HospitalElder Life Program na unidade de urgência e emergência de um hospital público universitário: um programa de intervenção multicomponente para prevenção de delirium / Modified Hospital Elder Life Program in the emergency department of a public university hospital: a multicomponent intervention program for preventing delirium

Resumo Objetivo Avaliar a viabilidade da implementação de uma adaptação do Hospital Elder Life Program (HELP) com a participação de cuidadores familiares em hospital público universitário. Método Estudo piloto descritivo exploratório desenvolvido com 30 pacientes internados e seus cuidadores. Os Formulários de Registro foram aplicados para identificar fatores de risco para delirium, selecionar protocolos de intervenção e acompanhar a implementação. Nível de satisfação dos participantes e barreiras para implementar o programa foram avaliados por meio de entrevistas qualitativas. Resultados secundários foram coletados dos prontuários médicos. Análise estatística descritiva foi realizada para caracterizar a amostra e análise de conteúdo foi usada para analisar dados qualitativos. Resultados A maioria dos pacientes era do sexo feminino (60%), com idade média de 74,3 anos, ensino fundamental incompleto (60%), viúvo/divorciado (56,7%) e morava com familiares (83,3%) em casa (93,3%). Haviam sido hospitalizados 56,7% no último ano e 93,3% tinham pelo menos um fator de risco para delirium. Assistência alimentar e reposição de líquidos foi o protocolo com maior adesão (96,2%) e orientação (76,5%) com menor. Os participantes ficaram satisfeitos e acreditam que o HELP contribuiu para melhorar os resultados dos pacientes. Os motivos para não realização da intervenção proposta estavam relacionados à estrutura ou organização hospitalar, ao paciente e ao acompanhante. Conclusão Nossos resultados sugerem que ter membros da família atuando como "voluntários" é uma estratégia viável para implementar o HELP. Essa estratégia pode promover sua implementação em hospitais públicos de países de baixa e média renda.

Abstract Objective To evaluate the feasibility of implementing an adaptation of the Hospital Elder Life Program (HELP) with the participation of family caregivers in a public university hospital. Method Descriptive exploratory pilot study developed with 30 hospitalized patients and their caregivers. Registration Forms were applied to identify risk factors for delirium, to select intervention protocols, and track implementation. Participants' level of satisfaction and barriers to implementing the program were assessed through qualitative interviews. Secondary results were collected from medical records. Descriptive statistical analysis was performed to characterize the sample and content analysis was used to analyze qualitative data. Results Most patients were female (60%), with a mean age of 74.3 years, incomplete elementary school (60%), widowed/divorced (56.7%) and living with family members (83.3%) at home (93.3%). 56.7% had been hospitalized in the last year and 93.3% had at least one risk factor for delirium. Food assistance and fluid replacement was the protocol with the highest adherence (96.2%) and guidance (76.5%) with the lowest. Participants were satisfied and believe that HELP contributed to improving patient outcomes. The reasons for not performing the proposed intervention were related to the hospital structure or organization, the patient and the companion. Conclusion Our results suggest that having family members act as "volunteers" is a viable strategy to implement HELP. This strategy can promote its implementation in public hospitals in low and middle-income countries.

The Perceived Impact of The First UK COVID-19 Lockdown on Companion Animal Welfare and Behaviour: A Mixed-Method Study of Associations with Owner Mental Health.

BACKGROUND: Companion animals may be a positive presence for their owners during the COVID-19 pandemic. However, the welfare of a companion animal is strongly influenced by the behaviour of their owners, as well as their physical and social environment. We aimed to investigate the reported changes in companion animal welfare and behaviour and to examine the association between these changes and companion animal owners' mental health. METHODS: A cross-sectional online survey of UK residents over 18 years of age was conducted between April and June 2020 (n = 5926). The questionnaire included validated, bespoke items measuring outcomes related to mental health, human-animal bonds and reported changes in animal welfare and behaviour. The final item of the survey invited open-ended free-text responses, allowing participants to describe experiences associated with human-animal relationships during the first UK lockdown phase. RESULTS: Animal owners made up 89.8% of the sample (n = 5323), of whom 67.3% reported changes in their animal's welfare and behaviour during the first lockdown phase (n = 3583). These reported changes were reduced to a positive (0-7) and negative (0-5) welfare scale, following principal component analysis (PCA) of 17 items. Participants reported more positive changes for cats, whereas more negative changes were reported for dogs. Thematic analysis identified three main themes relating to the positive and negative impact on companion animals of the COVID-19 pandemic. Generalised linear models indicated that companion animal owners with poorer mental health scores pre-lockdown reported fewer negative changes in animal welfare and behaviour. However, companion animal owners with poorer mental health scores since lockdown reported more changes, both positive and negative, in animal welfare and behaviour. CONCLUSION: Our findings extend previous insights into perceived welfare and behaviour changes on a very limited range of species to a wider range of companion animals. Owner mental health status has a clear, albeit small, effect on companion animal welfare and behaviour.

Matheuristics for Multi-UAV Routing and Recharge Station Location for Complete Area Coverage.

This paper presents matheuristics for routing a heterogeneous group of capacitated unmanned air vehicles (UAVs) for complete coverage of ground areas, considering simultaneous minimization of the coverage time and locating the minimal number of refueling stations. Whereas coverage path planning (CPP) is widely studied in the literature, previous works did not combine heterogeneous vehicle performance and complete area coverage constraints to optimize UAV tours by considering both objectives. As this problem cannot be easily solved, we designed high-level path planning that combines the multiobjective variable neighborhood search (MOVNS) metaheuristic and the exact mathematical formulation to explore the set of nondominated solutions. Since the exact method can interact in different ways with MOVNS, we evaluated four different strategies using four metrics: execution time, coverage, cardinality, and hypervolume. The experimental results show that applying the exact method as an intraroute operator into the variable neighborhood descent (VND) can return solutions as good as those obtained by the closest to optimal strategy but with higher efficiency.

The Influence of Human-Animal Interactions on Mental and Physical Health during the First COVID-19 Lockdown Phase in the U.K.: A Qualitative Exploration.

The coronavirus disease 2019 (COVID-19) pandemic presents an opportunity to explore the role of animals as sources of emotional and physical support during a period when most of the population is experiencing social and environmental challenges. We investigated how companion animal owners perceived the influence of human-animal interaction on their physical and mental health during the first COVID-19 lockdown phase in the U.K., and what concerns they had regarding their animals at this time. We also explored the impact of participants' interaction with non-companion animals during this phase. A cross-sectional online survey of U.K. residents aged over 18 was conducted between April and June 2020. The final item of the survey invited open-ended free-text responses, allowing participants to describe any experiences and/or perceptions of their human-animal relationships during the COVID-19 lockdown phase. A qualitative thematic analysis of responses was undertaken. Four main themes related to the following aspects of human-animal interactions during the COVID-19 lockdown phase were identified: the positive impact of animal ownership during the COVID-19 lockdown (e.g., amelioration of wellbeing and mental health), concerns relating to animal ownership during the COVID-19 lockdown (e.g., concerns over animals carrying the COVID-19 virus), grief and loss of an animal during the COVID-19 lockdown and the impact of engaging with non-companion animals during the COVID-19 lockdown. The findings complement and extend previous insights into the impact of human-animal interaction with both companion and non-companion animals. They also highlight the challenges of caring for an animal during the lockdown phase and indicate the need to consider the development of further targeted support strategies, such as "day care" for the companion animals of key workers in this context.

Training Program for Care Professionals in Nursing Homes: Effectiveness and Feasibility.

The aim of the current study was to analyze the effectiveness and feasibility of a training program for care professionals at two nursing homes, investigating the impact on their beliefs, attitudes, and knowledge regarding aging. Twenty-three formal caregivers at a private nursing home and 10 formal caregivers at a philanthropic nursing home participated in the training program, which consisted of five weekly meetings, each lasting 1.5 hours. Characterization of the sample was performed and effectiveness and feasibility of the intervention were analyzed. The training program improved participants' knowledge about older adults; however, their attitudes and beliefs regarding old age were not affected. Results also indicated that the intervention program was feasible at both nursing homes. The positive results of the study underscore the importance of training and continuing education of professionals who work with older adults, especially staff at nursing homes. [Journal of Gerontological Nursing, 46(11), 37-47.].

Introducing a Controlled Outdoor Environment Impacts Positively in Cat Welfare and Owner Concerns: The Use of a New Feline Welfare Assessment Tool.

There is much debate over the pros and cons of allowing cats to roam freely as opposed to keeping them confined indoors. We surveyed owners who implemented a commercial physical containment system to the outdoors to evaluate their characteristics and the apparent impact of this system on cat welfare and owner perceptions. As part of the latter aim, we also developed a new feline welfare assessment tool based on the mathematical relationship between different measures. The survey was circulated to customers over the preceding 2 years of ProtectaPet® between May and June 2019 and gathered 446 responses. Univariate analyses compared changes following installation on factors such as the amount of time the cat spent outside, other cats entering the owner's garden and owners' concerns about their cat outside. Principal component analysis was used to reduce 21 potential indicators of feline welfare into fewer variables. This resulted in 4 subscales, 2 relating to positive welfare and 2 relating to negative welfare. The effects of installation of the containment system and significant predictors of these four welfare subscales were assessed. The majority of respondents lived in an urban environment with a relatively small garden, had multiple cats and a history of feline trauma associated with a road traffic accident. As expected, the time spent outside significantly increased, while the frequency of other cats entering the garden and owner concern about leaving their cats outside significantly decreased. The 4 welfare subscales grouped into positivity, maintenance behaviors, health issues and fearfulness; installation of the system was associated with significant improvements across all of these. Time spent outside after installation had a significant effect on positivity and, to a lesser extent, maintenance behaviors. Overall, installation was associated with positive changes in both owner and cat quality of life, which seem to be particularly associated with an increased sense of security. This suggests that housing cats within a controlled outside environment with physical barriers can provide a practical solution for many of the problems associated with cats being allowed out.

Vivências de mães de crianças com câncer em cuidados paliativos mediante diagnóstico, tratamento e apoio familiar / Mothers´ experience of children with cancer under palliative care / Experiencias de madres de niños con cáncer en cuidados paliativos mediante diagnóstico, tratamiento y apoyo familiar

Objetivo: Investigar a vivência de mães de crianças com câncer em cuidados paliativos. Métodos: Trata-se de uma pesquisa de campo de natureza qualitativa realizada em um hospital no estado da Paraíba. A amostra foi composta por 10 mães de crianças com câncer em cuidados paliativos. Para viabilizar a coleta dos dados, foi utilizada entrevista semiestruturada. O material obtido foi analisado por meio da técnica de análise de conteúdo proposta por Bardin. Resultados: Extraíram-se duas categorias temáticas: vivência de mães frente ao diagnóstico e tratamento de criança com câncer; e importância do apoio familiar durante os cuidados à criança hospitalizada com câncer. Conclusão: Mediante o estudo, nota-se que os cuidados paliativos precisam ser inseridos integralmente na assistência às mães de crianças com câncer, haja vista a difícil vivência das genitoras no enfretamento do diagnóstico e tratamento do filho. É, pois, necessário, que os profissionais de saúde criem espaços de diálogos acolhedores

Objective: The study's main purpose has been to investigate the mothers' experiences of bearing-cancer children who were undergoing palliative care concerning the cancer diagnosis, its treatment and family support during hospitalization. Methods: It is a field research with a qualitative approach, which was carried out with 10 (ten) mothers of bearing-cancer children who were undergoing palliative care at a hospital in the Paraíba State. Data collection took place through semi-structured interviews, subsequently, being subjected to the content analysis as proposed by Bardin. Results: After analyzing the empirical material, the following thematic categories were elaborated: Experiences of mothers facing of the diagnosis and treatment of their cancer children undergoing palliative care; Importance of family support during care provision for hospitalized children bearing cancer. Conclusion: Palliative care must be fully integrated with care provision towards cancer children mothers. Furthermore, it is necessary to provide spaces for embracement dialogues by health professionals

Objetivo: Investigar la vivencia de madres de niños con cáncer en cuidados paliativos en cuanto al diagnóstico, tratamiento y apoyo familiar durante la hospitalización. Métodos: investigación exploratoria con abordaje cualitativo, realizada con diez madres de niños con cáncer en cuidados paliativos em un hospital del estado de Paraíba, mediante entrevista semiestructurada y sometida a análisis de contenido propuesto por Bardin. Resultados: se extrajeron dos categorías temáticas: la experiencia de las madres respecto al diagnóstico y tratamiento de un niño con cáncer, destacando el dolor, sufrimiento, angustia ante el diagnóstico del niño; y la importancia del apoyo familiar durante el cuidado de los niños hospitalizados con cáncer, orientado a compartir sentimientos, afrontar condiciones adversas y tomar decisiones difíciles. Conclusión: los cuidados paliativos deben estar plenamente integrados en la atención a las madres de niños con cáncer, y es necessário desarrollar espacios de diálogo de bienvenida por parte de los profesionales de la salud

Developing Diagnostic Frameworks in Veterinary Behavioral Medicine: Disambiguating Separation Related Problems in Dogs.

Diagnoses are widely used in both human and veterinary medicine to describe the nature of a condition; by contrast, syndromes are collections of signs that consistently occur together to form a characteristic presentation. Treatment of syndromes, due to either their lack of a clear biological cause or multiple causes, necessarily remains non-specific. However, the discovery of interventions may help refine the definition of a syndrome into a diagnosis. Within the field of veterinary behavioral medicine, separation related problems (SRPs) provide a good example of a syndrome. We describe here a comprehensive process to develop a diagnostic framework (including quality control assessments), for disambiguating the signs of SRPs as an example of a heterogeneous behavioral syndrome in non-human animals requiring greater diagnostic and treatment precision. To do this we developed an online questionnaire (243 items) that covered the full spectrum of theoretical bases to the syndrome and undertook a large-scale survey of the presenting signs of dogs with one or more of the signs of SRPs (n = 2,757). Principal components analysis (n1 = 345), replicated in a second sample (n2 = 417; total n = 762), was used to define the structure of variation in behavioral presentation, while hierarchical agglomerative cluster analysis cross checked with the partitioned around medoids method was used to determine sub-populations. A total of 54 signs were of value in defining a latent structure consisting of seven principal components (termed "exit frustration," "social panic," "elimination," "redirected frustration," "reactive communication," "immediate frustration," "noise sensitivity"), which divided the population in four clusters (termed "exit frustration," "redirected reactive," "reactive inhibited" and "boredom" related SRPs) with 11 sub-clusters (3, 3, 3, and 2, respectively). We used a bottom-up data-driven approach with numerous quality checks for the definition of robust clusters to provide a robust methodology for nosological studies in veterinary behavioral medicine, that can extend our understanding of the nature of problems beyond SRPs. This provides a solid foundation for future work examining aetiological, and differential treatment outcomes, that will allow both more effective treatment and prevention programmes, based on a fully appreciation of the nature of the problem of concern.

Conhecimento sobre situação vacinal e perfil de imunoproteção para hepatite B de trabalhadores da assistência hospitalar / Vacinal situation knowledge and Hepatitis B improvement profile of hospital assistance workers / Conocimiento sobre situación vacunal y perfil de inmunoprotección para Hepatitis B de trabajadores de la asistencia hospitalaria

Justificativa e Objetivos: Hepatite B é infecção viral universalmente prevalente e considerada a doença ocupacional infecciosa mais importante entre os profissionais de saúde, e o trabalhador de Enfermagem, por desenvolver ações invasivas em quantidade e frequência intensas, constitui grupo de extrema vulnerabilidade. Imunidade obtida por vacinação constitui estratégia preventiva eficaz, entretanto, cerca de 10% dos vacinados não alcançam títulos protetores de anticorpos, sendo necessário teste sorológico para confirmar imunidade. O objetivo deste estudo foi investigar o conhecimento da equipe de enfermagem sobre situação vacinale perfil deimunoproteção para hepatite B. Métodos: Estudo epidemiológico, analítico, com 70 trabalhadores de um hospital público de referência regional no Estado da Paraíba. Após consentimento, foram submetidos à entrevista, coleta de sangue e testes sorológicos para detecção dos marcadores HBsAg e anti-HBs, em duplicata, por Eletroquimioluminescência. Os dados coletados foram processados no SPSS versão 22.0 e analisados por estatística descritiva. Resultados: A maioria dos participantes é do sexo feminino (85,7%), com média de idade de 33,4 anos e nível médio de escolaridade (75,7%). Sobre a situação vacinal, 65,7% declararam possuírem esquema completo e 12,9% não lembravam/não sabiam se já haviam recebido imunobiológico. Sobre o teste para verificação do status imunológico, 25,7% informaram desconhecerem a existência de teste específico para tal detecção. Houve associação significativa entre categoria profissional e conhecimento sobre o Anti-HBs. Conclusão: O desconhecimento dos trabalhadores de enfermagem sobre seu status vacinal e imunológico os colocam em vulnerabilidade constante para a hepatite B, sinalizando a urgência de atitudes institucionais protetivas para este público.(AU)

Background and Objectives: Hepatitis B is an universally prevalent viral infection, it is considered the most important infectious occupational disease. Immunity obtained through vaccination is an effective preventive strategy, however, about 10% of vaccinees do not achieve protective antibody titers, requiring serological test to confirm immunity. The objective of this study was to investigate the knowledge of the nursing staff about the vaccination situation and immunoprotein profile to hepatites B. Methods: It is an epidemiological, analytical, conducted with 70 workers of a public hospital of regional reference in the State of Paraíba. After consent, they were submitted to the interview, blood collection and serological tests for the detection of HBsAg and anti-HBs markers, in duplicate, by Electrochemiluminescence. The data collected were processed using the SPSS version 22.0 and analyzed using descriptive statistics. Results: Most participants were women (85.7%), with a mean age of 33.4 years and a high school degree (75.7%). About vaccination status, 65.7% reported having complete scheme and 73.9% had blood test with 18.2% of non-seroconversion of them. Regarding the test for immunological status verification, 25.7% reported not knowing the existence of a specific test for such detection. There was a significant association between professional category and knowledge about Anti-HBs. Conclusion: There was a high percentage of non-seroconversion among nursing workers, which, concomitant with the lack of knowledge about their immunological status, made them vulnerable to the disease.(AU)

Justificación y objetivos: La Hepatitis B es una infección viral universalmente prevalente y considerada la enfermedad ocupacional infecciosa más importante entre los profesionales de la salud, y el trabajador de Enfermería, por desarrollar acciones invasivas en cantidad y frecuencia intensas, constituye un grupo de extrema vulnerabilidad. La inmunidad obtenida por vacunación constituye una estrategia preventiva eficaz, mientras que aproximadamente el 10% de los vacunados no alcanzan títulos protectores de anticuerpos, siendo necesario un análisis serológico para confirmar la inmunidad. El objetivo de este estudio fue investigar el conocimiento de personal del equipo de enfermería sobre situación vacunal y perfil de inmunoproteción contra lahepatitis B. Métodos: Estudio epidemiológico, analítico, con 70 trabajadores de un hospital público de referencia regional en el Estado de Paraíba. Después del consentimiento, fueron sometidos a la entrevista, recolección de sangre y pruebas serológicas para detección de los marcadores HBsAg y anti-HBs, en duplicado, por Electroquimioluminescencia. Los datos recopilados se procesaron en el SPSS versión 22.0 y se analizaron por estadística descriptiva. Resultados: La mayoría de los participantes es del sexo femenino (85,7%), con promedio de edad de 33,4 años y con nivel medio de escolaridad (75,7%). En cuanto a la situación vacunal, el 65,7% declaró poseer un esquema completo y el 73,9% hizo una prueba sanguínea, con un 18,2% de no seroconversión. Con respecto a la prueba para verificación del estado inmunológico, el 25,7% informó desconocer la existencia de una prueba específica para tal detección. Hubo asociación significativa entre categoría profesional y conocimiento sobre el anti-HBs. Conclusión: Se verificó alto porcentaje de no seroconversión entre los trabajadores de enfermería, situación que, concomitante al desconocimiento sobre su status inmunológico, los colocan vulnerables a la enfermedad.(AU)

Effects of Host Interspecific Interaction in the Maculinea-Myrmica Parasite-Host System.

A model of interspecific host competition in a system with one parasite (butterfly-Maculinea) and multiple potential hosts (ants-Myrmica) is presented. Results indicate that host interspecific competition increases the occurrence of multiple host behaviour in Maculinea natural populations but decreases the ability of the parasite populations to adapt to the most abundant host species. These qualitative predictions were compared with data on host specificity, with good agreement. Analysis of the data also indicates that Maculinea teleius and Maculinea arion respond differently to changes in relative host abundances. Maculinea teleius shows a larger fraction of sites where it displays multiple host behaviour and a larger fraction of sites where the niches of the hosts overlap. In some instances, Maculinea teleius is adapted to Myrmica hosts that are present in lower frequencies. Maculinea arion is locally more host-specific and occurs at sites where host interspecific competition is unlikely and is more frequently adapted to the most abundant host species.

Factors that impact functional performance of elderly with low back pain / Fatores que impactam o desempenho funcional de idosos com dor lombar

Abstract Introduction: Low back pain is a common condition among older adults and an important cause of disability. Objective: To evaluate the relationship between functional performance of older adults with low back pain and the following variables: sociodemographic and clinical factors, self-perceived health and back pain beliefs. Methods: A cross-sectional study that used data from the Back Complaints in the Elders international consortium. Information about sociodemographic factors (sex, age, marital status, formal education), clinical factors (intensity and frequency of pain, comorbidities), self-perceived health, back pain beliefs and functional performance (measured by the disability component of the Late Life Function and Disability Instrument - LLFDI) were collected through self-report. 191 older adults above 60 years with a new episode of back complaints who did not have any cognitive disorder, visual or hearing impairment, or motor disabilities participated in the study. A bivariate analysis was conducted between each independent variable and each outcome. Associations with p < 0.20 were selected for the multiple linear regression analysis, which was carried out for each LLFDI domain. Results: The multiple regression coefficients of determination were significant despite the modest magnitude. The variables related to functional performance were back beliefs, self-perceived health, formal education, pain frequency and marital status. Conclusion: These results may contribute to the expansion of health professionals' work in the therapeutic approach of low back pain, broadening its focus beyond clinical aspects in order to value beliefs of older adults and their self-perceived health.

Resumo Introdução: A dor lombar é condição comum em idosos e importante causa de incapacidade nessa população. Objetivo: Avaliar a relação das variáveis sóciodemográficas, clínicas, autopercepção de saúde e crenças com o desempenho funcional de idosos com dor lombar. Métodos: Estudo transversal que utilizou dados do projeto multicêntrico Back Complaints in the Elders. A amostra foi de 191 idosos que relataram novo episódio de dor lombar em menos de 6 semanas e não apresentavam alterações cognitivas, deficiências visuais, auditivas e motoras graves. Através do auto relato, foram coletadas informações sobre características sóciodemográficas (sexo, idade, estado civil, escolaridade), clínicas (intensidade e frequência da dor, comorbidades), autopercepção de saúde, crenças em relação às consequências da dor lombar e desempenho funcional (componente de incapacidade do Late Life Function and Disability Instrument - LLFDI). Foi realizada a análise bivariada de cada variável independente com cada desfecho (6 diferentes escores fornecidos pelo componente de incapacidade do LLFDI) e aquelas que apresentaram significância p < 0,20 entraram nos modelos de regressão múltipla para cada domínio do LLFDI. Resultados: Os coeficientes de determinação dos modelos multivariados foram significativos, apesar da modesta magnitude. As variáveis que se relacionaram com o desempenho funcional foram crenças, autopercepção de saúde, escolaridade, frequência da dor e estado civil. Conclusão: Esses resultados poderão contribuir para ampliação da atuação dos profissionais de saúde para além dos aspectos clínicos, valorizando as crenças dos idosos e sua autopercepção de saúde na abordagem terapêutica com foco na dor lombar.

Dynamic changes in ear temperature in relation to separation distress in dogs.

Infrared thermography can visualize changes in body surface temperature that result from stress-induced physiological changes and alterations of blood flow patterns. Here we explored its use for remote stress monitoring (i.e. removing need for human presence) in a sample of six pet dogs. Dogs were tested in a brief separation test involving contact with their owner, a stranger, and social isolation for two one-minute-periods. Tests were filmed using a thermographic camera set up in a corner of the room, around 7m from where the subjects spent most of the time. Temperature was measured from selected regions of both ear pinnae simultaneously. Temperatures of both ear pinnae showed a pattern of decrease during separation and increase when a person (either the owner or a stranger) was present, with no lateralized temperature differences between the two ears. Long distance thermographic measurement is a promising technique for non-invasive remote stress assessment, although there are some limitations related to dogs' hair structure over the ears, making it unsuitable for some subjects.

O questionário de atividades funcionais de Pfeffer: revisão integrativa da literatura brasileira / Pfeffer’s functional activities questionnaire: an integrative review of the brazilian literature

O Questionário de Atividades Funcionais (Functional Activities Questionnaire – FAQ) tem grande importância clínica em razão da sua capacidade de identificar perdas funcionais em indivíduos com suspeita de demência. O presente estudo tem o objetivo de: 1) Identificar os grupos clínicos com os quais o instrumento é utilizado no Brasil; 2) Identificar qual versão do questionário é usada nos estudos brasileiros; 3) Avaliar o instrumento quanto ao estágio de validação, à confiabilidade e à adaptação para o contexto brasileiro, identificando as lacunas existentes e as necessidades de aprimoramento; e 4) Identificar o método de administração e o ponto de corte mais formal desse instrumento no Brasil. Realizou-se uma revisão integrativa da literatura a partir de busca nas bases de dados Lilacs, SCIELO Brasil e PUBMED, sendo que 45 estudos compuseram a amostra. Constatou-se que diferentes versões baseadas no FAQ são usadas no Brasil, não sendo possível concluir se a versão original é a mais utilizada. Esses questionários são amplamente empregados em idosos com alterações cognitivas. Foram encontrados 18 estudos de validade de construto, 15 de validade de critério e um de confiabilidade. Não foram encontrados estudos sobre a validade ecológica do FAQ. O ponto de corte utilizado com maior frequência como indicador de incapacidade funcional é o de 5 pontos. A entrevista com informante é a forma de aplicação mais utilizada. Em razão da diversidade de versões do FAQ no contexto nacional, é fundamental que o profissional tenha clareza sobre as evidências de validade da versão que utiliza para a prática clínica e de pesquisa.

Among the different assessment tools employed to measure functional capacity, the Functional Activities Questionnaire (FAQ) stands out due to its capacity for identifying functional damages in individuals with suspected dementia. The aims of the present study were: 1) identify clinical groups for which the FAQ is used in Brazil; 2) identify what version of the questionnaire is used in Brazilian studies; 3) evaluate the FAQ with regard to the stage of validation, reliability and adaptation to Brazilian culture; and 4) identify the most frequent administration method and cutoff point used for the FAQ in Brazil. An integrative review of the literature was performed based on a search of the Lilacs, SCIELO Brazil and PUBMED databases. Forty-five studies were selected to compose the sample. Different versions of the FAQ are used in Brazil and it was not possible to conclude whether the original version is the most employed. These questionnaires are widely used for older adults with cognitive impairment. Eighteen studies on construct validity, 15 on criterion validity and one on reliability were found. No study was found addressing the ecological validity of the FAQ. The most frequent cutoff point used as an indicator of functional disability was 5 points. An interview with the informant was the most frequent form of administering the questionnaire. Considering the diversity of versions of the FAQ in the national context, it is essential that the professional has clarity about the evidence of validity of the version which uses for clinical practice and research.

Psychometric properties of the Brazilian version of Pfeffer's Functional Activities Questionnaire.

Pfeffer's Functional Activities Questionnaire (FAQ) is one of the most commonly employed tools in studies on pathological cognitive aging. Despite the different versions of the questionnaire translated for use in clinical practice, few studies have analyzed the psychometric properties of the Brazilian version of the FAQ (P-FAQ). Thus, the aim of the present study was to analyze the P-FAQ with regard to internal consistency, factorial structure and associations with demographic factors (age, sex, and schooling), depressive symptoms, cognitive measures and other measures of functionality. One hundred sixty-one older adults were divided into four groups (91 with dementia, 46 with mild cognitive impairment, 11 with psychiatric disorders and 13 healthy controls). All participants were evaluated by cognitive, behavioral and functional tests and scales. Their caregivers answered the P-FAQ. The questionnaire showed high internal consistency (α = 0.91). Factor analysis revealed a two-factor structure, which, accounted for 66% of the total variance. The P-FAQ was not correlated with demographic factors, was weakly correlated with depressive symptoms (ϱ = 0.271, p < 0.01, R (2) = 7%) and strongly correlated with cognitive measures (Matttis Dementia Rating Scale total score: ϱ = -0.574, p < 0.01, R (2) = 33%) as well as complex instrumental activities of daily living (ϱ = -0.845, p < 0.01, R (2) = 71%). Cognitive performance and depression status were independent predictors of P-FAQ scores in regression models. The present findings indicate that the P-FAQ has satisfactory reliability, internal consistency, construct validity and ecological validity. Therefore, this questionnaire can be used in clinical practice and research involving the Brazilian population of older adults.

Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people

Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD. .

Development and analytical validation of a simple multivariate calibration method using digital scanner images for sunset yellow determination in soft beverages.

This paper proposed a novel methodology for the quantification of an artificial dye, sunset yellow (SY), in soft beverages, using image analysis (RGB histograms) and partial least squares regression. The developed method presented many advantages if compared with alternative methodologies, such as HPLC and UV/VIS spectrophotometry. It was faster, did not require sample pretreatment steps or any kind of solvents and reagents, and used a low cost equipment, a commercial flatbed scanner. This method was able to quantify SY in isotonic drinks and orange sodas, in the range of 7.8-39.7 mg L(-1), with relative prediction errors lower than 10%. A multivariate validation was also performed according to the Brazilian and international guidelines. Linearity, accuracy, sensitivity, bias, prediction uncertainty and a recently proposed tool, the ß-expectation tolerance intervals, were estimated. The application of digital images in food analysis is very promising, opening the possibility for automation.

Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people.

OBJECTIVE: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. RESULTS: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. CONCLUSION: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.

Evaluation of cognitive technologies in geriatric rehabilitation: a case study pilot project.

The aim of this study was to develop and evaluate low-cost technology for cognitive rehabilitation in older individuals with dementia and document changes stemming from a clinical case study using these tools. An activity board, a calendar, a routine organizer and a software program were used and evaluated by specialists (n = 7). A pre-post-case study with an elderly male with dementia was undertaken for four months. All rehabilitation resources were classified as appropriate by the specialists. Post-intervention scores demonstrated improvement in cognitive functioning and daily activities at home. There is a need for further research to assess the therapeutic effects in patients with dementia applying equipment and software to improve cognitive function.

Chemical investigation of Spigelia anthelmia Linn. used in Brazilian folk medicine as anthelmintic

An ethanol extract of aerial parts of Spigelia anthelmia was submitted to vacuum column chromatography being eluted with hexane, chloroform, ethyl acetate and methanol. The four extracts were assayed for anthelmintic activity against Haemonchus contortus, the main nematode in caprines. The ethyl acetate extract showed the strongest anthelmintic activity and the chemical study of this extract revealed as main constituents the alkaloid spiganthine and 3,7-dihydroxy-3',4'- dimethoxyflavone.