Tampa Scale for Kinesiophobia in chronic neck pain patients (TSK-neck): structural and construct validity and reliability in a Brazilian population.

BACKGROUND: To date, there are no studies in the literature that define the internal structure of the Tampa Scale for Kinesiophobia (TSK) in patients with chronic neck pain based on factorial analysis. As such, we aimed to verify and identify the best structure of the Brazilian version of the TSK in patients with chronic neck pain. METHODS: We included Brazilian participants aged ≥18 years, both sexes, with self-reported neck pain for more than 3 months and pain intensity ≥3 on the Numerical Pain Rating Scale (NPRS). Dimensionality and number of TSK items were assessed using confirmatory factor analysis (CFA). We tested the following internal structures: structure 1 (1 domain and 17 items), structure 2 (1 domain and 11 items), structure 3 (2 domains and 11 items), and structure 4 (2 domains and 9 items). We used the Pain-Related Catastrophizing Thoughts Scale (PCTS) and the NPRS for construct validity. In addition, we assessed test-retest reliability for the seven-day interval using intraclass correlation coefficient (ICC2,1), Cronbach's alpha to assess internal consistency, and ceiling and floor effects. RESULTS: The study sample included of 335 patients. Most were women (77.6%), young adults (~ 34 years), single (48.4%), with complete primary education (57.3%), physically inactive (66.6%), with a mean pain duration of 46 months and a mean pain intensity of ~ 5 points on the NPRS. Redundancy was found in the following items: item 1 with item 2 (modification indices = 21.419) and item 13 with item 15 (modification indices = 13.641). Subsequently, based on these paired analyses, the items with the lowest factor loadings (items 2 and 15) were excluded. As such, TSK structure 4 was composed of two domains ("somatic focus" and "activity avoidance") and 9 items, which showed adequate fit indices and lower AIC and SABIC values. We observed significant values (p < 0.05) with a correlation magnitude greater than 0.142 to 0.657 between the two domains of the TSK-neck and the other instruments (PCTS and NPRS). We found excellent reliability (ICC2,1 ≥ 0.96) and adequate internal consistency (Cronbach's alpha ≥0.98) of the TSK-neck. Finally, ceiling and floor effects were not observed. CONCLUSION: The TSK-neck structure with two domains (somatic focus and activity avoidance) and nine items is the most appropriate for patients with chronic neck pain.

Hypoxia sensing in the body: An update on the peripheral and central mechanisms.

An adequate supply of O2 is essential for the maintenance of cellular activity. Systemic or local hypoxia can be experienced during decreased O2 availability or associated with diseases, or a combination of both. Exposure to hypoxia triggers adjustments in multiple physiological systems in the body to generate appropriate homeostatic responses. However, with significant reductions in the arterial partial pressure of O2, hypoxia can be life-threatening and cause maladaptive changes or cell damage and death. To mitigate the impact of limited O2 availability on cellular activity, O2 chemoreceptors rapidly detect and respond to reductions in the arterial partial pressure of O2, triggering orchestrated responses of increased ventilation and cardiac output, blood flow redistribution and metabolic adjustments. In mammals, the peripheral chemoreceptors of the carotid body are considered to be the main hypoxic sensors and the primary source of excitatory feedback driving respiratory, cardiovascular and autonomic responses. However, current evidence indicates that the CNS contains specialized brainstem and spinal cord regions that can also sense hypoxia and stimulate brain networks independently of the carotid body inputs. In this manuscript, we review the discoveries about the functioning of the O2 chemoreceptors and their contribution to the monitoring of O2 levels in the blood and brain parenchyma and mounting cardiorespiratory responses to maintain O2 homeostasis. We also discuss the implications of the chemoreflex-related mechanisms in paediatric and adult pathologies.

Self-Testing of Ketone Bodies, along with Glucose, Using Touch-Based Sweat Analysis.

ß-Hydroxybutyrate (HB) is one of the main physiological ketone bodies that play key roles in human health and wellness. Besides their important role in diabetes ketoacidosis, ketone bodies are currently receiving tremendous attention for personal nutrition in connection to the growing popularity of oral ketone supplements. Accordingly, there are urgent needs for developing a rapid, simple, and low-cost device for frequent onsite measurements of ß-hydroxybutyrate (HB), one of the main physiological ketone bodies. However, real-time profiling of dynamically changing HB concentrations is challenging and still limited to laboratory settings or to painful and invasive measurements (e.g., a commercial blood ketone meter). Herein, we address the critical need for pain-free frequent HB measurements in decentralized settings and report on a reliable noninvasive, simple, and rapid touch-based sweat HB testing and on its ability to track dynamic HB changes in secreted fingertip sweat, following the intake of commercial ketone supplements. The new touch-based HB detection method relies on an instantaneous collection of the fingertip sweat at rest on a porous poly(vinyl alcohol) (PVA) hydrogel that transports the sweat to a biocatalytic layer, composed of the ß-hydroxybutyrate dehydrogenase (HBD) enzyme and its nicotinamide adenine dinucleotide (NAD+) cofactor, covering the modified screen-printed carbon working electrode. As a result, the sweat HB can be measured rapidly by the mediated oxidation reaction of the nicotinamide adenine dinucleotide (NADH) product. A personalized HB dose-response relationship is demonstrated within a group of healthy human subjects taking commercial ketone supplements, along with a correlation between the sweat and capillary blood HB levels. Furthermore, a dual disposable biosensing device, consisting of neighboring ketone and glucose enzyme electrodes on a single-strip substrate, has been developed toward the simultaneous touch-based detection of dynamically changing sweat HB and glucose levels, following the intake of ketone and glucose drinks.

Translation, cross-cultural adaptation, and validation of the Athlete Fear Avoidance Questionnaire (AFAQ) into Brazilian Portuguese.

BACKGROUND: Psychological factors play an important role in the adequate return of an athlete to sport. Our aim was to perform the translation, cross-cultural adaptation, and validation of the Athlete Fear Avoidance Questionnaire (AFAQ) into Brazilian Portuguese. METHODS: We performed the translation and cross-cultural adaptation and evaluated the structural validity, construct validity, and test-retest reliability. In addition to the AFAQ, we used the Numerical Pain Scale (NPS), Pain-Related Catastrophizing Thoughts Scale (PCTS), Self-Estimated Functional Inability because of Pain Questionnaire for athletes (SEFIP-sport), and Hospital Anxiety and Depression Scale (HADS). We used the exploratory factor analysis (EFA) to analyze the internal structure of the AFAQ. We used the Spearman's correlation coefficient (rho) to determine the magnitude of correlation between the AFAQ and the other instruments. We evaluated the test-retest reliability and internal consistency by means of intraclass correlation coefficient (ICC) and Cronbach's alpha, respectively. RESULTS: No adaptation was necessary to produce the AFAQ version in Brazilian Portuguese. We included 160 participants in the study. We identified the one-dimensionality of the AFAQ through the EFA with the implementation of parallel analysis (KMO = 0.83, p < 0.001 in Bartlett's Sphericity test). In construct validity, the magnitudes of correlation between the AFAQ and the other instruments ranged from 0.257 to 0.548. We identified adequate reliability (ICC = 0.85) and internal consistency (Cronbach's alpha = 0.90). CONCLUSION: The Brazilian version of the AFAQ with one domain and 10 items has adequate measurement properties in injured professional and recreational athletes.

Fear of Return to Sport Scale (FRESS): a new instrument for use in injured professional or recreational athletes in rehabilitation.

Objective: To create, develop, and validate the Fear of Return to Sport Scale (FRESS) for injured professional or recreational athletes in rehabilitation. Methods: This is a questionnaire validation study. To determine the structural and construct validity, 192 injured professional or recreational athletes of different sports modalities were included. We used a subsample with 32 participants to analyze test-retest reliability and internal consistency. Main outcome measures were the FRESS, Numerical Pain Scale (NPS), Pain-Related Catastrophizing Thoughts Scale (PCTS), Self-Estimated Functional Inability because of Pain Questionnaire for athletes (SEFIP-sport), and Hospital Anxiety and Depression Scale (HADS). Results: Initially, 25 questions were proposed by the specialists. Of these, 4 questions were excluded due to similarity with others. After applying the content validity coefficient, 8 questions were excluded for presenting a value lower than 0.80, leaving 13 items. The exploratory factor analysis identified the one-dimensional structure of the FRESS with 13 items. However, five items were excluded for presenting high covariance with the error of several other FRESS items in the confirmatory factor analysis. Thus, the final version of the FRESS was defined with one domain and eight items. Regarding the construct validity, we observed a magnitude of correlation varying between 0.257 and 0.470 between the FRESS and the instruments used here. We observed adequate test-retest reliability (intraclass correlation coefficient = 0.896) and internal consistency (Cronbach's alpha = 0.868). Ceiling and floor effects were not observed. Conclusion: The FRESS with one domain and eight items has acceptable measurement properties and its use in clinical and sports environments to measure the fear of returning to sport in injured professional or recreational athletes is supported. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-022-00975-4.

Barthel Index is a valid and reliable tool to measure the functional independence of cancer patients in palliative care.

BACKGROUND: Our objective was to verify the reliability, internal consistency and construct validity of the Barthel Index in Brazilian cancer patients in palliative care. METHODS: We included patients with cancer, both sexes, and age greater than or equal to 18 years. We used to evaluate patients the Barthel Index, Karnofsky Performance Scale (KPS), and European Organization for Research in the Treatment of Cancer Questionnaire-core 15 (EORTC-QLQ-C15-PAL). The measurement properties evaluated in this study were test-retest and inter-rater reliability and construct validity (tested by means of correlations with other instruments). RESULTS: We included 220 patients for construct validity and a subsample of 27 patients for reliability analyses. We observed adequate reliability (intraclass correlation coefficient ≥ 0.962) and internal consistency (Cronbach's alpha = 0.942). There were adequate correlations between the Barthel Index and the KPS (rho = 0.766), and the functional capacity domain of the EORTC-QLQ-C15-PAL (rho = -0.698). CONCLUSION: The Brazilian version of the Barthel Index presents adequate test-retest and inter-rater reliability, acceptable internal consistency, and valid construct for measuring functional independence in cancer patients.

Structural validity of the Japanese Orthopedic Association back pain evaluation questionnaire in individuals with chronic low back pain.

OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.

Structural validity of the Japanese Orthopedic Association back pain evaluation questionnaire in individuals with chronic low back pain

SUMMARY OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.

Brazilian version of the Neck Bournemouth Questionnaire does not have a well-defined internal structure in patients with chronic neck pain.

OBJECTIVE: To investigate the structural validity of the Brazilian version of the Neck Bournemouth Questionnaire in patients with chronic neck pain. DESIGN: Cross-sectional study. SETTING: Community participants collected via online platform. SUBJECTS: Participants with neck pain (minimal pain intensity of 3 points at rest on 11-point Numerical Rating Scale), both genders and aged ⩾18 years old. MAIN MEASURE: The Numerical Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia and the Neck Bournemouth Questionnaire were completed. Exploratory and confirmatory factor analyses were used to identify dimensionality and to compare different structures of the Neck Bournemouth Questionnaire. RESULTS: We included 103 participants. The sample consisted mostly of adults (mean age = 33.64 years, standard deviation = 10.48 years), females (n = 82, 79.6%), lean, single and with higher education. The exploratory factor analysis with implementation of the parallel analysis identified the one-dimensional structure of the Neck Bournemouth Questionnaire, with a Kaiser-Meyer-Olkin value of 0.80 and Bartlett's test significant (P < 0.05). We observed that all structures tested in this study presented a high amount of residues in confirmatory factor analysis, which were identified by the value of root mean square error of approximation > 0.08 and chi-square/degree of freedom > 3.00. CONCLUSION: The internal structure of the Brazilian version of the Neck Bournemouth Questionnaire is not clear and well-defined. It was not possible to identify the construct measured by the instrument in individuals with chronic neck pain.

Fluorescent patterning of paper through laser engraving.

While thermal treatment of paper can lead to the formation of aromatic structures via hydrothermal treatment (low temperature) or pyrolysis (high temperature), neither of these approaches allow patterning the substrates. Somewhere in between these two extremes, a handful of research groups have used CO2 lasers to pattern paper and induce carbonization. However, none of the previously reported papers have focused on the possibility to form fluorescent derivatives via laser-thermal engraving. Exploring this possibility, this article describes the possibility of using a CO2 laser engraver to selectively treat paper, resulting in the formation of fluorescent compounds, similar to those present on the surface of carbon dots. To determine the most relevant variables controlling this process, 3 MM chromatography paper was treated using a standard 30 W CO2 laser engraver. Under selected experimental conditions, a blue fluorescent pattern was observed when the substrate was irradiated with UV light (365 nm). The effect of various experimental conditions (engraving speed, engraving power, and number of engraving steps) was investigated to maximize the fluorescence intensity. Through a comprehensive characterization effort, it was determined that 5-(hydroxymethyl)furfural and a handful of related compounds were formed (varying in amount) under all selected experimental conditions. To illustrate the potential advantages of this strategy, that could complement those applications traditionally developed from carbon dots (sensors, currency marking, etc.), a redox-based optical sensor for sodium hypochlorite was developed.

Risco cardiovascular pelo escore de Framingham em serviços de cardiologia de uma cidade de médio porte de Minas Gerais / Cardiovascular risk by the Framingham score in cardiology services of a medium-sized city of Minas Gerais

Objetivo. Estratificar os pacientes de serviços ambulatoriais de cardiologia através do escore de Framingham, para subsidiar o planejamento de futuras intervenções. Métodos. Trata-se de um corte transversal realizado em serviços de cardiologia de centro público ambulatorial e consultório particular de cidade de médio porte de Minas Gerais. A amostragem foi aleatória, com 329 prontuários, de pacientes acima de 30 anos, com dados suficientes. Os dados foram utilizados para cálculo do risco cardiovascular dos pacientes a partir da aplicação do escore, com posterior processamento de dados em softwares estatísticos. Resultados. A idade dos participantes variou de 30 a 74 anos, 54,7% eram do sexo feminino e 74,8% foram atendidos no serviço público de saúde. Dentre os pacientes, 48% tinham valores de HDL inferiores a 45mg/ dL e 36,5% apresentaram LDL inferior a 100mg/dL. 22,5% dos pacientes eram tabagistas e 37,1% diabéticos. 46,2% dos pacientes tiveram valores sistólicos acima de 139mmHg e 61,7% tinham valores diastólicos abaixo de 85mmHg. Em 43,8% dos prontuários analisados o risco encontrado era baixo, em 36,5% era moderado, em 19,8% era alto. O risco médio da população foi de 13,4%. Conclusão. Na população estudada, a respeito dos fatores de risco cardiovascular que compõem o Escore de Framingham, destacam-se o DM, HAS, LDL-c e tabagismo como principais contribuintes da definição do risco. Os resultados encontrados a partir do estudo são importantes para o planejamento de futuras intervenções, principalmente na atenção primária a fim de prevenir o surgimento e implementar o controle de tais fatores. (AU)

Objectives. Stratify outpatient cardiology services patients through the Framingham score to assist the planning of future interventions. Methods. This is a cross-sectional study performed in cardiology services from an outpatient public center and a private clinic of a medium-sized city of Minas Gerais. The sampling was random, with 329 medical records, of patients over the age of 30 years, with sufficient data. The data were used to calculate the cardiovascular risk of patients through the application of the score, with subsequent data processing in statistical software. Results. The age of the participants ranged from 30 to 74 years, 54.7% were female and 74.8% were treated in the public health service. Among the patients, 48% had HDL-c values lower than 45mg/dL and 36.5% had LDL-c below 100mg/dL. 22.5% of the patients were smokers and 37.1% diabetics. 46.2% of the patients had systolic values greater or equal to 139mmHg and 61.7% had diastolic values less or equal to 85mmHg. In 43.8% of the analyzed medical records, the risk was found low, in 36.5% it was moderate, in 19.8% it was high. The average risk of the population was 13.4%. Conclusion. In the studied population, regarding the cardiovascular risk factors that compose the Framingham Score, DM, systemic arterial hypertension, LDL-c and smoking stand out as the main contributors to risk definition. The results found in the study are important for the planning of future interventions, especially in primary care in order to prevent the appearance and implement the control of such factors. (AU)

Puerpera with back pain and intermittent fever.

Can you diagnose this case of puerpera with back pain and intermittent fever? http://ow.ly/AC0U30k2OkF.

Prevalência de maloclusão em crianças de 05 anos de idade em um município Catarinense / Prevalence of malocclusion in children, age five, in a municipality of Santa Catarina - Brazil

A maloclusão é atualmente um dos maiores problemas de saúde bucal, sendo superada apenas pelas doenças cárie e periodontal. Objetivo: Analisar a prevalência da maloclusão em escolares, de cinco anos de idade, em um município catarinense. Metodologia: Trata-se de um estudo transversal de análise de¬scritiva. Foi desenvolvido em cinco distritos de Criciúma (Centro, Santa Luzia, Próspera, Rio Maina e Quarta Linha) no período de fevereiro a abril de 2016. Foi aplicado um questionário semiestruturado aos pais e ex¬aminada a oclusão de seus filhos, totalizando a participação de 100 crianças. Resultados: No exame 50% das crianças necessitam algum tipo de intervenção ortodôntica nessa fase. As meninas apresentaram mais maloclusão (58%). A sobressaliência foi a mais prevalente e 100% das crianças que a apresentaram necessitam de intervenção ortodôntica. As crianças que não apresentaram sobressaliência (32,4%) também necessitam de intervenção, por outra maloclusão, associação estatisticamente significativa (p<0,001). Os pais possuem o ensino médio completo (40,2%), e renda mensal de 3 a 5 salários mínimos (46,7%). Conclusão: A maloclusão predominante foi a sobressaliência, seguida do apinhamento dental. Grande parte das crianças examinadas requer algum tipo de intervenção ortodôntica. São importantes a criação de políticas públicas e a implantação desse serviço pelo município em estudo, pois, com a intervenção ortodôntica precoce, melhores serão o prog¬nóstico e o impacto na qualidade de vida dessas crianças

The malocclusion is currently one of the largest oral health problems, only surpassed by caries and periodontal disease. Objective: To analyze the prevalence of malocclusion in students, five years old, in a municipality of Santa Catarina in Brazil. Methodology: This is a cross-sectional study with a descriptive analysis. It was developed in five Criciúma city districts (Centro, Santa Luzia, Próspera, Rio Maina and Quarta Linha) from February to April 2016. A semi-structured questionnaire was administered to parents and examined the occlusion of their children, totaling 100 children. Results: In the test 50% of children need some type of orthodontic intervention at this stage. Girls had more malocclusion (58%). The overjet was the most prevalent and 100% of children who presented, require orthodontic intervention. Children who did not have overjet (32.4%) also require intervention by other malocclusion, statistically significant association (p <0.001). Parents have completed high school (40.2%), and monthly income 3 to 5 minimum wages (46.7%). Conclusion: The predominant malocclusion was the overjet, followed by dental crowding. Much of the examined children

Terapia ocupacional em oncologia

A Terapia Ocupacional é um campo de conhecimento e de intervenção que pode abranger as áreas da saúde, da educação e outras políticas sociais. Esta profissão trabalha com planejamentos e propostas para o alcance da independência e autonomia das pessoas. O terapeuta ocupacional pode atuar em diversos locais como hospitais, centros de reabilitação, unidades básicas de saúde, hopitais-dia, ambulatórios, consultórios particulares ou na própria residência do paciente, creches, escolas empresas. Apesar de ser um profissional pouco conhecido, em especial no campo de oncologia, pode ajudar a pessoa que tem câncer a ter condições físicas e emocionais para realizar atividades que tenham significado a ela. A pesquisa tem o intuito de estudar e divulgar sobre a atuação da terapia ocupacional do Grupo Hospitalar Conceição (GHC) e incentivar as Políticas de Humanização e a Clínica Ampliada e Compartilhada na instituição, explorando as possibilidades de ampliação das equipes multiprofissionais, por meio de entrevistas realizadas com profissionais da unidade de oncologia do GHC, e percebendo a relevância das ações de terapia ocupacional em oncologia na instituição.

Aspectos oclusais da displasia cleidocraniana: relato de um caso / Occlusal aspects of the cleidocranial dysplasia: a case reported

Este trabalho tem por objetivo a revisäo de literatura da DCC a partir de um caso tratado na disciplina de ortodontia da FO-UFRGS. A DCC é caracterizada por uma série de distúrbios que envolvem a dentiçäo e também distúbios sistêmicos. Entre os distúrbios da dentiçäo temos o retardo no desenvolvimento e na erupçäo dos dentes permanentes, presença de múltiplos dentes supranumerários, anomalia de forma e de volume dos dentes, maxila pouco desenvolvida, etc. Entre os distúrbios sistêmicos podemos citar: aplasia clavicular, baixa estatura, malformaçäo de ossos longos e dos dedos, crânio com fontanelas abertas, entre outros. Os pacientes com DCC devem ser acompanhados pelo Ortodontista por um longo período para que este possa controlar o desenvolvimento da oclusäo e instituir o tratamento no momento oportuno