Brazilian adaptation of the McLean Screening Instrument for Borderline Personality Disorder

Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach's alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians.

Preverbal visual photo screening Project implementation in Portugal / Implementação de projeto de foto rastreio visual pré-verbal em Portugal

Abstract Purpose: To present the design and implementation of an amblyopia risk factors screening project, in a large based Portuguese population. Methods: Two referral centers have been enrolled to assess all children aged 2 under their direct referral area. The photoscreener used was PlusOptix ® A09. At this age, the cut-off defined for referral was: ≥1 Diopter (D) of anisometropia, ≥1.5D of astigmatism, ≥2D of myopia and ≥1.5D of hyperopia. The results were reported to a reading platform that allowed the ophthalmologist to see all exams, and provide timely appointment with a complete ophthalmologic assessment for those who needed. Results: A total of 2867 photo screens were made to the population eligible to both referral centers, which comprises a coverage rate of 55%. Out of 2611 children under one of the referral area, 53% (n=1395) adhered to the screening. Within these children, 17.5% (n=245) were referred and 15.3 % (n=214) appointments were performed. The comparison of refraction between PlusOptix ® and cycloplegic refraction showed a strong correlation regarding the sphere and cylinder values. From the 214 children observed in consultation, glasses were prescribed in 25.7% (n=55), corresponding to 3.9% of all screened children under one of the referral area. This screening method showed a positive predictive value of 58.4%. Conclusion: This screening program may be highly relevant to eradicate untreated amblyopia from our population. The results may lead to the implementation of this project to the whole country.

Resumo Objetivo: Apresentação da implementação de um projeto de rastreio de fatores de risco de ambliopia, numa população alargada portuguesa. Métodos: dois centros de referência foram selecionados para avaliar todas as crianças de 2 anos, na sua área de referenciação direta. Para o foto rastreio foi utilizado o PlusOptix ® A09. Nesta idade, os valores definidos para referenciação foram: ≥1 Dioptria (D) de anosimetropia, ≥1.5 D de astigmatismo, ≥2 D de miopia e ≥1.5 D de hipermetropia. Os resultados foram reportados a uma plataforma de leitura que permitiu ao oftalmologista ver todos os exames e providenciar uma consulta oportuna com uma avaliação oftalmológica completa para aqueles que precisavam. Resultados: Foram realizados 2867 foto rastreios na população elegível para ambos os centros de referência, perfazendo uma taxa de cobertura de 55%. Das 2611 crianças sob uma área de referência, 53% (n = 1395) aderiram ao rastreio. Dentro desse grupo, 17,5% (n = 245) foram referenciadas e 15,3% (n = 214) consultas foram realizadas. Verificou-se uma forte correlação entre a refração do PlusOptix® e a refração cicloplégica. Das 214 crianças observadas em consulta, foram prescritos óculos em 25,7% (n = 55), correspondendo a 3,9% de todas as crianças sob uma área de referência. Este método de triagem mostrou um valor preditivo positivo de 58,4%. Conclusão: Este programa de rastreio pode ser altamente relevante para erradicar a ambliopia não tratada na nossa população. Os resultados podem levar à implementação deste projeto em todo o país.

Modelo para estimativa da geração de resíduos sólidos domiciliares em centros urbanos a partir de variáveis socioeconômicas conjunturais / Model to domestic solid waste generation estimative in urban areas based on socioeconomic conjuncture variables

Este trabalho apresenta um modelo matemático para estimar a geração de resíduos sólidos residenciais urbanos. O modelo foi desenvolvido a partir de uma base física espacial de bairros de Belo Horizonte e dos indicadores socioeconômicos das respectivas populações, referentes ao período de janeiro de 2006 a dezembro de 2010. Verificou-se intrínseca relação entre a geração per capita de resíduos e a renda per capita nas regiões estudadas, testificada por coeficiente de determinação de 0,85. Posteriormente, efetuou-se a validação do modelo com dados da capital de Minas Gerais e de Porto Alegre, na qual os valores estimados foram confrontados com a geração real informada pelas prestadoras de serviços de limpeza urbana locais. A despeito de elaborado com dados de Belo Horizonte e aferido com os de Porto Alegre, os resultados abrem a perspectiva de emprego do modelo proposto na estimativa de geração de resíduos sólidos em áreas urbanas.

This work presents a mathematical model to estimate the solid waste generation in urban areas. The model was developed based on spatial physic basis of neighborhoods of Belo Horizonte and of the respective economic indicators of their population. A strong relation between per capita solid waste generation and per capita income was confirmed due the high coefficient of the determination 0.85. Afterwards the model was validated by means of Belo Horizonte and Porto Alegre datasets in which the estimated values were compared with the real solid waste generation provided by the local services. Despite of data set from Belo Horizonte, the results open the perspective of the application of the model for estimating the solid waste generation in urban areas.

Avaliação do impacto da variação da renda no consumo domiciliar de água / Evaluation of the income variation impact on household water consumption

Este trabalho objetivou avaliar o impacto que a alteração da renda das famílias exerce sobre o consumo de água tratada fornecida pela concessionária (no caso, a Companhia de Saneamento de Minas Gerias - Copasa) no município de Belo Horizonte, ao longo de um histórico de 35 meses, abrangendo o período de agosto de 2003 a junho de 2006. Para tal, utilizaram-se dados da Pesquisa Mensal de Emprego (PME) do Instituto Brasileiro de Geografia e Estatística (IBGE), englobando 3.100 domicílios e 10.200 moradores, e os consumos residenciais micromedidos dos 6 distritos operacionais da Copasa. Os dados foram observados em seus períodos de forma que houvesse a compatibilização cronológica entre os mesmos. Os resultados mostraram relação intrínseca entre o consumo per capita e a renda mensal, balizados pelos gráficos de dispersão e pelos significativos coeficientes de determinação obtidos (superiores a 0,8), além do prognóstico de saturação do consumo demonstrado para classes sociais economicamente mais favorecidas.

This work aimed to investigate the role of income variation on household water consumption supplied by the dealership (in this case, the water supply and sanitation services of Minas Gerais, Brazil - Copasa) in the urban area of Belo Horizonte, based on data spanning a period of 35 months (from August 2003 to June 2006). For this, data of the Monthly Employment Survey (PME, acronym in Portuguese) of the Brazilian Institute of Geography and Statistics (IBGE, acronym in Portuguese) were used, comprising 3,100 households with their 10,200 dwellers, and the household water consumption of the 6 operatinal districts of the Copasa. The household water consumption data were defined in order to allow the water consumption observation period to coincide with the social economic data. The results pointed out clearly that the household water consumption is strongly linked with the economical condition of the served population. This aspect was evident by means of the observation of spatial distribution and water consumption scattered related to the social economic characteristics and was supported by the highest coefficients of determination (R² > 0.8) obtained and the predictable water consumption saturation for the more prosperous social economic classes.