Immature Stages, Natural History and Population Biology of Opoptera syme (Hübner, 1821), (Lepidoptera: Nymphalidae: Satyrinae) from Southeastern Brazil.

The present study describes the immature stages of Opoptera syme (Hübner, [1821]) using SEM and Micro-CT to generate 2D and 3D models to study the morphology and chaetotaxy, and present information on the natural history, behavior, and population biology. In laboratory, eggs were laid singly, and the isolated larvae passed through six to seven instars. Host plant in the study site is unknown, but larvae are known to feed on bamboos; in laboratory, larvae accepted the ornamental bamboo Bambusa textilis McClure, 1940. Adults are diurnal and univoltine, flying from December to April (the austral summer). The present study adds information to the biology and natural history of Brassolini, an iconic and still poorly known tribe of Neotropical butterflies.

Proposition of an Energy Intake Estimating Scale through Item Response Theory.

BACKGROUND: Traditional methods for assessing individual energy consumption often involve lengthy and intricate procedures. This study aims to introduce an Energy Consumption Estimation Scale, utilizing Item Response Theory (IRT) for adolescents aged 18-19 years. METHODS: This psychometric investigation applies IRT to 93 items extracted from a validated food frequency questionnaire. The study encompasses a representative sample of 2515 adolescents from the São Luís birth cohort in Brazil. The latent trait, energy intake, is derived using IRT and subsequently validated through hierarchical multiple linear regression modeling. Significance was established at p < 0.05. RESULTS: A Samejima's model was successfully fitted (CFI and TLI > 0.9 and RMSEA < 0.08), effectively capturing variations across all energy consumption levels. Factors associated with the latent trait demonstrate consistent behavioral patterns. Adolescents with higher energy intake exhibited increased consumption of dairy products, artificially sweetened beverages, and seasonal fruits and vegetables. CONCLUSIONS: The proposed Energy Consumption Estimation Scale demonstrates a reliable measurement of energy intake and serves as a practical and concise alternative for assessing energy consumption among adolescents. These findings suggest the potential for adapting similar models for different age groups and incorporating diverse food items based on the obtained results.

Characteristics of deaths by suicide in postmortem studies in Brazil: A systematic review and meta-analysis.

INTRODUCTION: Suicide is one of the leading causes of death, with a trend for its increase in Brazil in past decades. This study aimed to review the characteristics of suicides in Brazilian postmortem studies. METHODS: Studies investigating suicide deaths in Brazil, and based on autopsy or psychological autopsy were included. Proportions were pooled across studies with the use of random and fixed effects models. RESULTS: 6777 references were retrieved from six databases (searches up to January, 2023), and 45 studies included. In autopsy studies (k = 37, n = 16,231), substance use at toxicological analysis was found in 36.42% of cases (95% CI: 30.05-43.32), previous suicide attempts in 23.92% (95% CI: 6.73-57.78). In psychological autopsy studies (k = 8, n = 139), previous suicide attempts were reported in 28.09% (95% CI: 19.74-38.28), psychiatric conditions/symptoms in 90.67% (95% CI: 67.79-97.82), family history of suicidality in 21.33% (95% CI: 13.5-32.03). Most suicide deaths were reported in males and took place at the victim's home, hanging was the most frequent suicide method. Included studies presented significant limitations in quality assessment. CONCLUSION: Future studies should present more robust methodology, including bigger samples, the use of controls, and validated methodology.

Assessment of the Brazilian Version of the Epworth Sleepiness Scale Using Item Response Theory: A Psychometric Study.

There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima's graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item 'Sitting still in a public place', the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item 'Sitting around talking to someone' presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.

Exploring Anthocyanin and Free and Bound Phenolic Compounds from Two Morphotypes of Araçá (Psidium cattleianum Sabine) by LC-ESI-QqQ-MS/MS.

Araçá is a Brazilian native fruit belonging to the Myrtaceae family. Although some studies already prove its health benefits, it is still necessary to explore the phenolic compounds in all its parts separately. This study aimed to investigate the free, esterified, glycosylated, and insoluble phenolics in two morphotypes of araçá, red and yellow, evaluating peel, pulp, and seed separately, using liquid chromatography coupled to mass spectrometry (LC-ESI-QqQ-MS/MS). Fourteen phenolics and five anthocyanins were quantified in both morphotypes. The peels presented the highest contents, followed by the pulp and seeds. Red araçá stood out over the yellow one only in the phenolic fractions resulting from the peel, with the yellow araçá being superior in the phenolic fractions of the pulp and seed. The highest antioxidant capacities were detected for the pulp-esterified phenolics (498.3 µmol g-1) and peel-free phenolics (446.7 µmol g-1) of yellow araçá. Principal component analysis (PCA) indicated specific markers to differentiate the samples. All parts of the araçá proved to be a rich source of phenolic compounds, in different fractions, mainly in the peel. This information will be beneficial to stimulate the consumption of native fruits and their possible use in the development of new products.

Compreensão dos usuários sobre os níveis de atenção à saúde com enfoque na atenção primária à saúde / Users' understanding of health care levels with a focus on primary health care

Objetivo: analisar a compreensão dos usuários sobre os níveis de atenção à saúde com enfoque na atenção primária à saúde. Método: estudo de quantitativo, com delineamento transversal, exploratório e descritivo realizado no Hospital Municipal e Unidade Básica de Saúde localizados no município de Arandu/SP, no período de 15 a 31 de outubro de 2021. Resultados: idade média foi de 31 a 59 anos com 54,71%, sexo feminino com representatividade de 92,45%, 39,62% possuíam o ensino médio e 71,69% religião católica. A ocupação prevalente foi do lar e aposentado com 13,20%. 60,37% não apresentam morbidades, 81,13% procuram o hospital para atendimento, 81% destacou a escuta qualificada das demandas pelo hospital e 83% afirmaram que o agendamento no Centro de Saúde é difícil de conseguir. Conclusão: a construção de políticas públicas e ampliação dos serviços de assistência primária à saúde são a melhor estratégia para garantir a sustentabilidade dos sistemas de saúde.(AU)

Objective: to analyze users' understanding of health care levels with a focus on primary health care. Method: a basic, exploratory and descriptive study carried out at the Municipal Hospital and Health Unit carried out in the municipality of Arandu/SP1, from 15 to 31 of 2020. Results: mean age was 31 to 59 years with54.71%, female sex, representing 92.45%, 39.62% had high school and 71.69% were Catholic. The predominant occupation was housewives and retired with 13.20%. 60.37% do not have morbidities 81.13% and demand 8 the hospital for care, 1% highlighted to respect the demands by the hospital 83% said scheduling at the Health Center is difficult to achieve. Conclusion: the construction of public policies and health care services guaranteed to the best health strategy to guarantee the maintenance of health systems.(AU)

Objetivo: analizar la comprensión de los usuarios sobre los niveles de atención de salud con enfoque en la atención primaria de salud. Método: estudio cuantitativo, transversal, exploratorio y descriptivo realizado en el Hospital Municipal y Unidad Básica de Salud localizados en el municipio de Arandu/SP, del 15 al 31 de octubre de 2021. Resultados: la edad media fue de 31 a 59 años con 54,71%, sexo femenino con una representatividad de 92,45%, 39,62% tenían enseñanza media y 71,69% religión católica. La ocupación prevalente fue doméstica y jubilado con 13,20%. El 60,37% no tenían morbilidades, el 81,13% buscaban el hospital para ser atendidos, el 81% destacaron la escucha calificada de las demandas por el hospital y el 83% afirmaron que la programación en el Centro de Salud es difícil de conseguir. Conclusión: la construcción de políticas públicas y la ampliación de los servicios de atención primaria son la mejor estrategia para garantizar la sostenibilidad de los sistemas de salud.(AU)

Incidence, Risk Factors and Effective Treatment Strategies for Chylothorax After Pediatric Heart Surgeries: Retrospective Analysis of Large Database in Single Institution.

Background: Risk factors for postoperative chylothorax in children who had cardiothoracic procedures are not always clear. Due to complex course in post-operative care, It's always challenging to find the risk factors, and their management. Objective: The aim of our study was to identify the incidence, risk factors and effective treatment approaches for chylothorax after pediatric heart surgery. Methods: Children who had the cardiac surgery and subsequently developed chylothorax were included in the study. The ratio of the experimental group to the control group was 1:2. Decannulations of extracorporeal membrane oxygenation (ECMO) were not included in the analysis of patient outcomes. For each patient, we keep track of their age, weight, gender, syndrome, RACH-1 scoring, fluid balance, bypass time, clamp time, redo operations, open or close heart surgeries, and rhythm difficulties. Care logs were kept for every single therapy that was administered. Primary outcome was chylothorax, with secondary outcomes included time in the intensive care unit (ICU), length of hospital stay (LOS), and death. Results: 5210 surgeries were performed in six years. 96 patients developed the chylothorax with incidence of 1.8%. In chylothorax group, mean weight was 6.7 ± 4.2, while mean age was 11.7 ± 15.2. Clamp time was 74.5 ± 53.5 versus 39.9 ± 13.7. Mean bypass time was 128.34(76.25) versus 84.3 ± 25.1 with an odds ratio 1.02 (Z test 0.0001). Six (6.3%) children with chylothorax had redo cardiac surgeries in the same admission (p-value 0.01) while none in other. Five (5.2%) cases got operated by thoracotomy, three from left side. Mean Chest tube duration was 10±7.8 days versus 3.8±2.4 in control group. (p-value 0.02). chylothorax resolved (mean resolving time = 4 days) in 76 (79.2%) children with monogen formula. Two patients receive midodrine with no significant effect. Four children underwent surgical repair for chylothorax. Conclusion: Bypass time linearly increases incidence of chylothorax. Younger age, low weight, syndromic children, redo operations, non-open-heart surgeries, and arrhythmias also contribute to this. Gender, fluid balance, and RACHS-1 Scoring were not significant. While further research and testing are required for the use of midodrine. However, the low-fat formula of Monogen has proven to be an effective treatment.

Regional communication and media analysis of aquaculture in Atlantic islands.

The way the media portrays aquaculture-related events can influence how this industry is perceived by the public and affect its success. Since media are an important source of public information, media content analysis has been carried out in several regions of the world. This study aimed to determine which aspects of aquaculture were more exposed and how they were discussed by regional media in the Madeira archipelago, an oceanic group of Portuguese islands. Analysis of aquaculture's media coverage in the two most-read regional newspapers of Madeira was carried out over a 5-year period (2017 to 2021). For each news article, the assessment focused on the geographic scope, the main topics covered, the stakeholders with access to the debate, and the general tone of the article (risk/benefit framework). A total of 297 articles were analyzed. Results indicate the occurrence of trigger events that contributed to a shift in the amount of news published and in the way media framed aquaculture. In general, political and economic issues dominated the coverage, whereas social, environmental, scientific, and landscape matters received less media attention. The voice of the government was predominant throughout the 5 years in analysis and aquaculture was generally framed with a balanced tone, slightly more negative. Open and transparent communication between the stakeholders and the media is fundamental for the sustainable development of the aquaculture industry.

Brazilian National Food and Nutritional Security System: what are the similarities in the decentralization process?

This study aimed to analyze the multiple characteristics of the decentralization of the Brazilian National Food and Nutritional Security System (SISAN) in a period before the institutional dismantling. Data from the 26 Brazilian states were collected in two public information systems, referring to the years 2017/2018. An exploratory and descriptive study was performed using a hierarchical cluster analysis, based on an analysis model with multiple characteristics of the system decentralization. The results indicated the formation of three clusters, showing the similarity among states with greater intersectoral and participatory character, better relationship with municipalities, and allocation of resources. On the other hand, states with less intersectoral and participatory character, linked to the low allocation of resources, execution of food security actions, and municipal support were clustered. These clusters composed mainly of North and Northeastern states, with a lower Gross Domestic Product, average Human Development Index, and a higher occurrence of food insecurity, expressed characteristics that may be related to greater obstacles in the system decentralization process. This information can help in the decision-making about the SISAN in a more equitable manner, supporting the actors involved in its maintenance and defense, at a time when the country presents an austere political and economic situation, marked by the progressive worsening of food insecurity.

A seeding-based neuronal model of tau aggregation for use in drug discovery.

Intracellular accumulation of tau protein is a hallmark of Alzheimer's Disease and Progressive Supranuclear Palsy, as well as other neurodegenerative disorders collectively known as tauopathies. Despite our increasing understanding of the mechanisms leading to the initiation and progression of tau pathology, the field still lacks appropriate disease models to facilitate drug discovery. Here, we established a novel and modulatable seeding-based neuronal model of full-length 4R tau accumulation using humanized mouse cortical neurons and seeds from P301S human tau transgenic animals. The model shows specific and consistent formation of intraneuronal insoluble full-length 4R tau inclusions, which are positive for known markers of tau pathology (AT8, PHF-1, MC-1), and creates seeding competent tau. The formation of new inclusions can be prevented by treatment with tau siRNA, providing a robust internal control for use in qualifying the assessment of potential therapeutic candidates aimed at reducing the intracellular pool of tau. In addition, the experimental set up and data analysis techniques used provide consistent results in larger-scale designs that required multiple rounds of independent experiments, making this is a versatile and valuable cellular model for fundamental and early pre-clinical research of tau-targeted therapies.

Novel repertoire of tau biosensors to monitor pathological tau transformation and seeding activity in living cells.

Aggregates of the tau protein are a well-known hallmark of several neurodegenerative diseases, collectively referred to as tauopathies, including frontal temporal dementia and Alzheimer's disease (AD). Monitoring the transformation process of tau from physiological monomers into pathological oligomers or aggregates in a high-throughput, quantitative manner and in a cellular context is still a major challenge in the field. Identifying molecules able to interfere with those processes is of high therapeutic interest. Here, we developed a series of inter- and intramolecular tau biosensors based on the highly sensitive Nanoluciferase (Nluc) binary technology (NanoBiT) able to monitor the pathological conformational change and self-interaction of tau in living cells. Our repertoire of tau biosensors reliably reports i. molecular proximity of physiological full-length tau at microtubules; ii. changes in tau conformation and self-interaction associated with tau phosphorylation, as well as iii. tau interaction induced by seeds of recombinant tau or from mouse brain lysates of a mouse model of tau pathology. By comparing biosensors comprising different tau forms (i.e. full-length or short fragments, wild-type, or the disease-associated tau(P301L) variant) further insights into the tau transformation process are obtained. Proof-of-concept data for the high-throughput suitability and identification of molecules interfering with the pathological tau transformation processes are presented. This novel repertoire of tau biosensors is aimed to boost the disclosure of molecular mechanisms underlying pathological tau transformation in living cells and to discover new drug candidates for tau-related neurodegenerative diseases.

Intramuscular Anti-D treatment for immune thrombocytopenia: A single centre experience.

Intravenous Anti-Rhesus-D immunoglobulin (Anti-D) is a first-line treatment option for immune thrombocytopenia in non-splenectomised and RhD-positive patients. In this report, we retrospectively review our experience with intramuscular (IM) Anti-D treatment in 74 adult patients between 1990 and 2018. We found that 73% of patients showed a response; almost all of them had complete responses (68.9%), and 26% achieved complete responses sustained at least 6 months after treatment discontinuation. [Correction added on 02 December 2022, after first online publication: In the preceding sentence, '(68.89%)' has been corrected to '(68.9%)' in this version.] No significant side effects were observed with no cases of acute haemolysis or anaemia reported. We conclude from this study that IM Anti-D is an effective and safe treatment for immune thrombocytopenia.

Brazilian National Food and Nutritional Security System: what are the similarities in the decentralization process? / Sistema Nacional de Segurança Alimentar e Nutricional: quais são as semelhanças no processo de descentralização? / Sistema Nacional de Seguridad Alimentaria y Nutricional: ¿cuáles son las similitudes en el proceso de descentralización?

This study aimed to analyze the multiple characteristics of the decentralization of the Brazilian National Food and Nutritional Security System (SISAN) in a period before the institutional dismantling. Data from the 26 Brazilian states were collected in two public information systems, referring to the years 2017/2018. An exploratory and descriptive study was performed using a hierarchical cluster analysis, based on an analysis model with multiple characteristics of the system decentralization. The results indicated the formation of three clusters, showing the similarity among states with greater intersectoral and participatory character, better relationship with municipalities, and allocation of resources. On the other hand, states with less intersectoral and participatory character, linked to the low allocation of resources, execution of food security actions, and municipal support were clustered. These clusters composed mainly of North and Northeastern states, with a lower Gross Domestic Product, average Human Development Index, and a higher occurrence of food insecurity, expressed characteristics that may be related to greater obstacles in the system decentralization process. This information can help in the decision-making about the SISAN in a more equitable manner, supporting the actors involved in its maintenance and defense, at a time when the country presents an austere political and economic situation, marked by the progressive worsening of food insecurity.

Este estudo teve como objetivo analisar as múltiplas características da descentralização do Sistema Nacional de Segurança Alimentar e Nutricional (SISAN) em um período anterior ao desmonte institucional. Dados dos 26 estados brasileiros foram coletados em dois sistemas públicos de informação, referentes aos anos de 2017/2018. Um estudo exploratório e descritivo foi realizado por meio de uma análise de cluster hierárquica baseada em um modelo de análise com múltiplas características de um sistema descentralizado. Os resultados indicaram a formação de três clusters, mostrando a semelhança entre os estados com maior caráter intersetorial e participativo, assim como melhor relação com municípios e alocação de recursos. De forma oposta, os estados com menor caráter intersetorial e participativo foram agrupados, ligados à baixa alocação de recursos, execução de ações de segurança alimentar e de apoio municipal fracos. Os clusters compostos principalmente por estados do Norte e Nordeste, com menor Produto Interno Bruto, Índice de Desenvolvimento Humano médio e maior ocorrência de insegurança alimentar, expressaram características que podem estar relacionadas a maiores obstáculos na descentralização. Essas informações podem auxiliar na tomada de decisão do SISAN de forma mais equitativa, servindo de apoio aos atores envolvidos em sua manutenção e defesa, em um momento em que o país apresenta uma situação política e econômica de austeridade, marcada pela piora progressiva da situação de insegurança alimentar.

Este estudio tuvo como objetivo analizar las múltiples características de la descentralización del Sistema Nacional de Seguridad Alimentaria y Nutricional (SISAN) en el periodo anterior al desmantelamiento institucional. Los datos de los 26 estados brasileños se recolectaron de dos sistemas de información pública referentes al periodo 2017/2018. Se realizó un estudio exploratorio y descriptivo mediante análisis de clúster jerárquico basado en un modelo de análisis con múltiples características de un sistema descentralizado. Los resultados indicaron la formación de tres clústeres, mostrando la similitud entre los estados de mayor intersectorialidad y participación, así como una mejor relación con los municipios y asignación de recursos. Por otro lado, se agruparon los estados de menor carácter intersectorial y participativo, vinculados a la baja asignación de recursos, ejecución de acciones de seguridad alimentaria y débil apoyo municipal. Los clústeres compuestos principalmente por los estados del Norte y Nordeste de Brasil, con menor Producto Interno Bruto, Índice de Desarrollo Humano medio y mayor ocurrencia de inseguridad alimentaria tuvieron características expresadas que pueden estar relacionadas con mayores obstáculos en la descentralización. Estos datos pueden ayudar al SISAN en la toma de decisiones de manera más equitativa y servir de apoyo a los actores involucrados en su mantenimiento y defensa, en momentos en que el país se enfrenta a una situación política y económica de austeridad, marcada por el progresivo empeoramiento de la inseguridad alimentaria.

Emergency Veno-Arterial Extracorporeal Membrane Oxygenation for Pericardial Decompression Syndrome.

Background: Pericardiocentesis is a therapeutic lifesaving intervention for patients presenting with cardiogenic shock due to pericardial effusion with signs of tamponade. Pericardial decompression syndrome (PDS) is a rare fatal complication that may occur after pericardiocentesis. Case Presentation. We report a case of a patient with idiopathic primary pulmonary hypertension who presented with massive pericardial effusion complicated with rapid hemodynamic and respiratory deterioration. Gradual therapeutic pericardiocentesis was done but progressive circulatory collapse occurred. Emergent veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was applied. Echocardiography revealed severe right ventricle failure. Unfortunately, the patient developed acute progressive thrombocytopenia and bilaterally diffuse subarachnoid hemorrhage after 4 days of ECMO support. Conclusions: Therapeutic pericardiocentesis can be occasionally fatal in cases of significant pulmonary hypertension with massive pericardial effusion when complicated by pericardial decompression syndrome. Acute significant thrombocytopenia may occur with VA-ECMO support resulting in fatal bleeding.

Effects of a Serine Protease Inhibitor N-p-Tosyl-L-phenylalanine Chloromethyl Ketone (TPCK) on Leishmania amazonensis and Leishmania infantum.

Studies have previously demonstrated the importance of serine proteases in Leishmania. A well-known serine protease inhibitor, TPCK, was used in the present study to evaluate its in vitro and in vivo antileishmanial effects and determine its mechanism of action. Despite slight toxicity against mammalian cells (CC50 = 138.8 µM), TPCK was selective for the parasite due to significant activity against L. amazonensis and L. infantum promastigote forms (IC50 = 14.6 and 31.7 µM for L. amazonensis PH8 and Josefa strains, respectively, and 11.3 µM for L. infantum) and intracellular amastigotes (IC50 values = 14.2 and 16.6 µM for PH8 and Josefa strains, respectively, and 21.7 µM for L. infantum). Leishmania parasites treated with TPCK presented mitochondrial alterations, oxidative stress, modifications in lipid content, flagellar alterations, and cytoplasmic vacuoles, all of which are factors that could be considered as contributing to the death of the parasites. Furthermore, BALB/c mice infected with L. amazonensis and treated with TPCK had a reduction in lesion size and parasite loads in the footpad and spleen. In BALB/c mice infected with L. infantum, TPCK also caused a reduction in the parasite loads in the liver and spleen. Therefore, we highlight the antileishmanial effect of the assessed serine protease inhibitor, proposing a potential therapeutic target in Leishmania as well as a possible new alternative treatment for leishmaniasis.

Subtilisin of Leishmania amazonensis as Potential Druggable Target: Subcellular Localization, In Vitro Leishmanicidal Activity and Molecular Docking of PF-429242, a Subtilisin Inhibitor.

Subtilisin proteases, found in all organisms, are enzymes important in the post-translational steps of protein processing. In Leishmania major and L. donovani, this enzyme has been described as essential to their survival; however, few compounds that target subtilisin have been investigated for their potential as an antileishmanial drug. In this study, we first show, by electron microscopy and flow cytometry, that subtilisin has broad localization throughout the cytoplasm and membrane of the parasite in the promastigote form with foci in the flagellar pocket. Through in silico analysis, the similarity between subtilisin of different Leishmania species and that of humans were determined, and based on molecular docking, we evaluated the interaction capacity of a serine protease inhibitor against both life cycle forms of Leishmania. The selected inhibitor, known as PF-429242, has already been used against the dengue virus, arenaviruses, and the hepatitis C virus. Moreover, it proved to have antilipogenic activity in a mouse model and caused hypolipidemia in human cells in vitro. Here, PF-429242 significantly inhibited the growth of L. amazonensis promastigotes of four different strains (IC50 values = 3.07 ± 0.20; 0.83 ± 0.12; 2.02 ± 0.27 and 5.83 ± 1.2 µM against LTB0016, PH8, Josefa and LV78 strains) whilst having low toxicity in the host macrophages (CC50 = 170.30 µM). We detected by flow cytometry that there is a greater expression of subtilisin in the amastigote form; however, PF-429242 had a low effect against this intracellular form with an IC50 of >100 µM for intracellular amastigotes, as well as against axenic amastigotes (94.12 ± 2.8 µM for the LV78 strain). In conclusion, even though PF-429242 does not affect the intracellular forms, this drug will serve as a tool to explore pharmacological and potentially leishmanicidal targets.

[Supply of best childbirth practices in maternity units of Rede Cegonha according to Item Response Theory]. / Oferta das boas práticas do parto em maternidades da Rede Cegonha segundo a Teoria de Resposta ao Item.

This study aimed to develop an intelligible scale to measure the level of supply of best practices in labor, childbirth and delivery in maternity units in the Rede Cegonha (RC) based on the workers' perception. The scale consisted of seventeen items related to best practices, based on the instrument used in the "Evaluation of care during delivery and birth in maternity hospitals in the RC" research The three-parameter logistic model of Item Response Theory was used to create the scale and analyze the items. The scale consisted of three levels. In the first level, there are maternity hospitals that adequately offered strategies for welcoming and encouraging the pregnant woman to circulate during labor. The second level maternity wards also included the adequate offer of the right to a companion of choice, massage, ball and different birth positions. Finally, the third level maternity hospitals also offered an adequate delivery stool, as well as the items already mentioned. The findings of this study showed the contribution of each item in measuring the level of supply of best practices in care for labor, childbirth and delivery and the construction of an intelligible scale to assess RC maternity hospitals.

Este estudo objetivou elaborar uma escala interpretável para mensurar o nível de oferta das boas práticas no trabalho de parto e parto em maternidades da Rede Cegonha (RC) a partir da percepção dos trabalhadores. A escala foi composta por dezessete itens relacionados às boas práticas, obtidos a partir do instrumento utilizado na pesquisa "Avaliação da atenção ao parto e nascimento em maternidades da RC". O modelo logístico de três parâmetros da Teoria de Resposta ao Item foi utilizado para criação da escala e análise dos itens. A escala foi composta por três níveis âncoras. No primeiro nível âncora, tem-se maternidades que ofertavam adequadamente estratégias para o acolhimento e estimulando a gestante a deambular no trabalho de parto. As maternidades do segundo nível incluíram também a oferta adequada do direito a acompanhante de livre escolha da mulher, massagem, bola e diferentes posições de parto. Por fim, têm-se as maternidades do terceiro nível ofereciam também adequadamente banqueta de parto, bem como os itens já citados. Os achados deste estudo mostraram a contribuição de cada item na mensuração do nível de oferta das boas práticas de atenção ao trabalho de parto e parto e a construção de uma escala interpretativa para avaliação das maternidades da RC.

Oferta das boas práticas do parto em maternidades da Rede Cegonha segundo a Teoria de Resposta ao Item / Supply of best childbirth practices in maternity units of Rede Cegonha according to Item Response Theory

Resumo Este estudo objetivou elaborar uma escala interpretável para mensurar o nível de oferta das boas práticas no trabalho de parto e parto em maternidades da Rede Cegonha (RC) a partir da percepção dos trabalhadores. A escala foi composta por dezessete itens relacionados às boas práticas, obtidos a partir do instrumento utilizado na pesquisa "Avaliação da atenção ao parto e nascimento em maternidades da RC". O modelo logístico de três parâmetros da Teoria de Resposta ao Item foi utilizado para criação da escala e análise dos itens. A escala foi composta por três níveis âncoras. No primeiro nível âncora, tem-se maternidades que ofertavam adequadamente estratégias para o acolhimento e estimulando a gestante a deambular no trabalho de parto. As maternidades do segundo nível incluíram também a oferta adequada do direito a acompanhante de livre escolha da mulher, massagem, bola e diferentes posições de parto. Por fim, têm-se as maternidades do terceiro nível ofereciam também adequadamente banqueta de parto, bem como os itens já citados. Os achados deste estudo mostraram a contribuição de cada item na mensuração do nível de oferta das boas práticas de atenção ao trabalho de parto e parto e a construção de uma escala interpretativa para avaliação das maternidades da RC.

Abstract This study aimed to develop an intelligible scale to measure the level of supply of best practices in labor, childbirth and delivery in maternity units in the Rede Cegonha (RC) based on the workers' perception. The scale consisted of seventeen items related to best practices, based on the instrument used in the "Evaluation of care during delivery and birth in maternity hospitals in the RC" research The three-parameter logistic model of Item Response Theory was used to create the scale and analyze the items. The scale consisted of three levels. In the first level, there are maternity hospitals that adequately offered strategies for welcoming and encouraging the pregnant woman to circulate during labor. The second level maternity wards also included the adequate offer of the right to a companion of choice, massage, ball and different birth positions. Finally, the third level maternity hospitals also offered an adequate delivery stool, as well as the items already mentioned. The findings of this study showed the contribution of each item in measuring the level of supply of best practices in care for labor, childbirth and delivery and the construction of an intelligible scale to assess RC maternity hospitals.

Analysis of the AUDIT factor structure in adolescents between 18 and 19 years.

OBJECTIVE: To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years. METHODS: Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS: The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, "was injured or someone else was injured due to drinking." Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments. CONCLUSION: The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol.