La aplicación del saber médico. Hipertensión y daño cognitivo

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Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

Análisis bibliométrico de instrumentos de medición de la ira en el marco de salud mental / Bibliometric analysis of anger measurement instruments in the mental health framework / Análise bibliométrica de instrumentos de mensuração da raiva no âmbito da saúde mental

El artículo buscó como objetivo identificar el conocimiento acerca de la ira y los instrumentos psicométricos diseñados para evaluarla en el marco de la salud mental. En la metodología se consideró las bases de datos de Dialnet, Scielo, Google Scholar, Sciencedirect y Scopus, llegando a 26,290 artículos. De esta cifra, 11,523 artículos fueron eliminados debido a la condición de duplicación, y otros 7,523 por no encontrarse en un idioma elegible o por ser un documento incompleto. Además, se excluyeron 4,933 artículos cuyas temáticas no estaban relacionadas con los test de ira en el marco de la salud mental. Luego, se obtuvieron 2,311 artículos; pero tras una revisión manual, se eliminaron 1,259 más. Posteriormente, fue posible recuperar un total de 1,052. De estos, se seleccionaron 140 para análisis. Finalmente, después analizar la finalidad que buscaba cada artículo, quedaron un total de 50 artículos enfocados en instrumentos psicométricos que evalúan la ira en el marco de salud mental. Estableciéndose en los resultados que, la base de datos con la mayor frecuencia de estudios encontrados es Sciencedirect, con un 36% del total de estudios, además, España es el país con la mayor frecuencia de estudios encontrados, representando el 38% del total. Concluyendo que, los instrumentos más frecuentemente empleados se encuentran el STAXI-2, seguido del DAS y el DAX

The objective of the article was to identify knowledge about anger and the psychometric instruments designed to evaluate it in the framework of mental health. The methodology considered the databases of Dialnet, Scielo, Google Scholar, Sciencedirect and Scopus, reaching 26,290 articles. Of this figure, 11,523 articles were eliminated due to duplication status, and another 7,523 because they were not in an eligible language or because they were an incomplete document. In addition, 4,933 articles were excluded whose topics were not related to anger tests in the framework of mental health. Then, 2,311 articles were obtained; but after a manual review, 1,259 more were removed. Subsequently, it was possible to recover a total of 1,052. Of these, 140 were selected for analysis. Finally, after analyzing the purpose sought by each article, there were a total of 50 articles focused on psychometric instruments that evaluate anger in the mental health framework. Establishing in the results that the database with the highest frequency of studies found is Sciencedirect, with 36% of the total studies, in addition, Spain is the country with the highest frequency of studies found, representing 38% of the total. Concluding that, the most frequently used instruments are the STAXI-2, followed by the DAS and the DAX

O objetivo do artigo foi identificar o conhecimento sobre a raiva e os instrumentos psicométricos concebidos para avaliá-la no âmbito da saúde mental. A metodologia considerou as bases de dados Dialnet, Scielo, Google Scholar, Sciencedirect e Scopus, chegando a 26.290 artigos. Desse número, 11.523 artigos foram eliminados por estarem duplicados e outros 7.523 por não estarem em idioma elegível ou por serem documentos incompletos. Além disso, foram excluídos 4.933 artigos cujos temas não estavam relacionados aos testes de raiva no âmbito da saúde mental. Obtiveram-se então 2.311 artigos; mas após uma revisão manual, mais 1.259 foram removidos. Posteriormente, foi possível recuperar um total de 1.052. Destes, 140 foram selecionados para análise. Por fim, após análise da finalidade buscada por cada artigo, obteve-se um total de 50 artigos focados em instrumentos psicométricos que avaliam a raiva no âmbito da saúde mental. Estabelecendo nos resultados que a base de dados com maior frequência de estudos encontrados é a Sciencedirect, com 36% do total de estudos, além disso, a Espanha é o país com maior frequência de estudos encontrados, representando 38% do total. Concluindo que os instrumentos mais utilizados são o STAXI-2, seguido do DAS e do DAX

Análisis bibliométrico de instrumentos de medición de la ira en el marco de salud mental

El artículo buscó como objetivo identificar el conocimiento acerca de la ira y los instrumentos psicométricos diseñados para evaluarla en el marco de la salud mental. En la metodología se consideró las bases de datos de Dialnet, Scielo, Google Scholar, Sciencedirect y Scopus, llegando a 26,290 artículos. De esta cifra, 11,523 artículos fueron eliminados debido a la condición de duplicación, y otros 7,523 por no encontrarse en un idioma elegible o por ser un documento incompleto. Además, se excluyeron 4,933 artículos cuyas temáticas no estaban relacionadas con los test de ira en el marco de la salud mental. Luego, se obtuvieron 2,311 artículos; pero tras una revisión manual, se eliminaron 1,259 más. Posteriormente, fue posible recuperar un total de 1,052. De estos, se seleccionaron 140 para análisis. Finalmente, después analizar la finalidad que buscaba cada artículo, quedaron un total de 50 artículos enfocados en instrumentos psicométricos que evalúan la ira en el marco de salud mental. Estableciéndose en los resultados que, la base de datos con la mayor frecuencia de estudios encontrados es Sciencedirect, con un 36% del total de estudios, además, España es el país con la mayor frecuencia de estudios encontrados, representando el 38% del total. Concluyendo que, los instrumentos más frecuentemente empleados se encuentran el STAXI-2, seguido del DAS y el DAX.

The objective of the article was to identify knowledge about anger and the psychometric instruments designed to evaluate it in the framework of mental health. The methodology considered the databases of Dialnet, Scielo, Google Scholar, Sciencedirect and Scopus, reaching 26,290 articles. Of this figure, 11,523 articles were eliminated due to duplication status, and another 7,523 because they were not in an eligible language or because they were an incomplete document. In addition, 4,933 articles were excluded whose topics were not related to anger tests in the framework of mental health. Then, 2,311 articles were obtained; but after a manual review, 1,259 more were removed. Subsequently, it was possible to recover a total of 1,052. Of these, 140 were selected for analysis. Finally, after analyzing the purpose sought by each article, there were a total of 50 articles focused on psychometric instruments that evaluate anger in the mental health framework. Establishing in the results that the database with the highest frequency of studies found is Sciencedirect, with 36% of the total studies, in addition, Spain is the country with the highest frequency of studies found, representing 38% of the total. Concluding that, the most frequently used instruments are the STAXI-2, followed by the DAS and the DAX.

O objetivo do artigo foi identificar o conhecimento sobre a raiva e os instrumentos psicométricos concebidos para avaliá-la no âmbito da saúde mental. A metodologia considerou as bases de dados Dialnet, Scielo, Google Scholar, Sciencedirect e Scopus, chegando a 26.290 artigos. Desse número, 11.523 artigos foram eliminados por estarem duplicados e outros 7.523 por não estarem em idioma elegível ou por serem documentos incompletos. Além disso, foram excluídos 4.933 artigos cujos temas não estavam relacionados aos testes de raiva no âmbito da saúde mental. Obtiveram-se então 2.311 artigos; mas após uma revisão manual, mais 1.259 foram removidos. Posteriormente, foi possível recuperar um total de 1.052. Destes, 140 foram selecionados para análise. Por fim, após análise da finalidade buscada por cada artigo, obteve-se um total de 50 artigos focados em instrumentos psicométricos que avaliam a raiva no âmbito da saúde mental. Estabelecendo nos resultados que a base de dados com maior frequência de estudos encontrados é a Sciencedirect, com 36% do total de estudos, além disso, a Espanha é o país com maior frequência de estudos encontrados, representando 38% do total. Concluindo que os instrumentos mais utilizados são o STAXI-2, seguido do DAS e do DAX.

Standardization of Dental Vulnerability Scale scores (EVO-BR).

BACKGROUND: Dental Vulnerability Scale (EVO-BR) is an instrument developed to help identifying oral health-vulnerable individuals. This scale comprises 15 items distributed into 4 dimensions. It is the first instrument with the potential to guide clinical and managerial decisions in the oral health field. The aim is to validate a score to enable using EVO-BR in Primary Health Care (PHC). METHOD: The investigated sample included PHC users in five Brazilian regions. Data were collected at two different stages: in 2019 (São Paulo) and in 2022 (Minas Gerais, Mato Grosso, Roraima, Pernambuco e Paraná). Exploratory descriptive study of this scale scores was carried out to create classification ranges. Subsequently, discriminant analysis was performed to assess the accuracy of the established classification. Boosting regression was carried out to check items' weight for the instrument score. RESULTS: EVO-BR score ranged from 0 (highest vulnerability) to 15 (lowest vulnerability). Four (4) classification configurations were tested. Score equal to 12 points was the one presenting the best classification of the assessed individuals (100% were correctly classified). Boosting regression has evidenced that items 1 and 2 (Overall health domain) and 14 and 15 (Health Services domain) had the strongest influence on this instrument's score. CONCLUSION: The process to standardize the EVO-BR score and, consequently, to develop assessment ranges, is an important step in the fight against health inequalities, since it provides a tool to help planning actions and interventions aimed at meeting specific needs of the population in the Primary Health Care context.

Psychometric properties of the health literacy instrument in Brazil (HLS-EU-BR47).

BACKGROUND: Health literacy (HL) is a key component of health promotion and sustainability and contributes to well-being. Despite its global relevance, HL is an under-researched topic in South America but is now debuting its exploration in Brazil. To leverage its benefits for South America, the mere translation of validated tools into Portuguese is insufficient. Rather, it is necessary to examine their validity. This study aims to assess the psychometric properties of the European Health Literacy Questionnaire (HLS-EU-BR47) using the Item Response Theory (IRT) in a population-based sample of adults in Brazil. METHODS: A cross-sectional online study was conducted across Brazil and included 1028 participants aged 18 years and above (80% women). Cronbach's alpha, McDonald's omega, factor analysis, graded responses model, Item Characteristic Curve, HL levels based on this, HL standard calculation, IRT, and regular score correlation were computed. RESULTS: The instrument exhibit high reliability (Cronbach's alpha 0.95). Factor analysis yielded one factor. IRT was appropriate for data analysis because it allowed quality evaluation of items and constructed a scale to quantify HL. The 47 items and latent features of respondents in the same unit of measurement are positioned in the construction of the HLS-EU-BR47 instrument. The percentages of individuals at each HL level, calculated using IRT, were found to be comparable to those obtained through the standard computation, e.g., 3.2% of people reported very low HL versus 10.8% inadequate HL, 56.2% reported low HL versus 39.5% problematic HL, 31.1% had moderate HL versus 30.1% sufficient HL, and 9.5% had high HL versus 19.7% with excellent HL. The mean HL scores were comparable between women and men (33.9 vs. 33.7, P = 0.36). CONCLUSION: This study provides new evidence of the validity of a widely used HL instrument for the population of South America (in this case, Brazil). This tool can be utilized by citizens, health professionals, and regional/national policymakers to inform the development of initiatives to assess and improve the HL of individuals, groups, and communities. Further studies are needed to confirm and extend the findings and to explore the influence of local cultures and practices in the vast Brazilian territory on HL.

Análisis psicométrico de la escala de evaluación de la percepción del teletrabajo femenino durante situaciones de confinamiento familiar: el caso del COVID-19 / Psychometric analysis of the female teleworking perception scale during situations of family confinement: the case of COVID-19 / Análise psicométrico e validade da escala de percepção do teletrabalho feminino em situações de confinamento familiar: o caso da COVID-19

El estudio examina las características psicométricas de una escala que mide la percepción sobre el teletrabajo femenino en la población chilena en situación de confinamiento familiar, construida durante la pandemia por COVID-19. El cuestionario explora la interacción entre los ámbitos del trabajo y la familia, centrándose específicamente en la salud mental, las actitudes hacia el teletrabajo femenino, las dinámicas familiares relacionadas con el teletrabajo femenino y las dinámicas laborales en el contexto del teletrabajo femenino durante la pandemia. Los resultados indican una fuerte coherencia interna tanto para la escala global como para sus cuatro dimensiones diferenciadas: Salud Mental, ámbito laboral, teletrabajo femenino y ámbito familiar. El análisis factorial exploratorio (AFE) revela índices de ajuste favorables gl = 17; p<0.183; x 2 /gl = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 para los 12 ítems en las cuatro dimensiones, alineándose bien con la estructura teórica respaldando los fundamentos del constructo balance trabajo/familia.

The study examines the psychometric characteristics of a scale that measures the perception of female teleworking in the Chilean population in a situation of family confinement, built during the COVID-19 pandemic. The questionnaire explores the interaction between the spheres of work and family, specifically focusing on mental health, attitudes towards female teleworking, family dynamics related to female teleworking, and work dynamics in the context of female teleworking during the pandemic. The results indicate strong internal coherence both for the global scale and for its four differentiated dimensions: Mental Health, work environment, female teleworking and family environment. The exploratory factor analysis (EFA) reveals favorable adjustment indices df = 17; p<0.183; χ 2 /df = 22.211; CFI = 0.995; NNFI = 0.983; RMSEA = 0.052 for the 12 items in the four dimensions, aligning well with the theoretical structure supporting the foundations of the work/family balance construct.

O estudo examina as características psicométricas de uma escala que mede as percepções do teletrabalho feminino na população chilena em confinamento familiar, construída durante a pandemia da COVID-19. O questionário explora a interação entre os domínios do trabalho e da família, concentrando-se especificamente na saúde mental, nas atitudes em relação ao teletrabalho feminino, na dinâmica familiar relacionada ao teletrabalho feminino e na dinâmica do trabalho no contexto do teletrabalho feminino durante a pandemia. Os resultados indicam uma forte consistência interna tanto para a escala geral quanto para suas quatro dimensões distintas: saúde mental, ambiente de trabalho, teletrabalho feminino e ambiente familiar. A análise fatorial exploratória (AFE) revela índices de ajuste favoráveis gl = 17; p<0,183; χ 2 /gl = 22,211; CFI = 0,995; NNFI = 0,983; RMSEA = 0,052 para os 12 itens nas quatro dimensões, alinhando-se bem com a estrutura teórica que sustenta os fundamentos do conceito de equilíbrio entre trabalho e família.

Effect of laparoscopic handle size on surgical performance: A randomized crossover trial.

Laparoscopic instrument handles design and dimensions are crucial to determine the configuration of surgeons' hand grip and, therefore, can have a deleterious effect on overall surgical efficiency and surgeons' comfort. The aim of this study is to investigate the impact of laparoscopic handle size and hand surface area on surgical task performance. A single-blind, randomized crossover trial was carried out with 29 novice medical students. Participants performed three simulated tasks in "black box" simulators using two scissor-type handles of different sizes. Surgical performance was assessed by the number of errors and time required to complete each task. Hand anthropometric data were measured using a 3D scanner. Execution time was significantly higher when cutting and suturing tasks were performed with the smaller handle. In addition, hand surface area was positively correlated with peg transfer task time when performed with the standard handle and was correlated with cutting task time in small and standard handle groups. We also found positive correlations between execution time and the number of errors executed by larger-handed participants. Our findings indicate that laparoscopic handle size and hand area influence surgical performance, highlighting the importance of considering hand anthropometry variances in surgical instrument design.

Intra and Inter-Device Reliabilities of the Instrumented Timed-Up and Go Test Using Smartphones in Young Adult Population.

The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.

Psychometric Properties of the Spanish Version of the Cognitive Problems and Strategies Assessment in Patients with Bipolar Disorder.

Cognitive deficits play an important role in Bipolar Disorder (BPD). The Cognitive Problems and Strategies Assessment (CPSA) is a measure that evaluates the patient's perception of cognitive difficulties, and the spontaneous use of compensatory strategies and could thus have potential utility for clinical practice in patients with BPD. Our aim was to determine the validity and reliability of the Cognitive Problems and Strategies Assessment (CPSA) in Bipolar Disorder (BPD). Ninety-three BPD outpatients and 90 controls completed the Assessment of Problems with Thinking and Memory (APTM) questionnaire and the Assessment of Memory and Thinking Strategies (AMTS) questionnaire which constitute the CPSA, the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), as a measure of convergent validity, and general sociodemographic data. Cronbach's alpha coefficient, Spearman's correlation coefficient and independent sample t tests were used for Internal consistency, Convergent validity and Discriminant validity. The APTM had a Cronbach's alpha coefficient of 0.93 and the AMTS 0.90. The COBRA score and the APTM were significantly correlated. BPD patients exhibited higher scores on the APTM and lower scores on the AMTS than controls. The present instrument enriches the clinician's repertoire for rapid and inexpensive cognitive evaluation in BPD.

Factors influencing NiTi endodontic file separation: A thematic review.

Nickel-titanium (NiTi) file separation during endodontic treatment is an undesirable event. This phenomenon needs to be understood by knowing the factors influencing fracture in endodontic files. There is a large amount of literature where these factors and their influence have been studied, increasing the knowledge about the mechanisms involved, mainly related to wire technology, file shapes and geometry, operator manipulation, the anatomy of the root canal, and the irrigation and sterilization processes. As many factors are involved, the complexity of the fracture phenomena increases and the isolated correlation of one factor with the file fracture becomes a small part of comprehending the separation phenomena. This thematic review aims to compile important reports from 2014 to 2022 on the factors influencing NiTi file separation. The information obtained was classified into wire technology, file geometry, operational aspects, irrigation and sterilization, and anatomy. For this purpose, the Scopus, Web of Science and ScienceDirect databases were consulted using a search string. Filters were applied to consolidate the final set of relevant papers covering the subject of factors influencing endodontic file separation. It was found that the fracture of NiTi files incorporates different mechanisms that operate simultaneously during the endodontic procedure and strongly affect the instrument performance. The collected information promotes good practices to prevent file separation.

Development, validation and measurement of patient satisfaction questionnaire in Spanish in drive thru services adapted to hospital pharmacies during COVID-19 pandemic.

Background: There are no validation studies on patient satisfaction surveys in Spanish that can evaluate a hospital pharmacy drive-thru service. Objective: To develop and apply a pharmacy drive-thru satisfaction survey in Spanish during the COVID-19 pandemic with an analysis of the instrument validation. Methods: This was a qualitative study for developing, validating, and measuring patient satisfaction who used the drive-thru pharmacy during the COVID-19 pandemic. Content validity was obtained by a two-round Delphi and patient interview for apparent validity. The questionnaire was administered to 110 patients. The researchers made an item reduction by inter-item and item-total correlation analysis, stability validation by a test-retest, a test of reliability by Cronbach's alpha, and extraction of factors by an exploratory factorial analysis. Likewise, confirmatory factor analysis was developed to obtain a structural equation model based on generating an instrument of two sub-models of latent factors (service and place) with ten observed variables (items). Results: A questionnaire was developed that relates six observable variables to the latent factor service and four observable variables to the latent factor place which are ten items based on a Likert scale from 1 to 5, obtaining a Cronbach's alpha = 0.901. The mean population satisfaction score was 4.523. The model presented a Root Mean Square Error of Approximation (RMSEA) of 0.026 (0.000-0.098), and standardized beta values greater than 0.2 according to the confirmatory factor analysis. Therefore, the goodness-of-fit of our model is consistent and the instrument of patient satisfaction with the use of drive-thru has been validated. Patient satisfaction had a mean of 4.9 points. Conclusions: This study developed and validated a reliable scale that evaluates satisfaction in a hospital pharmacy drive-thru service during COVID-19 pandemic that can be applied in other Spanish speaking countries. A great percentage of the patients that were evaluated had good satisfaction.

Micro-CT Assessment of Filling Removal Effectiveness in the Apical Third of Curved Canals with Different Types of Anatomy.

Introduction: The aim of this study was to assess the effectiveness of filling removal material from the apical third of curved mesial root canals of mandibular molars. Reciprocating instrumentation followed by additional rotary instrumentation with instruments made of alloys with different heat treatments was evaluated. Materials and Methods: Thirty-six mesial roots of mandibular molars were divided into two groups: Group Class IV consisted of 16 roots with two independent canals, and Group Class II consisted of 20 roots with two canals that merged into one at their apical level. Each of these two groups were further divided into two subgroups, according to the additional rotary instrument used after the reciprocating instrumentation: Group RH and Group RM for Hyflex and Mtwo, respectively. After each procedural step, the roots were scanned by micro-tomography. After each step of filling removal, the Wilcoxon matched pair test and the Mann-Whitney test were used for the evaluation between groups. The significance level adopted was 5%. Results: Significant differences were observed between groups with different Class II and Class IV anatomies, regarding filling removal after Reciproc (P<0.05). After the use of an additional rotary instrumentation, no differences were observed between the two groups (P>0.05). Conclusions: In the apical third of mesial roots of mandibular molars with Class II anatomy, an additional rotary instrumentation was shown to be necessary for improving the removal of filling material after using the single-file reciprocating instrumentation technique.

Content validity of an instrument for analysing nurses' knowledge of peripherally inserted central catheters.

Peripherally inserted central catheters (PICCs) ensure safe and long-lasting venous access. Using validated instruments to assess nurses' knowledge of PICC use will allow educational measures to improve this area of care to be developed. OBJECTIVE: This study aimed to build an instrument for analysing nurses' knowledge about PICCs and assess its content validity. METHODS: A psychometric study was used with the construction of a knowledge analysis instrument. This was developed in two stages: instrument construction; and content validation by expert judges using the content validity ratio. RESULTS: The panel of experts comprised nine nurses. Nineteen changes related to content and semantics were suggested for the instrument. CONCLUSION: The research allowed for the construction and validation of a tool for knowledge analysis; this is relevant to practice as no such knowledge instrument exists. It is proposed to use this assessment instrument to identify gaps in knowledge and implement focused training interventions.

Otherness measuring scale: design and validation for social sciences.

This paper is the result of a scale validation process, applicable to social science research, which allows the constructs of otherness and coexistence and their relationship to be trasnformed into measurable, systematized variables. In turn, this scale is the product of a research project whose main objectives were (i) to demonstrate the relationship between coexistence as an independent variable and otherness as a dependent variable, and (ii) to create and statistically validate a scale to measure both variables, so to use it in applied research. The sample consisted of 600 participants. Three instruments were used: two semantic differentials and a 33-item questionnaire. The application was carried out virtually due to the SARS-CoV-2 virus. The method includes a mixed type of work, i.e., qualitative, and quantitative procedures. The results showed two factors, the other as strange or foreign and the other as equal. The final scale consisted of 10 items, with a Cronbach's alpha of 0.86 and variance explaining 58% of the otherness.

Evidencias psicométricas de la Wong-Law Emotional Intelligence Scale (WLEIS) en universitarios de Lambayeque-Perú / Psychometric evidence of the Wong-Law Emotional Intelligence Scale (WLEIS) in university students from Lambayeque-Peru

RESUMEN Introducción: La inteligencia emocional (IE) es una habilidad clave para el desarrollo personal y académico de los estudiantes universitarios. Por ello, es conveniente disponer de instrumentos pertinentes para medir este constructo. Objetivo: El presente estudio tiene como objetivo analizar las evidencias de validez y confiabilidad de la Escala de Inteligencia Emocional de Wong-Law (WLEIS) en estudiantes universitarios de la región de Lambayeque, Perú. Método: Nuestro estudio tiene un diseño instrumental. Aplicamos un cuestionario virtual distribuido en redes sociales a 317 estudiantes universitarios (124 varones y 193 mujeres) de diferentes carreras profesionales, con edades comprendidas entre 18 y 30 años (M=20,3; DE=2,7). Se realizó un análisis factorial confirmatorio (estimador WLSMV) y se evaluó la consistencia interna. Resultados: Se encontraron cuatro factores correlacionados, de orden superior, y bifactoriales, siendo el primero el que presentó los índices de mejor ajuste: X2(98) = 262.63, p < .001, CFI = .97, TLI = .96, RMSEA = .07 (IC 90%; .06 - .08), SRMR = .04 y WRMR = .91. Los resultados de consistencia interna utilizando el coeficiente omega son ωSEA = .81, ωOEA= .79, ωUOE= .84 y ωROE = .85. Conclusión: La WLEIS en estudiantes universitarios de la región Lambayeque del Perú tiene suficientes evidencias de validez y confiabilidad para garantizar la pertinencia de su aplicación.

ABSTRACT Introduction: Emotional intelligence (EI) is a key skill for the personal and academic development of university students. Therefore, it is appropriate to have relevant instruments to measure this construct. Objective: This study aims to analyze the evidence of validity and reliability of the Wong-Law Emotional Intelligence Scale (WLEIS) in university students in the region of Lambayeque, Peru. Method: Our study has an instrumental design. We applied a virtual questionnaire distributed in social networks to 317 university students (124 males and 193 females) from different professional careers, aged between 18 and 30 years (M=20.3; SD=2.7). Confirmatory factor analysis was performed (WLSMV estimator), and internal consistency was assessed. Result: We found four correlated factors, higher order, and bifactor, the first being the one with the best-fit indices: X2(98) = 262.63, p < .001, CFI = .97, TLI = .96, RMSEA = .07 (CI 90%; .06 - .08), SRMR = .04 and WRMR = .91. Internal consistency results using the omega coefficient are ωSEA = .81, ωOEA= .79, ωUOE= .84 and ωROE = .85. Conclusion: The WLEIS in university students in the Lambayeque region of Peru has sufficient evidence of validity and reliability to guarantee the relevance of its application.

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case / Sinusite maxilar odontogênica por corpo estranho após extração dentária: relato de um caso incomum

Background: Odontogenic maxillary sinusitis caused by a foreign body presents diagnostic and therapeutic challenges due to its infrequent occurrence and unique characteristics compared to sinusitis originating from other sources. CaseReport:Illustrating such fact, this report presents the clinical case of a 37-year-old woman referred complaining of pain in the same region where she had extracted her upper right first molar five days before. The intraoral examination revealed the presence of an orifice in the region, suggesting oroantral communication. Imaging exams revealed opacification of the right maxillary sinus and the unexpected presence of a highly radiodense object. With the diagnosis of maxillary sinusitis due to a foreign body established, the surgical approach initially consisted of administering preoperative medication, preceded by access to the maxillary antrum using the Caldwell-Luc technique. The object was found and removed, consisting of a surgical drill. At follow-up there was complete absence of symptoms and complete closure of communication. Conclusion: Cases of odontogenic maxillary sinusitis caused by drill detachment after tooth extraction are fairly uncommon. A thorough clinical evaluation proved to be essential and the Caldwell-Luc access was effective, safe and with good postoperative results, even with the absence of standardized diagnostic and management methods(AU)

Contexto: A sinusite maxilar odontogênica causada por corpo estranho apresenta desafios diagnósticos e terapêuticos devido à sua ocorrência infrequente e características únicas em comparação com sinusites originadas de outras fontes. Relato do Caso: Ilustrando tal fato, este relato apresenta o caso clínico de uma mulher de 37 anos de idade encaminhada com queixa de dor em mesma região que havia extraído o primeiro molar superior direito cinco dias antes. Ao exame intraoral verificou-se a presença de um orifício na região, sugerindo comunicação oroantral. Os exames de imagem revelaram opacificação do SM direito e a inesperada presença de um objeto altamente radiodenso. Com o diagnóstico de sinusite maxilar por corpo estranho estabelecido, a abordagem cirúrgica consistiu inicialmente na administração de medicação pré-operatória, precedida pelo acesso ao antro maxilar através da técnica de Caldwell-Luc. O objeto foi encontrado e removido, consistindo em uma broca cirúrgica. Ao acompanhamento houve ausência completa dos sintomas e total fechamento da comunicação. Conclusão: Casos de sinusite maxilar odontogênica causada por descolamento da broca após extração dentária são bastante incomuns. Uma avaliação clínica minuciosa mostrou-se primordial e o acesso de Caldwell-Luc eficaz, seguro e com bons resultados pós-operatórios, mesmo com as ausências de métodos de diagnóstico e manejo padronizados.(AU)

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.

Psychometric properties of the Providers Survey in the Brazilian context of mental health: a validation study

ABSTRACT BACKGROUND: Precisely determining the aspects related to an instrument's validity and reliability measures allows for greater assurance of the quality of the results. OBJECTIVES: To analyze the psychometric properties of The Providers Survey in the Brazilian context of mental health services. DESIGN AND SETTING: The instrument validation study was conducted in Montes Claros, Minas Gerais, Brazil. METHODS: The validation study was conducted using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist to analyze its validity and reliability. RESULTS: A committee of expert judges performed content validation after which the Content Validity Index was calculated. Construct validation took place through Exploratory Factor Analysis using the Kaiser-Meyer-Olkin Test criterion and Bartlett's Sphericity Test. Reliability was verified using test-retest reliability. The significance level adopted for the statistical tests was 5% (P < 0.05). The final instrument comprised 54 questions. The Content Validity Index was 97%. Exploratory Factor Analysis identified a Kaiser-Meyer-Olkin index of 0.901 and Bartlett's Sphericity Test with P < 0.001. We obtained a Cronbach's alpha coefficient of 0.95 and an intraclass correlation coefficient of 0.849. CONCLUSIONS: The Providers Survey, translated and adapted into Portuguese, was named the Work Assessment Instrument for the Recovery of Mental Health. It presented adequate psychometric properties for evaluating work-related practices for the recovery of psychosocial care network users.

Percepción de fonoaudiólogos sobre nuevas tecnologías de la información y comunicación / Perception of speech therapist on new information and communication technologies

Objetivo: Analizar la percepción de los profesionales Fonoaudiólogos respecto al uso de nuevas Tecnologías de la Información y Comunicación en los procesos de evaluación e intervención fonoaudiológica. Métodos: Diseño de investigación cuantitativo, descriptivo, de corte transversal. Un total de 123 participantes contestaron el cuestionario de percepción. Se analizaron 14 ítems del módulo II, para los cuales se calculó el promedio, desviación estándar y coeficiente de variación. Además, se analizaron las respuestas positivas, respuestas neutras y respuestas negativas sobre el uso de las nuevas Tecnologías de la Información y Comunicación, la efectividad en distintos grupos etarios y las mejoras en los procesos de evaluación e intervención. Resultados: El 80% de los participantes declara que el uso de nuevas Tecnologías de la Información y Comunicación es efectivo en el proceso de evaluación, mientras que el 83% opina lo mismo en relación con la intervención. Además, el 51% declara que no tiene claridad de las mejoras en los resultados del proceso de evaluación y el 46% declara lo mismo en el proceso de intervención. Conclusión: Los profesionales perciben que las nuevas Tecnologías de la Información y Comunicación tienen mayor efectividad en niños y niñas mayores de 6 años. El uso de Tablet y Computador es percibido por los participantes como apropiado, sin embargo, no garantiza mejoras en los resultados de los procesos de evaluación e intervención. Los resultados respaldan futuras investigaciones en el campo de fonoaudiología para mejorar la atención a los usuarios y aprovechar las ventajas en este campo

Objective: To analyze the perception of speech-language pathologists professionals regarding the utilization of new Information and Communication Technologies in speechlanguage evaluation and intervention processes. Methods: Quantitative, descriptive, cross-sectional research design. A total of 123 participants responded to the perception questionnaire. Fourteen items were analyzed, for which the mean, standard deviation, and coefficient of variation were calculated. Furthermore, positive, neutral, and negative responses were examined concerning the use of new Information and Communication Technologies, their effectiveness across different age groups, and improvements in evaluation and intervention processes. Results: 80% of the participants affirm that the use of new Information and Communication Technologies is effective in the evaluation process, and 83% hold the same opinion regarding intervention. Furthermore, 51% state that they lack clarity regarding improvements in evaluation process outcomes with the use of new Information and Communication Technologies, while 46% declare the same in the intervention process. Conclusion: Professionals perceive that new Information and Communication Technologies are more effective for children over 6 years old. The use of tablet and computer is perceived by the participants as appropiate; however, it does not guarantee improvements in the outcomes of evaluation and intervention processes. The results support future research in the field of speech-language pathology to enhance user care and capitalize on the advantages of this domain

O impacto da ausência do brincar precoce no processo do desenvolvimento psíquico do bebê / Absence of early play and its impact on the psychic development of infants / El impacto de la ausencia del juego precoz en el proceso del desarrollo psíquico del bebé / L'absence de jeux précoces et son impact dans le développement psychique des nourrissons

Resumo A pesquisa teve como objetivo estudar o impacto da ausência do brincar precoce no desenvolvimento psíquico do bebê, quando ele se encontra privado de trocas lúdicas na relação bebê-cuidadora, no contexto das creches. A correlação dos resultados dos instrumentos IRDI, MPPE e AP3 no acompanhamento longitudinal de cinco bebês, dos 8 meses de vida aos 4 anos de idade, apontou que a ausência do brincar precoce resulta no empobrecimento do brincar simbólico e entraves no processo de subjetivação da criança.

Abstract This study investigate the absence of early play, that is, the deprivation of playful exchanges with caregivers in the nursery environment, and its impact on the psychic development of infants. Results from a longitudinal study with five infants, from 8 months to 4 years of age, collected by the IRDI, MPPE and AP3 instruments showed that the absence of early play results in the impoverishment of further symbolic play and in obstacles to the child's subjectivation process.

Resumen La investigación tiene como objetivo estudiar el impacto de la ausencia del juego precoz en el desarrollo psíquico en bebés, cuando estos se encuentran privados de intercambios lúdicos en la relación bebé-cuidador/a. En el ámbito de las guarderías, la correlación de los resultados de los instrumentos IRDI, MPPE y AP3 en el acompañamiento longitudinal de cinco bebés de ocho meses a cuatro años indicó que la ausencia del juego precoz provoca empobrecimiento del juego símbolo e impedimentos en el proceso de subjetividad del niños.

Résumé Cette étude s'intéresse à l'absence de jeux précoces, c'est-à-dire à la privation d'échanges ludiques avec les soignants dans l'espace de la crèche, et à son impact dans le développement psychique des nourrissons. Les résultats d'une étude longitudinale auprès de cinq nourrissons, suivis de 8 mois à 4 ans, recueillis à l'aide des instruments IRDI, MPPE et AP3, ont montré que l'absence de jeux précoces entraîne un appauvrissement des jeux symboliques ultérieurs et des obstacles au processus de subjectivation de l'enfant.