[Validation of the European Portuguese Version of a Pediatric Palliative Needs Assessment Tool: The Pediatric Palliative Screening Scale]. / Validação da Versão Portuguesa de um Instrumento de Avaliação de Necessidades Paliativas Pediátricas: A Pediatric Palliative Screening Scale.

INTRODUCTION: The Pediatric Palliative Screening Scale (PaPaS Scale) was designed to help professionals to identify life-limiting or life-threatening children/young people with complex chronic conditions who would benefit from pediatric palliative care and facilitate their timely and appropriate referral. The aim of this study was to translate, culturally adapt and validate the PaPaS Scale for the Portuguese pediatric population. MATERIAL AND METHODS: A quantitative methodological study involving translation, cultural adaptation and validation of a scale was performed. In the first phase, the translation and cultural adaptation of the original version of the PaPaS Scale from English to European Portuguese was undertaken. The second phase consisted of evaluating the psychometric properties of the Portuguese version of the PaPaS Scale. RESULTS: Fifty-one enquires pertaining to children/young adults with complex chronic conditions were completed and returned, the sum of the responses to the items on the scale revealed that 84.4% of the patients had an indication for referral to pediatric palliative care. The internal consistency analysis obtained a value of Cronbach's alpha above 0.80, so the scale was considered adequate for the analyzed data. In our sample, the item-total correlation values indicated that the 11 variables measured the PaPaS Scale with good reliability and unidimensionally. The confirmatory factor analysis suggested that the items were significant, consistent, and presented convergent validity globally. Only item "2.2. Treatment side effects" obtained a value below the defined threshold. CONCLUSION: The PaPaS Scale was translated and adapted to the European Portuguese version, allowing its immediate use in the Portuguese population. It will be essential to design multicentric studies to expand the knowledge about the psychometric characteristics of this scale.

Introdução: A Pediatric Palliative Screening Scale (PaPaS Scale) foi desenhada para ajudar os profissionais a identificar as crianças/jovens com doença crónica complexa, limitante ou ameaçadora da vida que beneficiariam de cuidados paliativos pediátricos e facilitar referenciação atempada e apropriada. O objetivo deste estudo foi traduzir, adaptar culturalmente e validar a PaPaS Scale para a população pediátrica portuguesa. Material e Métodos: Realizou-se um estudo metodológico quantitativo de tradução, adaptação cultural e validação de uma escala. Numa primeira fase, procedeu-se à tradução e adaptação cultural da versão original da PaPaS Scale de inglês para português europeu. A segunda fase consistiu na avaliação das propriedades psicométricas da versão portuguesa da Escala PaPaS. Resultados: Numa amostra de 51 questionários referentes a crianças/jovens com doença crónica complexa, a soma das respostas aos itens da escala revelou que 84,4% dos doentes tinham indicação para ser referenciados aos cuidados paliativos pediátricos. Na análise de consistência interna obteve-se um valor do alfa de Cronbach superior a 0,80, pelo que se pôde considerar a escala como adequada aos dados analisados. De facto, os valores de correlação item-total indicaram que as 11 variáveis mediram com boa fiabilidade e de forma unidimensional a escala PaPaS. Na análise fatorial confirmatória, os resultados obtidos indicaram que globalmente os itens eram significativos, consistentes e apresentaram validade convergente. Apenas o item "2.2. Efeitos secundários do tratamento" obteve um valor abaixo do limiar definido. Conclusão: A PaPaS Scale foi traduzida e adaptada para a versão em português europeu, o que permite a sua utilização imediata na população portuguesa. Torna-se importante o desenho de estudos, preferencialmente multicêntricos, que aprofundem as características psicométricas desta escala.

Genetic variation of 12 X-chromosomal STR loci in an East Timor sample.

East Timor (República Democrática de Timor Leste) is a country with a population around 1 million inhabitants located in Southeast Asia and composed of 13 districts, including the eastern half of the Timor Island, Ataúro and Jaco islands, and the coastal enclave of Oecusse-Ambeno located in West Timor. Examples of the importance of X-chromosomal short tandem repeats (STRs) analysis include parentage identification, namely in cases involving father/daughter relationships, paternity in close relative deficiency cases without access to the putative father, maternity testing, and in rape or incest cases. In this study, 149 saliva samples were collected from unrelated individuals from East Timor and 12 X-chromosomal STRs genotyped using Investigator® Argus X-12 kit (Qiagen). A total of 13 alleles not included in Investigator Argus X-12 allelic ladder (off-ladder alleles) were found, four of which never reported (alleles 34.1 and 38.1 at DXS10134, allele 17.2 at DXS10074, and allele 28.1 at DXS10146). Allele 27.3 at DXS10101 and alleles 26, 28, and 29 at DXS10148 have already been observed in other populations but their frequencies are considerably higher in East Timor population. Allele frequencies and population statistic parameters were calculated for East Timor population and data contextualized in Southeast Asia/Pacific Region.

Cymbopogon citratus industrial waste as a potential source of bioactive compounds.

BACKGROUND: Cymbopogon citratus (Cc), commonly known as lemongrass, is a very important crop worldwide, being grown in tropical countries. It is widely used in the food, pharmaceutical, cosmetic and perfumery industries for its essential oil. Cc aqueous extracts are also used in traditional medicine. They contain high levels of polyphenols, which are known for their antioxidant and anti-inflammatory properties. Hydrodistillation of lemongrass essential oil produces an aqueous waste (CcHD) which is discarded. Therefore a comparative study between CcHD and Cc infusion (CcI) was performed to characterize its phytochemical profile and to research its antioxidant and anti-inflammatory potential. RESULTS: HPLC-PDA/ESI-MS(n) analysis showed that CcI and CcHD have similar phenolic profiles, with CcHD presenting a higher amount of polyphenols. Additionally, both CcI and CcHD showed antioxidant activity against DPPH (EC50 of 41.72 ± 0.05 and 42.29 ± 0.05 µg mL(-1) respectively) and strong anti-inflammatory properties, by reducing NO production and iNOS expression in macrophages and through their NO-scavenging activity, in a dose-dependent manner. Furthermore, no cytotoxicity was observed. CONCLUSION: The data of this study encourage considering the aqueous solution from Cc leaf hydrodistillation as a source of bioactive compounds, which may add great industrial value to this crop.

Symptoms other than pain in palliative care in Portugal.

OBJECTIVE: To study the burden of patients' symptoms other than pain and their treatment by Portuguese palliative care teams. METHODS: Of the 21 Portuguese palliative care teams identified, 10 accepted to participate. Data from all patients observed on the 18th week of 2011 were collected. RESULTS: One hundred and sixty-four patients were included in this study. One hundred and fifty-one patients (92%) had cancer. The patients' median age was 71 years (16-95) and 84 (51%) were females. The main symptoms were fatigue (116 [85%]) and depression/sadness (107 [65%]). Many different drugs were used for symptom control and other aims. Symptoms and drugs used here are similar to those practiced in other countries. CONCLUSION: The practice of palliative care in Portugal seems to be similar to those in other countries.

A cross-sectional survey of pain in palliative care in Portugal.

OBJECTIVE: The purpose of this work is to study the prevalence, intensity, and treatment of pain in Portuguese palliative care teams. METHODS: Twenty-one palliative care teams were invited to participate in a cross-sectional survey. Ten of these accepted and were included in the study. Data of all patients observed on the 18th week of 2011 were collected. The data collected concerning pain were: demographic data, pain intensity, drugs prescribed, and invasive techniques. The intensity of pain was rated using a five-point verbal rating scale from none to maximum. The Pain Management Index (PMI) was used to calculate the adequacy of the analgesia. RESULTS: A total of 164 patients were included in this study. One hundred fifty-one (92 %) had cancer. The median age was 71 years (16 to 95). Eighty-four (51 %) were females. Pain was directly assessed in 136 (83 %) of the patients, whereas 27 patients could not report pain because of cognitive failure. Of those directly assessed, 77 (57 %) had pain when they were assessed: 42 (55 %) mild, 25 (32 %) moderate, 9 (12 %) severe, and 1 (1 %) maximum. Non-opioid analgesics were used: paracetamol in 61 (37 %) and NSAID in 20 (12 %). Tramadol was the only opioid for mild to moderate pain used in 25 (15 %) patients. The opioids most used for moderate to intense pain were: morphine 74 (45 %), transdermal (TD) fentanyl 32 (20 %), and buprenorphine TD 28 (17 %). The adjuvants most used were: corticosteroids 38 (23 %), gabapentin 37 (23 %), and amitriptyline 15 (9 %). Only five (4 %) patients had a negative PMI, meaning an inadequate analgesia. CONCLUSION: The general prevalence of pain is similar to that reported by other. The prevalence of moderate to severe pain is also similar to that reported in other studies, although severe pain is somewhat lower than indicated in most reports. According to the PMI, pain control was acceptable to good.

A cross-sectional survey of the activity of palliative care teams in Portugal.

Of the 21 Portuguese teams identified, 10 accepted to participate in the study. A total of 164 patients were included with a median of 15.5 per team (4-32). Of all the patients included, 60 (37%) were identified as inpatients in palliative care units; 59 (36%) by an intrahospital support team; 26 (16%) as outpatients; and 19 (12%) at home. The median age was 71 years (16-95). Fifty-one percent were females. The diagnosis was cancer in 151 (92%) patients. The most common cancer was colorectal in 22 (15%) patients, followed by gastric 17 (11%), head and neck 17 (11%), breast 15 (10%), and lung cancers 14 (9%). All patients were treated by doctors and nurses experienced in palliative care.