reliable raters (r ≥ 0.7) with 60% in ranking scale, 47% in VAS and 37% in LS. Forming subgroups corresponding to the intra-individual reliability substantially increased group level reliabilities. Based on measures of relative reliability, an extreme reduction in resolution as provided by the ranking from pairwise comparisons seems to be a valuable tool in footwear comfort assessments if assessment time is of minor importance. No preference can be provided for the two investigated rating scales. Besides the assessment type, a selection of the best raters in additional reliability checks seems to be a prerequisite for further comfort-related studies.

Qualidade de vida e autoestima em idosas submetidas e não submetidas à cirurgia estética / Quality of life and self-esteem in elderly patients who did or did not have cosmetic surgery

Introdução: A realidade do envelhecimento populacional chegou ao campo da Cirurgia Plástica, provada pelo crescimento do número de idosos que se submetem à cirurgia estética (CE). A pesquisa objetiva avaliar a importância da CE para o idoso, e se existe diferença de qualidade de vida e autoestima entre idosas que se submeteram e que não se submeteram à cirurgia estética. Métodos: Pesquisa casocontrole, sendo o grupo-caso formado por 25 idosas que se submeteram à CE e o grupo-controle por 25 idosas que não fizeram CE, pareados pelos dados socioeconômicos. Os instrumentos aplicados foram: Minimental, questionário de qualidade de vida (WHOQOL-BREF), escala de autoestima de Rosenberg e um questionário elaborado para pesquisa de dados sociodemográficos, motivação e satisfação com a CE. Resultados: A média de idade foi 67,26 anos e a escolaridade média, de 9,96 anos. As cirurgias mais realizadas foram a abdominoplastia e a blefaroplastia. Os motivos mais escolhidos foram o desconforto físico, o desejo de melhoria da qualidade de vida (QV) e a insatisfação com a autoimagem. Não foram encontradas idosas com baixa autoestima e o nível de satisfação foi alto quando relacionado com a própria vida ou a vida social. Não houve diferença de QV e autoestima entre os dois grupos analisados. Conclusão: As motivações das idosas para realização de CE são de ordem física e psicológica. Não houve diferença de QV e autoestima entre idosas submetidas e não submetidas à CE. Analisando-se as idosas submetidas à CE, foram comprovados altos níveis de satisfação pessoal e na vida social.

Introduction: The reality of aging has caught up with the field of plastic surgery, shown by the growth in the number of elderly patients who undergo cosmetic surgery (CS). To evaluate its importance in elderly women, this study examined differences in quality of life and self-esteem among those who did or did not undergo CS. Methods: This casecontrol study included 25 elderly women who underwent CS and a control group of 25 elderly women who did not undergo CS; the groups were matched by socioeconomic data. Assessment methods included the Mini-Mental State Examination, a quality of life (QOL) questionnaire (World Health Organization Quality of Life-Bref), the Rosenberg Self-Esteem Scale, and a questionnaire developed for the study of sociodemographic data, motivation, and satisfaction with CS. Results: The mean age was 67.26 years, with a mean of 9.96 years of education. The most common surgeries were abdominoplasty and blepharoplasty. The most common motivations were physical discomfort, desire to improve QOL, and dissatisfaction with self-image. No subjects were found to have low self-esteem and the level of satisfaction with personal or social life was high. There was no difference in QOL or self-esteem between the 2 groups. Conclusion: Physical and psychological motivations cause the elderly to undergo CS. There was no difference in QOL or self-esteem among elderly women who did or did not have CS. Elderly women who underwent CS showed high levels of satisfaction with their personal and social life.

Development of Questionnaire for Auditory Localization.

OBJECTIVE: Localization plays an important role in identifying the source of the stimuli. Aural localization is based on the phase (period-related time), intensity level, and spectral differences between the sounds at each ear. Various behavioral measures are available to check the interaural level, time, and frequency differences, which provide information on an individual's ability to localize the sound source. This might vary depending on the audibility and amplification devices. Although these behavioral measures are available, the perceptual quality of localization cannot be obtained using these measures. This study aimed to develop a questionnaire for auditory localization. MATERIALS AND METHODS: A questionnaire was prepared, the content validated, and administered on 120 individuals in the age range of 18-50 years who were divided into three different groups. RESULTS: The results of the descriptive and item analysis revealed a significant difference between the groups, with group I showing better localization ability. No significant difference was observed between the groups II and III. The receiver operating curve and cut-off scores were obtained. Individuals with a score of <42.5 on the questionnaire have better or good localization ability. The area covered under the curve is 0.987; therefore, the sensitivity and specificity of the questionnaire is also high. CONCLUSION: It can be concluded that this questionnaire is a simple, valid, and preliminary measure for the auditory localization ability of an individual.

Cross-cultural validation of the Child Adolescent Teasing Scale for Colombian students / Validação transcultural da Child Adolescent Teasing Scale para estudantes colombianos / Validación transcultural del Child Adolescent Teasing Scale para escolares colombianos

ABSTRACT Objective: to carry out the cross-cultural validation of the instrument "Child Adolescent Teasing Scale" for the Colombian student population. Method: methodological study carried out with students aged 8 to 15, from public and private educational institutions in the municipality of Ibagué, Colombia. The form for the characterization of students and the Child Adolescent Teasing Scale were used. Results: the cross-cultural adaptation process was organized in seven steps: comparison of the Spanish version of the instrument with the original English version, back-translation, consensus version, face validity and terminology adjustment by students, face and content validity by experts, assessment committee for the final version, pilot test and reliability. Conclusion: the version adapted to the Spanish spoken in Colombia of the Child Adolescent Teasing Scale (Escala de burlas para niños y adolescentes), which assesses the frequency and distress caused by teasing, showed desirable results in terms of validity and reliability.

RESUMO Objetivo: realizar a validação transcultural do instrumento "Child Adolescent Teasing Scale" para a população de estudantes colombianos. Método: estudo metodológico com estudantes de 8 a 15 anos, de instituições educacionais públicas e privadas de Ibagué, Colômbia. Utilizou-se o formulário de caracterização e a "Child Adolescent Teasing Scale". Resultados: o processo de adaptação transcultural foi organizado em sete etapas: comparação da versão em espanhol do instrumento com a versão original em inglês, retrotradução, versão consenso, validade facial e adaptação da terminologia pelos estudantes, validade facial e de conteúdo por especialistas, comissão de avaliação para a versão final, teste piloto e confiabilidade. Conclusão: a versão adaptada ao espanhol usado na Colômbia da "Child Adolescent Teasing Scale" (Escala de zombarias para crianças e adolescentes), que mede a frequência e o incômodo devido às zombarias, mostrou resultados recomendáveis em termos de validade e confiabilidade.

RESUMEN Objetivo: realizar la validación transcultural del instrumento "Child Adolescent Teasing Scale" para la población de escolares colombianos. Método: estudio metodológico con escolares de 8 a 15 años, de instituciones educativas públicas y privadas de Ibagué, Colombia. Se usó la ficha de caracterización y el Child Adolescent Teasing Scale. Resultados: el proceso de adaptación transcultural se organizó en siete etapas: comparación de la versión en español del instrumento con la versión original en inglés, retrotraducción, versión consenso, validez facial y adaptación al lenguaje por escolares, validez facial y de contenido por expertos, comité de evaluación para la versión final, prueba piloto y confiabilidad. Conclusión: la versión adaptada al español usado en Colombia del Child Adolescent Teasing Scale (Escala de burlas para niños y adolescentes), que mide frecuencia y molestia por las burlas, mostró resultados recomendables de validez y confiabilidad.

Validity of questions about activities of daily living to screen for dependency in older adults.

OBJECTIVE: To determine the criterion validity of the activities of daily living present in functionality questionnaires in older adults for population surveys and to identify which activities are valid to quantify the real daily need for help of this population. METHODS: This is a population sample of older adults stratified by levels of functionality, according to self-perception of dependency in the activities of daily living. Self-perception was compared with the gold standard - direct observation of these activities in the household of older adults by a trained professional, blinded to the answers in the questionnaire. At the visit, it was decided if the older adult needed help to perform any of the activities of daily living for the research. The sensitivity of each activity of daily living was greater when the self-assessment that there was no need for help coincided with the assessment of the professional. Specificity indicates coincidence regarding the need for help in the activities of daily living - coefficients of sensitivity and specificity above 70% were considered as indicative of good validity. RESULTS: Self-assessments showed better sensitivity than specificity - older adults and observers agreed more on daily independency than on dependency. All activities showed sensitivity above 70%. Some activities had low (go shopping: 55%) or very low specificity (brush the hair: 33%). The best specificities were to take a shower and dress up (95.8% for both), among the personal ones, and to use transportation and perform banking transactions (78% for both), among the instrumental ones. CONCLUSIONS: Activities of daily living can be valid indicators of functional dependence. The best coefficients of validity were generally obtained for personal activities. Some activities with good sensitivities and specificities - walk 100 meters, take a shower, and lie down in and get out of the bed - can be used to classify older adults into low, average, and high need for help depending on the affected activities and, therefore, can help in the planning of health services aimed at them. OBJETIVO: Determinar a validade de critério das atividades de vida diária constantes em questionários de funcionalidade em idosos para inquéritos populacionais e identificar quais atividades são válidas para quantificar a necessidade real de ajuda diária dessa população. MÉTODOS: Amostra populacional de idosos estratificada por níveis de funcionalidade, segundo a autopercepção de dependência nas atividades de vida diária. Autopercepção foi comparada com o padrão ouro - observação direta no domicílio dos idosos nessas atividades por profissional treinado e cego para respostas no questionário. Na visita decidiu-se, para efeito da pesquisa, se o idoso precisava de ajuda para realizar alguma das atividades de vida diária. A sensibilidade de cada atividade de vida diária foi maior quando a autoavaliação de que não havia necessidade de ajuda coincidiu com a avaliação do profissional. A especificidade indica coincidência quanto à necessidade de ajuda na atividades de vida diária - coeficientes de sensibilidade e especificidade acima de 70% foram considerados indicativos de boa validade. RESULTADOS: As autoavaliações mostraram sensibilidade melhor que especificidade - idosos e observadores concordaram mais quanto à independência do que quanto à dependência cotidiana. Todas as atividades mostraram sensibilidade acima de 70%. Algumas atividades tiveram uma especificidade baixa (fazer compras: 55%) ou muito baixa (pentear os cabelos: 33%). As melhores especificidades foram tomar banho e vestir-se (95,8% ambas), entre as pessoais, e utilizar transporte e realizar movimento bancário (ambas com 78%), entre as instrumentais. CONCLUSÕES: Atividades de vida diária podem ser indicadores válidos de dependência funcional. Os melhores coeficientes de validade em geral foram obtidos pelas atividades pessoais. Destacam-se algumas atividades com boas sensibilidades e especificidades - andar 100 metros, tomar banho e levantar/deitar na cama - que podem servir para classificar os idosos em baixa, média e alta necessidade de ajuda dependendo das atividades afetadas e, dessa forma, auxiliar no planejamento dos serviços de saúde voltados aos idosos.

A Machine Learning-based Method for Question Type Classification in Biomedical Question Answering.

BACKGROUND AND OBJECTIVE: Biomedical question type classification is one of the important components of an automatic biomedical question answering system. The performance of the latter depends directly on the performance of its biomedical question type classification system, which consists of assigning a category to each question in order to determine the appropriate answer extraction algorithm. This study aims to automatically classify biomedical questions into one of the four categories: (1) yes/no, (2) factoid, (3) list, and (4) summary. METHODS: In this paper, we propose a biomedical question type classification method based on machine learning approaches to automatically assign a category to a biomedical question. First, we extract features from biomedical questions using the proposed handcrafted lexico-syntactic patterns. Then, we feed these features for machine-learning algorithms. Finally, the class label is predicted using the trained classifiers. RESULTS: Experimental evaluations performed on large standard annotated datasets of biomedical questions, provided by the BioASQ challenge, demonstrated that our method exhibits significant improved performance when compared to four baseline systems. The proposed method achieves a roughly 10-point increase over the best baseline in terms of accuracy. Moreover, the obtained results show that using handcrafted lexico-syntactic patterns as features' provider of support vector machine (SVM) lead to the highest accuracy of 89.40 %. CONCLUSION: The proposed method can automatically classify BioASQ questions into one of the four categories: yes/no, factoid, list, and summary. Furthermore, the results demonstrated that our method produced the best classification performance compared to four baseline systems.

Testing whether patients with diabetes and healthy people perceive the meaning of the items in the Persian version of the SF-36 questionnaire similarly: a differential item functioning analysis.

PURPOSE: It has been rarely studied whether observed disparity in health-related quality-of-life (HRQoL) scores between patients with diabetes and healthy individuals is due to differential item functioning (DIF) or a true difference in the underlying construct. This study aimed to examine DIF in the SF-36 questionnaire and its effect on comparing HRQoL scores between patients with diabetes and healthy people. METHODS: The sample consisted of 230 patients with type 2 diabetes and 642 healthy individuals who filled out the Persian version of the SF-36 questionnaire. To detect DIF across patients with diabetes and healthy individuals, multiple-group multiple-indicator multiple-causes model was used. In addition, item calibration strategy was used to determine whether the effect of item-level DIF was transferred to the scale level. RESULTS: Nine out of thirty-six (25 %) items were detected as DIF, of which one item (11 %) was flagged as uniform and eight items (89 %) as non-uniform DIF. Most of the DIF items were detected in the mental health component which includes vitality, perceived mental health and social functioning subscales rather than in physical health component. Moreover, nonsignificant latent mean differences for general health perception and social functioning subscales became significant after DIF calibration. CONCLUSION: The findings of the present study show that patients with diabetes and healthy individuals perceived some items in the SF-36 questionnaire differently. More importantly, in some subscales, the effect of item-level DIF was transferred to the scale level. Consequently, considerable caution should be taken in comparing HRQoL scores between patients with diabetes and healthy individuals.

Validity of questions about activities of daily living to screen for dependency in older adults / Validade das perguntas sobre atividades da vida diária para rastrear dependência em idosos

ABSTRACT OBJECTIVE To determine the criterion validity of the activities of daily living present in functionality questionnaires in older adults for population surveys and to identify which activities are valid to quantify the real daily need for help of this population. METHODS This is a population sample of older adults stratified by levels of functionality, according to self-perception of dependency in the activities of daily living. Self-perception was compared with the gold standard - direct observation of these activities in the household of older adults by a trained professional, blinded to the answers in the questionnaire. At the visit, it was decided if the older adult needed help to perform any of the activities of daily living for the research. The sensitivity of each activity of daily living was greater when the self-assessment that there was no need for help coincided with the assessment of the professional. Specificity indicates coincidence regarding the need for help in the activities of daily living - coefficients of sensitivity and specificity above 70% were considered as indicative of good validity. RESULTS Self-assessments showed better sensitivity than specificity - older adults and observers agreed more on daily independency than on dependency. All activities showed sensitivity above 70%. Some activities had low (go shopping: 55%) or very low specificity (brush the hair: 33%). The best specificities were to take a shower and dress up (95.8% for both), among the personal ones, and to use transportation and perform banking transactions (78% for both), among the instrumental ones. CONCLUSIONS Activities of daily living can be valid indicators of functional dependence. The best coefficients of validity were generally obtained for personal activities. Some activities with good sensitivities and specificities - walk 100 meters, take a shower, and lie down in and get out of the bed - can be used to classify older adults into low, average, and high need for help depending on the affected activities and, therefore, can help in the planning of health services aimed at them.

RESUMO OBJETIVO Determinar a validade de critério das atividades de vida diária constantes em questionários de funcionalidade em idosos para inquéritos populacionais e identificar quais atividades são válidas para quantificar a necessidade real de ajuda diária dessa população. MÉTODOS Amostra populacional de idosos estratificada por níveis de funcionalidade, segundo a autopercepção de dependência nas atividades de vida diária. Autopercepção foi comparada com o padrão ouro - observação direta no domicílio dos idosos nessas atividades por profissional treinado e cego para respostas no questionário. Na visita decidiu-se, para efeito da pesquisa, se o idoso precisava de ajuda para realizar alguma das atividades de vida diária. A sensibilidade de cada atividade de vida diária foi maior quando a autoavaliação de que não havia necessidade de ajuda coincidiu com a avaliação do profissional. A especificidade indica coincidência quanto à necessidade de ajuda na atividades de vida diária - coeficientes de sensibilidade e especificidade acima de 70% foram considerados indicativos de boa validade. RESULTADOS As autoavaliações mostraram sensibilidade melhor que especificidade - idosos e observadores concordaram mais quanto à independência do que quanto à dependência cotidiana. Todas as atividades mostraram sensibilidade acima de 70%. Algumas atividades tiveram uma especificidade baixa (fazer compras: 55%) ou muito baixa (pentear os cabelos: 33%). As melhores especificidades foram tomar banho e vestir-se (95,8% ambas), entre as pessoais, e utilizar transporte e realizar movimento bancário (ambas com 78%), entre as instrumentais. CONCLUSÕES Atividades de vida diária podem ser indicadores válidos de dependência funcional. Os melhores coeficientes de validade em geral foram obtidos pelas atividades pessoais. Destacam-se algumas atividades com boas sensibilidades e especificidades - andar 100 metros, tomar banho e levantar/deitar na cama - que podem servir para classificar os idosos em baixa, média e alta necessidade de ajuda dependendo das atividades afetadas e, dessa forma, auxiliar no planejamento dos serviços de saúde voltados aos idosos.

Conhecimento Sobre a Insuficiência Cardíaca em Participantes e não Participantes de Reabilitação / Knowledge About Heart Failure in Participants and Non-Participants Cardiac Rehabilitation

A insuficiência cardíaca é uma síndrome de caráter sistêmico, cuja complexidade, agregada à falta de conhecimento dos pacientes sobre a doença, pode afetar a aderência ao tratamento. Objetivo: Comparar o nível de conhecimento sobre a doença de pacientes com insuficiência cardíaca, participantes e não participantes de programas de reabilitação cardiopulmonar e metabólica. Método: Estudo transversal com amostra intencional estratificada em dois grupos: 61 participantes e 62 não participantes de programas de reabilitação. O nível de conhecimento sobre doença foi avaliado por meio de um questionário. Resultados: Os participantes de reabilitação apresentaram maior conhecimento quando comparados aos não participantes (41,9 ± 8,5 e 33,8 ± 11,6, respectivamente; p < 0,003) e houve correlação negativa moderada entre idade e nível de conhecimento apenas no grupo não participante de reabilitação (p < 0,001). Conclusão: Pacientes portadores de insuficiência cardíaca que participam de programas de reabilitação apresentaram mais conhecimento sobre sua doença em relação aos não participantes.

Heart failure is a systemic character syndrome whose complexity aggregate to lack of knowledge of the patients about the disease can affect adherence to treatment. Objective: To compare the level of knowledge about the disease in patients with heart failure participants and non-participants of cardiopulmonary and metabolic rehabilitation programs. Method: Cross-sectional study with an intentional sample stratified into two groups: 61 participants and 62 non-participating of rehabilitations. The level of knowledge about the disease was assessed by the questionnaire. Results: Participants rehabilitations had higher knowledge when compared to non-participants (41.9 ± 8.5 and 33.8 ± 11.6, respectively; p <0.001). The level of knowledge had positive correlations with sociodemographic variables schooling for both group of rehabilitation (p < 0.001) and for the group of non-participants (p < 0.001). We found moderate positive correlation between income and the level of knowledge only in the group of rehabilitation participants (p < 0.003) and moderate negative correlation between age the level of knowledge only in the non-participant group of rehabilitation (p < 0.001). Conclusion: Patients with heart failure participating in rehabilitations programs had more knowledge about their disease compared to nonparticipants.

Systematic comparative content analysis of 17 psychosocial work environment questionnaires using a new taxonomy.

BACKGROUND: Many questionnaires have been developed to measure how psychosocial characteristics are perceived in a work environment. But the content validity of these questionnaires has rarely been questioned due to the absence of a reference taxonomy for characteristics of work environments. OBJECTIVES: To propose an exhaustive taxonomy of work environment characteristics involved in psychosocial risks and to apply this taxonomy to questionnaires on workplace psychosocial factors. METHODS: The taxonomy was developed by categorizing factors present in the main theoretical models of the field. Questionnaire items most frequently cited in scientific literature were retained for classification. RESULTS: The taxonomy was structured into four hierarchical levels and comprises 53 categories. The 17 questionnaires analyzed included 927 items: 59 from the "physical environment" category, 116 from the "social environment" category, 236 from the "work activity" category, 255 from the "activity management" category, and 174 from the "organizational context" category. CONCLUSIONS: There are major content differences among analyzed questionnaires. This study offers a means for selecting a scale on the basis of content.

Perfil das alterações vasculares periféricas em dependentes de crack acompanhados em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD) / Profile of peripheral vascular changes in crack-cocaine addicts receiving treatment at a Psychosocial Care Center for Alcohol and Drugs

CONTEXTO: O consumo de crack é um dos grandes desafios em saúde pública, e o uso dessa droga tem efeitos diretos na saúde de seus usuários. OBJETIVOS: Avaliar o perfil das alterações vasculares em pacientes com dependência de crack em Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-AD) e observar os possíveis efeitos vasculares periféricos. MÉTODOS: Trata-se de um estudo observacional, descritivo, de corte transversal. Os pacientes da amostra foram submetidos a um questionário objetivo para avaliar questões demográficas, padrão de uso da droga, coexistência de diabetes melito, hipertensão arterial ou tabagismo, exame físico e ecográfico. Os dados foram sumarizados e analisados estatisticamente com teste qui-quadrado ou teste exato de Fisher. RESULTADOS: A média de idade da amostra foi de 33,29 (±7,15) anos, e 74% eram do gênero masculino. A média de idade de início de uso da droga foi de 23,4 (±7,78) anos, com tempo médio de uso de 9,58 (±5,64) anos. O consumo médio diário de pedras de crack foi de 21,45 (±8,32) pedras. A alteração de pulsos em membros inferiores foi mais frequente em mulheres. A prevalência do espessamento da parede arterial nos membros inferiores foi de 94,8%. O tempo de uso da droga apresentou associação estatística (p = 0,0096) com alteração do padrão de curva espectral das artérias dos membros inferiores. CONCLUSÕES: Há alterações vasculares periféricas em usuários de crack. O tempo de uso da droga exerceu um maior impacto nesse sistema, o que sugere associação entre o uso do crack e a diminuição de fluxo arterial.

BACKGROUND: Consumption of crack is one of the major challenges in public health and taking this drug has direct effects on the health of those who use it. OBJECTIVES: To evaluate the profile of vascular abnormalities in patients receiving treatment for crack dependency at a Psychosocial Care Center for Alcohol and Drugs and to observe possible peripheral vascular effects. METHODS: The study design is observational, descriptive and cross-sectional. An objective questionnaire was administered to the patients in the sample to collect data on demographic details; drug use profile; and concomitant diabetes mellitus, arterial hypertension and/or smoking; and physical and ultrasound examinations were conducted. Data were summarized and analyzed statistically with the chi-square test or Fisher’s exact test. RESULTS: The mean age of the sample was 33.29 (±7.15) years, and 74% were male. Mean age at onset of drug use was 23.4 (±7.78) years and mean time since onset was 9.58 (±5.64) years. Mean consumption of crack rocks was 21.45 (±8.32) per day. The rate of abnormal lower limb pulses was higher among women. The prevalence of artery wall thickening in lower limbs was 94.8%. Time since starting to use crack exhibited a statistically significant association (p = 0.0096) with abnormalities in the spectral curve profiles of lower limb arteries. CONCLUSIONS: Crack users exhibit peripheral vascular disorders. Length of time since starting to use the drug had the greatest impact on this system, suggesting an association between crack use and reduced arterial flow.

Validação do questionário de qualidade de vida na úlcera venosa crônica em língua portuguesa (Charing Cross Venous Ulcer Questionnaire -CCVUQ-Brasil) / Validation of the Portuguese language version of a chronic venous ulcer quality of life questionnaire (Charing Cross Venous Ulcer Questionnaire - CCVUQ-Brazil)

CONTEXTO: Instrumentos de qualidade de vida vêm sendo usados nos últimos anos. Para a úlcera venosa, há um importante questionário específico, o Charing Cross Venous Ulcer Questionnaire (CCVUQ), já traduzido para português em recente estudo, mas necessitando do teste de suas propriedades psicométricas e da consequente validação para ser utilizado no Brasil. OBJETIVOS: Validar o questionário de qualidade de vida na úlcera venosa em língua portuguesa, o CCVUQ-Brasil. MÉTODOS: A versão traduzida do questionário foi aplicada em 50 indivíduos. Sua consistência interna foi analisada, sendo posteriormente reaplicado (30 minutos e entre 7 e 15 dias após a primeira aplicação) para testar a reprodutibilidade. Os resultados foram comparados com o 36-Item Short Form Health Survey (SF-36) para testar a validade. RESULTADOS: A versão em português é semântica e culturalmente semelhante à versão original em inglês, tendo consistência interna satisfatória, alta correlação na verificação da reprodutibilidade e validade de constructo significativa. CONCLUSÕES: O CCVUQ-Brasil encontra-se validado na língua portuguesa.

BACKGROUND: The use of quality of life instruments has become widespread over recent years. There is an important questionnaire specifically designed for patients with venous ulcers, the Charing Cross Venous Ulcer Questionnaire (CCVUQ), which has already been translated into Portuguese as part of a recent study, but its psychometric properties still need to be tested to complete its validation for use in Brazil. OBJECTIVES: To validate the Portuguese version of a venous ulcer quality of life questionnaire, the CCVUQ-Brazil. METHODS: The translated version of the questionnaire was administered to 50 individuals and its internal consistency was analyzed. It was re-administered (30 minutes and 7 to 15 days after the first administration) in order to test its reproducibility. RESULTS: were compared with results for the 36-Item Short Form Health Survey (SF-36) to test validity. Results: The Portuguese version is semantically and culturally similar to the original version in English. It has satisfactory internal consistency, it exhibited high correlations in tests of reproducibility and it has significant construct validity. CONCLUSIONS: The Portuguese version of the CCVUQ-Brazil has been validated for use.

Avaliação psicométrica do Questionário de Mudança Corporal para adolescentes / Psychometric evaluation of the Body Change Questionnaire for adolescents / Evaluación psicométrica del Cuestionario sobre Cambios Físicos para adolescentes

Resumo O estudo objetivou analisar a validade de construto, consistência interna e reprodutibilidade do Questionário de Mudança Corporal (QMC). Foram avaliados 439 meninas e meninos (13 a 22 anos). A validade de construto foi avaliada por meio da análise fatorial exploratória e correlações entre os escores do QMC, Body Shape Questionnaire (BSQ) e Escala de Silhuetas (ES). A confiabilidade foi acessada usando-se a consistência interna, e a reprodutibilidade pelo teste-reteste e pela correlação intraclasse. A escala apresentou estrutura fatorial composta por seis fatores, os quais representaram quase em sua totalidade as subescalas do instrumento. As correlações para a amostra total entre o QMC e as outras escalas variaram de 0,37 a 0,46. A consistência interna apresentou valores entre 0,78 e 0,96 para cada um dos fatores, e a correlação intraclasse foi condizente com uma boa reprodutibilidade. Os escores do teste-reteste não apresentaram diferenças significantes para a amostra total e entre os sexos. Conclui-se que o QMC apresenta boas qualidades psicométricas para os adolescentes brasileiros.

Abstract This study aimed to examine construct validity, internal consistency, and reproducibility of the Body Change Questionnaire (BCQ). A total of 439 female and male adolescents (13-22 years of age) were evaluated. Construct validity was assessed by exploratory factor analysis and correlation between the scores of the BCQ and the Body Shape Questionnaire (BSQ) and Scale Silhouettes (SS). Reliability was assessed through internal consistency and reproducibility using test-retest and intra-class correlation. The scale presented a six-factor structure that almost entirely accounted for the instrument’s subscales. Correlations for the total sample between BCQ and scores of the other questionnaires ranged from 0.37 to 0.46. Internal consistency varied from 0.78 to 0.96 for each of the factors, and intra-class correlation was consistent with good reproducibility. The test-retest scores showed no statistically significant differences for the total sample or according to sex. The BCQ showed good psychometric qualities for Brazilian adolescents.

Resumen El objetivo del estudio fue evaluar la validez de constructo, la consistencia interna y la reproducibilidad del Cuestionario de Cambios Físicos (QMC por sus siglas en portugués). Se evaluaron a 439 niñas y niños (13-22 años). La validez de constructo se evaluó mediante análisis factorial exploratorio y las correlaciones entre las puntuaciones de la QMC, Body Shape Questionnaire (BSQ) y la Escala Silhouettes (ES). La confiabilidad se consiguió por la consistencia interna y la reproducibilidad test-retest y la correlación intra-clase. La escala tiene una estructura factorial compuesta por seis factores, que representaron casi en su totalidad las subescalas del instrumento. Las correlaciones de la muestra total entre QMC y las puntuaciones de los otros de cuestionarios oscilaron 0,37-0,46. La consistencia interna varió de 0,78 y 0,96 para cada uno de los factores y la correlación intraclase fue consistente con buena reproducibilidad. Las puntuaciones de test-retest mostraron diferencias significativas para la muestra total y de género. La conclusión es que el QMC tiene buenas cualidades psicométricas en adolescentes brasileños.