The Body Appreciation Scale-2: Psychometric evaluation of the Puerto Rican Spanish version among women aged ≥ 50 years who are breast cancer survivors.

PURSPOSE: Self-perceived body image may impact women's well-being and levels of depressive symptomatology after cancer-related treatment. The Body Appreciation Scale-2 (BAS-2) is a 10-item, unidimensional tool used to assess body appreciation, a facet of body image. A culturally relevant version of the BAS-2 was needed for the Spanish spoken in Puerto Rico. A cross-cultural adaptation of the BAS-2 for Spanish spoken in Puerto Rico was conducted and tested its psychometric properties, using a methodological design. It was hypothesized that the BAS-2 adapted for Puerto Rican Spanish would have an internal consistency with a Cronbach α value greater than 0.70 and a unidimensional structure; and that body appreciation would be positively and significantly correlated to mental health and would be negatively and significantly correlated to depression and body mass index. METHODS: One hundred-nine participants were recruited with a diagnosis of breast cancer (stages 0 to III) who completed adjuvant curative therapy at least two months to five years prior to recruitment. RESULTS: Participants had an average age of 61.5 years (SD = 7.1), and 64.2% had a bachelor's degree or higher educational level. The internal consistency of the BAS-2 adapted for the Puerto Rican Spanish was Cronbach α = 0.92. Exploratory factor analysis indicated one-dimensionality of the test. Body appreciation was negatively correlated with higher levels of depressive symptomatology and with a higher body mass index, and positively correlated with higher levels of mental health. CONCLUSION: The BAS-2 adapted for the Spanish of Puerto Rico is a psychometrically sound instrument to assess body image.

Microbial Diversity in Children with Gastroenteritis in the Amazon Region of Brazil: Development and Validation of a Molecular Method for Complete Sequencing of Viral Genomes.

INTRODUCTION: Metagenomic sequencing is a powerful tool that is widely used in laboratories worldwide for taxonomic characterization of microorganisms in clinical and environmental samples. In this study, we utilized metagenomics to investigate comprehensively the microbial diversity in fecal samples of children over a four-year period. Our methods were carefully designed to ensure accurate and reliable results. MATERIAL AND METHODS: Validated and analyzed were metagenomic data obtained from sequencing 27 fecal samples from children under 10 years old with gastroenteritis over a four-year period (2012-2016). The fecal specimens were collected from patients who received care at public health facilities in the northern region of Brazil. Sequencing libraries were prepared from cDNA and sequenced on the Illumina HiSeq. Kraken-2 was utilized to classify bacterial taxonomy based on the 16S rRNA gene, using the Silva rRNA database. Additionally, the Diamond program was used for mapping to the non-redundant protein database (NR database). Phylogenomic analyses were conducted using Geneious R10 and MEGA X software, and Bayesian estimation of phylogeny was performed using the MrBayes program. The results indicate significant heterogeneity among norovirus strains, with evidence of recombination and point mutations. This study presents the first complete genome of parechovirus 8 in the region. Additionally, it describes the bacterial populations and bacteriophages present in feces, with a high abundance of Firmicutes and Proteobacteria, including an increased proportion of the Enterobacteriaceae family. The presented data demonstrate the genetic diversity of microbial populations and provide a comprehensive report on viral molecular characterization. These findings are relevant for genomic studies in gastrointestinal infections. The metagenomic approach is a powerful tool for investigating microbial diversity in children with gastroenteritis. However, further studies are imperative to conduct genomic analysis of identified bacterial strains and thoroughly analyze antimicrobial resistance genes.

Evaluating the persistence of malachite green residues in tilapia and pacu fish.

Although banned in food-producing animals, residues of malachite green (MG) and its primary metabolite, leucomalachite green (LMG), have been found in fish due to illegal use in aquaculture and the release of industrial wastewater, which represent a serious risk to food and environmental securities. This study aimed to investigate the residue depletion profile of MG and LMG in edible tissues of Nile tilapia (Oreochromis niloticus) and pacu (Piaractus mesopotamicus) cultured simultaneously under the same environmental conditions to support control measures in case of abuse. An analytical method involving QuEChERS sample preparation and liquid chromatography coupled to tandem mass spectrometry was developed, validated, and applied to quantify MG and LMG residues in fish fillets from two depletion experiments after treatment by immersion bath (MG at 0.10 mg L-1 for 60 min). During the experiment, the average water temperature was 30 ºC, while the pH was 6.9. The method is selective, precise (CV = 0.4 - 22%) and accurate (recovery 92 - 114%). The limits of detection and quantification are 0.15 and 0.5 ng g-1, respectively. In both species, the sum of MG and LMG residues were quantified up to the 32nd day post-exposure, and the concentrations were significantly higher in the pacu fillets (up to 3284 ng g-1) than in Nile tilapia (up to 432 ng g-1). The sums of MG and LMG residues were below 2 ng g-1 at 44 days and 342 days for Nile tilapia and pacu, respectively - the Minimum Required Performance Limit (MRPL) for analytical methods intended to monitor forbidden substances in food according to old European Commission guidelines. The persistence of MG residues in pacu may be attributed to its higher lipid content, which favors the accumulation of the non-polar metabolite LMG. These results provide insights into the concern about human, animal, and environmental health risks resulting from unauthorized use or aquatic contamination by industrial wastewater containing MG residues.

Residue Depletion Profile and Estimation of Withdrawal Period for Sulfadimethoxine and Ormetoprim in Edible Tissues of Nile Tilapia (Oreochromis sp.) on Medicated Feed.

Sulfadimethoxine (SDM) and ormetoprim (OMP) are antimicrobials used in combination to treat bacterial infections in fish farming. The use of this drug combination is not yet regulated in some countries, such as Brazil. Due to the lack of regulated drugs for aquaculture in Brazil, this study investigated the residue depletion profile of SDM and OMP in Nile tilapia (Oreochromis sp.) after oral administration. Fish were treated with medicated feed containing a 5:1 ratio of SDM:OMP at the dose of 50 mg kg BW-1 for five consecutive days with an average water temperature of 28 °C. The drugs were incorporated into the feed by using a gelatin coating process which promoted homogeneity in drug concentration and prevented the drug leaching into the water during medication. The SDM and OMP determination in fish fillets (muscle plus skin in natural proportions) was performed using the QuEChERS approach followed by LC-MS/MS quantification. The analytical method was validated according to Brazilian and selected international guidelines. A withdrawal period of 9 days (or 252 °C days) was estimated for the sum of SDM and OMP residues at concentration levels below the maximum residue level of 100 µg kg-1.

Caminhos de um comitê de ética: 10 anos da Plataforma Brasil / Trajectory of an ethics commitee: 10 years of Plataforma Brasil / Trayectoria de un comité de ética: 10 años de la Plataforma Brasil

Resumo Esta pesquisa buscou traçar o perfil do Comitê de Ética da Universidade Estadual Vale do Acaraú, Ceará, nos 10 anos da Plataforma Brasil. Levantaram-se pesquisas realizadas entre 2012 e 2021, conforme atores ou processos, seguindo a análise descritiva. Houve prevalência feminina e do campo da saúde ou ciências biológicas, e pareceristas tiveram maior formação acadêmica, tempo de experiência e número de projetos em relação a pesquisadores. Das 2.295 pesquisas analisadas, houve flutuações temporais, com concentração de projetos anteriormente aprovados até 2015, finalizados em 2016 e em trâmite em 2021, com evidente diminuição em 2020 e 2021. Foram mais frequentes pesquisas originais de centros coordenadores, institucionais, brasileiras, autofinanciadas, sem área temática, com decisão ética favorável, em até três meses e tempo de fluxo reduzido entre quinquênios. Termo de consentimento livre e esclarecido e riscos destacaram-se como principais óbices éticos. Esse panorama valoriza a importância da plataforma para o progresso científico.

Abstract This study outlines the profile of the Ethics Committee of the Acaraú Valley State University, Ceará, Brazil, after 10 years of Plataforma Brasil. Bibliographic search surveyed research conducted between 2012 and 2021 according to actors and processes, following descriptive analysis. Results showed a prevalence of female researchers from the health or biological sciences field, and reviewers had a greater academic background, length of experience, and number of projects than researchers. Of the 2,295 studies analyzed, most were approved by 2015, completed in 2016 and under evaluation in 2021, with clear decrease in 2020 and 2021. Original research from national self-funded institutional coordinating centers without thematic area, with a favorable ethical opinion within three months, and reduced flow time between quinquennia stood out. Main ethical obstacles concerned the informed consent and risks. This overview highlights the importance of the platform for scientific progress.

Resumen Esta investigación rastreó el perfil del Comité de Ética de la Universidad Estadual Vale do Acaraú, Ceará, Brasil, en los 10 años de la Plataforma Brasil. Los estudios ocurrieron entre 2012 y 2021 según actores o procesos, siguiendo el análisis descriptivo. Predominaron mujeres del campo de la salud o las ciencias biológicas y, comparados con los investigadores, los árbitros tenían alto nivel de formación académica, mayor tiempo de experiencia y proyectos. En 2.295 estudios hubo fluctuaciones temporales, con concentración de proyectos aprobados hasta 2015, completados en 2016 y en curso en 2021, con disminución evidente entre 2020-2021. Los estudios más frecuentes provienen de los centros coordinadores, institucionales, brasileños, autoapoyados, sin área temática, con decisión ética favorable hasta tres meses y tiempo de flujo reducido entre quinquenios. El formulario de consentimiento y los riesgos fueron los principales obstáculos éticos. Este panorama valora la importancia de la plataforma al progreso científico.

Evolutionary and Molecular Analysis of Complete Genome Sequences of Norovirus From Brazil: Emerging Recombinant Strain GII.P16/GII.4.

Noroviruses (NoVs) are enteric viruses that cause acute gastroenteritis, and the pandemic GII.4 genotype is spreading and evolving rapidly. The recombinant GII.P16/GII.4_Sydney strain emerged in 2016, replacing GII.P31/GII.4_Sydney (GII.P31 formerly known as GII.Pe) in some countries. We analyzed the complete genome of 20 NoV strains (17 GII.P31/GII.4_ Sydney and 3 GII.P16/GII.4_Sydney) from Belém and Manaus, Brazil, collected from 2012 to 2016. Phylogenetic trees were constructed by maximum likelihood method from 191 full NoV-VP1 sequences, demonstrated segregation of the Sydney lineage in two larger clades, suggesting that GII.4 strains associated with GII.P16 already have modifications compared with GII.P31/GII.4. Additionally, the Bayesian Markov Chain Monte Carlo method was used to reconstruct a time-scaled phylogenetic tree formed by GII.P16 ORF1 sequences (n = 117) and three complete GII.P16 sequences from Belém. The phylogenetic tree indicated the presence of six clades classified into different capsid genotypes and locations. Evolutionary rates of the ORF1 gene of GII.P16 strains was estimated at 2.01 × 10-3 substitutions/site/year, and the most recent common ancestors were estimated in 2011 (2011-2012, 95% HPD). Comparing the amino acid (AA) sequence coding for ORF1 with the prototype strain GII.P16/GII.4, 36 AA changes were observed, mainly in the non-structural proteins p48, p22, and RdRp. GII.P16/GII.4 strains of this study presented changes in amino acids 310, 333, 373, and 393 of the antigenic sites in the P2 subdomain, and ML tree indicating the division within the Sydney lineage according to the GII.P16 and GII.P31 polymerases. Notably, as noroviruses have high recombination rates and the GII.4 genotype was prevalent for a long time in several locations, additional and continuous evolutionary analyses of this new genotype should be needed in the future.

Food safety evaluation for the use of albendazole in fish: residual depletion profile and withdrawal period estimation.

Due to the lack of drugs regulated for aquaculture, we have evaluated the use of albendazole (ABZ) - a potential drug to be regulated for fish - under food safety perspectives assessing the depletion profile of ABZ and its main metabolites (albendazole sulphoxide - ABZSO, albendazole sulphone - ABZSO2 and albendazole amino sulphone - ABZ-2-NH2SO2) in fish fillets (muscle and skin) after single dose oral administration of 10 mg ABZ kg-1 body weight. For the drug administration, a suitable procedure for ABZ incorporation into fish feed was employed, obtaining good homogeneity of ABZ concentration among feed pellets (CV<4.1%) and low drug leaching when medicated feed remained in the water for up to 60 min (<2.7%). After medication, fish were euthanised at 8, 12, 24, 48, 72, 96 and 120 h and fillets collected. Depletion studies in various fish species (patinga and tilapia) were conducted simultaneously, under water temperature at 30.4 ± 0.3 °C and pH 6.8 ± 0.1. The highest concentrations for the sum of residues (ABZ, ABZSO, ABZSO2 and ABZ-2-NH2SO2) in fish fillet were 1210 ng g-1 in patinga and 637 ng g-1 in tilapia. Under the employed rearing conditions, the obtained results did not indicate a requirement for a minimum withdrawal period to be proposed for tilapia considering the maximum residue limit of 100 µg g-1, since the determined residual concentration was

Microgliosis is associated with visual memory decline in patients with temporal lobe epilepsy and hippocampal sclerosis: A clinicopathologic study.

Hippocampal sclerosis (HS) is characterized by neuronal loss and gliosis. The intensity and distribution of these histopathological findings over the Cornu Ammonis (CA) subfields are important for the classification of HS and prognostication of patients with temporal lobe epilepsy (TLE). Several studies have associated the neuronal density reduction in the hippocampus with cognitive decline in patients with TLE. The current study aimed at investigating whether the expression of glial proteins in sclerotic hippocampi is associated with presurgical memory performance of patients with TLE. Before amygdalohippocampectomy, patients were submitted to memory tests. Immunohistochemical and morphometric analyses with glial fibrillary acidic protein (GFAP) for astrogliosis and human leucocyte antigen DR (HLA-DR) for microgliosis were performed in paraffin-embedded HS and control hippocampi. Sclerotic hippocampi exhibited increased gliosis in comparison with controls. In patients with TLE, the area and intensity of staining for HLA-DR were associated with worse performance in the memory tests. Glial fibrillary acidic protein was neither associated nor correlated with memory test performance. Our data suggest association between microgliosis, but not astrogliosis, with visual memory decline in patients with TLE.

Antimicrobial activity and inhibition of the NorA efflux pump of Staphylococcus aureus by extract and isolated compounds from Arrabidaea brachypoda.

Arrabidaea brachypoda is a native shrub of the Brazilian Cerrado widely used in the folk medicine for treatment of renal diseases and articular pains. This study aimed to, first, evaluate the antimicrobial activity of both extracts and isolated molecules Brachydins BR-A and BR-B obtained from the flowers of A. brachypoda against Staphylococcus aureus, Escherchia coli and Candida albicans species. A second objective was to investigate if these natural products were able to potentiate the Norfloxacin activity against the strain Staphylococcus aureus SA1199-B that overexpress the norA gene encoding the NorA efflux pump. Extracts and isolated compounds were analyzed by HPLC-PDA and LC-ESI-MS respectively. Minimal inhibitory concentrations of Norfloxacin or Ethidium Bromide (EtBr) were determined in the presence or absence of ethanolic extract, dichloromethane fraction, as well as BR-A or BR-B by microdilution method. Only BR-B showed activity against Candida albicans. Addition of ethanolic extract, dichloromethane fraction or BR-B to the growth media at sub-inhibitory concentrations enhanced the activity of both Norfloxacin and EtBr against S. aureus SA1199-B, indicating that these natural products and its isolated compound BR-B were able to modulate the fluoroquinolone-resistance possibly by inhibition of NorA. Moreover, BR-B inhibited the EtBr efflux in the SA1199-B strain confirming that it is a NorA inhibitor. Isolated BR-B was able to inhibit an important mechanism of multidrug-resistance very prevalent in S. aureus strains, thus its use in combination with Norfloxacin could be considered as an alternative for the treatment of infections caused by S. aureus strains overexpressing norA.

Molecular and evolutionary characterization of norovirus GII.17 in the northern region of Brazil.

BACKGROUND: Currently, norovirus (NoV) is associated with one-fifth of all acute gastroenteritis (AGE) cases worldwide. The NoV GII.17_2014 variant has been associated with gastroenteritis outbreaks in several Asian countries, replacing the previously dominant Sydney 2012 variant. There is limited data about circulation of this new strain in Brazil. This study aimed to describe the phylogenetic and evolutionary characteristics of the GII.17_2014 strains in the Northern region of Brazil. METHODS: NoV was detected by enzyme immunoassay (EIA) in 645 stool samples of AGE cases that were reported in Pará and Amazonas states during 2015-2016. All positive samples were tested for NoV GI and GII by reverse transcription polymerase chain reaction (RT-PCR) and the amplicons were subjected to genome sequencing. The GII.17-positive samples were retested by PCR using different sets of designed primers, which target a highly conserved capsid gene region. Next, the amplicons were sequenced and phylogenetically analyzed using Bayesian inferences. RESULTS: Of the 645 samples tested, 208 (32.2%) tested were positive for NoV by EIA, among which 95 (45.7%) were genotyped. Among the genotyped samples, 12 (12.6%) were characterized as GII.17_2014 with the first case detected in November 2015 (1/30, 3.3%) and the others in 2016 (11/65, 16.9%). All strains found in our study were clustered in clade D (epidemic strain). The uncorrelated log-normal model estimations calculated the rate of evolution for GII-17 strains as 1.95 × 10- 3 (1.28 × 10- 3-2.63 × 10- 3). In total, 36 nucleotide changes were observed after analyzing the VP1 sequence, among which 28 occurred in the P2 region. CONCLUSIONS: These data demonstrate the evolutionary dynamics in NoV GII.17_2014 strains, which indicated high mutation rates with nucleotide substitutions and indels that are related to the elevated levels of antigenic diversity. This partly explains the increase in viral prevalence.

Bcl-2/Bax ratio increase does not prevent apoptosis of glia and granular neurons in patients with temporal lobe epilepsy.

Temporal lobe epilepsy (TLE) is usually associated with hippocampal sclerosis (HS), characterized by gliosis and neuronal loss, mainly in the cornus ammonis (CA). Regardless the type of HS, gliosis is associated with neuronal loss. Indeed, glial reactivation seems to induce both neuronal and glial apoptosis. Anti-apoptotic mechanisms are also activated in order to contain the cell death in chronic epilepsy. However, the role of the intrinsic apoptosis pathway in human TLE is unclear, mainly in relation to glial death. The purpose of this study was to evaluate the reactive gliosis areas in parallel with Bcl-2/Bax ratio and active caspase 3 immunoreactivity in hippocampi of TLE patients in comparison with control hippocampi. We also sought to investigate whether the levels of these markers were correlated with TLE clinical parameters. Paraffin-embedded sclerotic and control hippocampi were collected for immunohistochemical analyses of glial fibrillary acidic protein (GFAP), human leucocyte antigen DR (HLA-DR), neuronal nuclei protein (NeuN), Bax, Bcl-2 and active caspase 3. Sclerotic hippocampi presented higher immunoreactivity areas of GFAP and HLA-DR than controls, with similar values in HS types 1 and 2. Bcl-2 protein expression was increased in epileptic hippocampi, while Bax expression was similar to controls. Despite Bcl2/Bax ratio increase, granular neurons and glia exhibited active caspase 3 expression in TLE hippocampi, while controls did not show staining for the same marker. In conclusion, glial and neuronal death is increased in sclerotic hippocampi, independently of HS type, and co-localized with gliosis. Furthermore, Bcl-2/Bax ratio increase does not prevent expression of active caspase 3 by glia and granular neurons in TLE.

Desenvolvimento e análise sensorial de bebida probiótica à base de extrato de arroz / Development and sensory analysis of probiotic drink based on rice extract

Alimentos funcionais são a nova tendência da indústria de alimentos, em consequência da comprovação científica das relações existentes entre alimentos e saúde e, sobretudo, do interesse do consumidor por novas alternativas saudáveis. Diante dessa realidade, promoveu-se uma ampla divulgação no uso dos probióticos para a manutenção da saúde do intestino, levando a um considerável aumento no seu consumo. No Brasil, os produtos mais populares, carreadores dessas bactérias, são os leites fermentados. O Kefir apresenta as mesmas características funcionais dos probióticos, mas de custo reduzido. O objetivo deste trabalho foi desenvolver uma bebida à base de extrato de arroz fermentado com kefir não lácteo. A análise sensorial mostrou que a bebida obteve 93,44% de aceitação e 65,57% de intenção de compra pelos provadores. Conclui-se que é viável o desenvolvimento e a comercialização da bebida fermentada funcional a base de extrato de arroz, podendo oferecer benefícios adicionais à saúde dos consumidores.(AU)

Desenvolvimento e análise sensorial de bebida probiótica à base de extrato de arroz / Development and sensory analysis of probiotic drink based on rice extract

Alimentos funcionais são a nova tendência da indústria de alimentos, em consequência da comprovação científica das relações existentes entre alimentos e saúde e, sobretudo, do interesse do consumidor por novas alternativas saudáveis. Diante dessa realidade, promoveu-se uma ampla divulgação no uso dos probióticos para a manutenção da saúde do intestino, levando a um considerável aumento no seu consumo. No Brasil, os produtos mais populares, carreadores dessas bactérias, são os leites fermentados. O Kefir apresenta as mesmas características funcionais dos probióticos, mas de custo reduzido. O objetivo deste trabalho foi desenvolver uma bebida à base de extrato de arroz fermentado com kefir não lácteo. A análise sensorial mostrou que a bebida obteve 93,44% de aceitação e 65,57% de intenção de compra pelos provadores. Conclui-se que é viável o desenvolvimento e a comercialização da bebida fermentada funcional a base de extrato de arroz, podendo oferecer benefícios adicionais à saúde dos consumidores.

Importância da temática tuberculose na graduação em enfermagem: a discursividade dos docentes / La importancia del tema tuberculosis en la graduación en enfermería: el discurso de los profesores / The importance of tuberculosis as a theme in nursing graduation: the discourse of professors

Objetivo analisar a discursividade dos docentes sobre a importância da temática tuberculose nos cursos de graduação em Enfermagem. Método estudo qualitativo do tipo exploratório, desenvolvido entre janeiro e março de 2015 em duas universidades públicas de Enfermagem do estado do Amazonas, Brasil. Participaram do estudo 15 docentes do curso de Enfermagem, sendo a maioria do sexo feminino, possuía mestrado, com mais de cinco anos na docência, experiência anterior à docência e apenas um vínculo profissional. Utilizou-se a Análise do Discurso de matriz francesa como princípio teórico-metodológico. Resultados emergiram, como resultados, dois blocos discursivos: Importância da temática da tuberculose na estrutura curricular; e Papel do enfermeiro no controle da tuberculose. Conclusão os sentidos produzidos pelo discurso dos docentes permitiram concluir que a tuberculose, por ser uma doença importante do ponto de vista epidemiológico e social, precisa ter maior abrangência na matriz curricular dos cursos de graduação em Enfermagem, tendo vista o protagonismo dessa profissão nas ações de controle da doença.

Objetivo analizar los discursos de profesores sobre la importancia del tema tuberculosis en los cursos de graduación en Enfermería. Método estudio exploratorio, cualitativo, desarrollado de enero a marzo de 2015 en dos universidades de Enfermería en el estado de Amazonas, en Brasil. Quince docentes del corso de Enfermería participaron del estudio. La mayoría eran mujeres, con másteres, profesoras hace más de cinco años, con experiencias de trabajo antes que fueran profesoras, y solamente un trabajo. El estudio utilizó el Análisis de Discurso de base teórica y metodológica francesa. Resultados dos blocos discursivos emergieron como resultados: La importancia del tema tuberculosis en el programa del corso; y El papel de los enfermeros en el control de tuberculosis. Conclusión los significados producidos por los discursos de los profesores posibilitaron concluir que, puesto que la tuberculosis es una enfermedad importante desde un punto de vista epidemiológico, necesita estar más presente en los programas de cursos de graduación en Enfermería, gracias al papel esencial de esos profesionales en las acciones de control de esa enfermedad.

Objective analyze the discourses of professors about the importance of the theme tuberculosis in Nursing graduation courses. Method qualitative, exploratory study, developed from January to March 2015 in two public Nursing universities in the state of Amazonas, Brazil. Fifteen professors from the Nursing course participated in the study. Most were female, had master's degrees, were teachers for more than five years, had working experience prior to being professors, and only one job. The study used Discourse Analysis from a French theoretical-methodological framework. Results two discursive blocks emerged as results: The Importance of the Theme Tuberculosis in the Syllabus; and The Role of the Nurse in Tuberculosis Control. Conclusion the meanings produced by the discourses of the professors made it possible to conclude that, since tuberculosis is an important disease from an epidemiological standpoint, it must be more broadly present in the syllabus of Nursing graduation courses, due to the main role these professionals have in the actions to control this disease.

Emotion-oriented coping increases the risk of depression among caregivers of end-stage renal disease patients undergoing hemodialysis.

PURPOSE: We investigated the possible association between coping style and depressive feelings among caregivers of end-stage renal disease patients undergoing hemodialysis. METHODS: We studied 107 main caregivers of hemodialysis patients. Main caregiver was defined as the person on whom the patient counts for daily care or the one the patient calls upon in case of difficulties. Demographic data of caregivers and clinical data of patients were collected. The Jalowiec Coping Scale was applied to score two styles of coping: problem-oriented coping (POC) and emotion-oriented coping (EOC). Depression was screened by the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). A score ≥16 was used to classify depression. Comparisons were made by Student's t and Chi-square tests. The Pearson's test was used to assess correlation between scores. Linear and logistic regressions were used, respectively, to test variables as predictors of the CES-D scores and the presence of depression. RESULTS: The depression rate among caregivers was 71.9%. In the comparison between depressed and non-depressed caregivers, only EOC score differed, being higher among depressed ones (69.8 vs. 62.4; p < 0.001). EOC score was positively correlated with depression score (r = 0.368; p = <0.001). In the multivariate analysis, EOC independently predicted both the depression score (b = 0.272; p = 0.001) and the presence of depression (OR 1.221; 95% CI 1.123-1.339; p = 0.001). CONCLUSION: Our results indicate that EOC is associated with and increases the risk of depression among caregivers of HD patients. We propose that strategies aiming to strengthen POC and diminish EOC can be applied to minimize depressive feelings.

Compliance With Injury Prevention Measures in Youth Pitchers: Survey of Coaches in Little League of Puerto Rico.

BACKGROUND: Because of the problem of elbow and shoulder injuries in baseball pitchers between 9 and 14 years of age, the USA Baseball Medical & Safety Advisory Committee and the Department of Recreation and Sports in Puerto Rico developed injury prevention guidelines for pitchers. The purpose of this study was to determine the compliance of pitching coaches of 9- to 14-year-old Little League teams in Puerto Rico with the Administrative Order 2006-01 and the USA Baseball guidelines. HYPOTHESES: (1) The coaches will have a satisfactory level of compliance with the Administrative Order as well as with the USA Baseball guidelines and (2) both the level of education of the coach as well as the years of experience will correlate with the level of compliance. STUDY DESIGN: Descriptive cross-sectional study. LEVEL OF EVIDENCE: Level 5. METHODS: A self-administered questionnaire was developed based on the Administrative Order and on the USA Baseball guidelines. A descriptive univariate analysis was conducted to determine the mean coach compliance with both guidelines. Pearson correlation coefficients were used to describe the correlation between the level of education and the years of experience of the coaches with the level of compliance. RESULTS: Thirty-five coaches (response rate, 78%) participated in the study. On average, the coaches complied with 70% of the Administrative Order and with 73% of the USA Baseball guidelines. No significant correlations were found. CONCLUSION: The coaches who participated in the study did not reflect a satisfactory level of compliance with the USA Baseball guidelines or with the Administrative Order. CLINICAL RELEVANCE: These findings emphasize the need for reinforcing compliance with the injury prevention guidelines and the need to provide resources and training to coaches to effectively prevent elbow and shoulder injuries in pitchers.

RESEARCH MISCONDUCT POLICIES AT HIGHER EDUCATION INSTITUTIONS IN PUERTO RICO.

Institutional policies on research serve to guide graduate students in conducting research. Eight universities in Puerto Rico met the inclusion criteria, and were found to have research misconduct policies for conducting research. The policies were analyzed quantitatively to determine the extent to which these included relevant specific information on procedures needed to address issues that arise in a research misconduct allegation. Comparison of the eight policies revealed that five policies obtained a high score in all five dimensions analyzed. Well-covered topics in the policies included the content of the inquiry report and the content of the investigation report; while the least covered topics were pursuing the allegation, appeal process, and mentoring. Institutions need to revise their research misconduct policies and add more precise information; more institutions need to create these policies.

Development of a questionnaire to assess the determinants of exercise among breast cancer survivors in Puerto Rico.

The Theory of Planned Behavior (TPB) serves to understand determinants that predict the intention to exercise. According to this theory, attitudes, subjective norms, and perceptions of behavioral control determine intention. This is the first theory-based tool designed to measure the determinants of exercise among women in Puerto Rico who are breast cancer survivors. Understanding the determinants will assist in planning theory based interventions. The purpose of this study was to develop a TPB-based questionnaire to assess the determinants of exercise of breast cancer survivors in Puerto Rico and to evaluate its psychometric properties. Quantitative and qualitative methods were used for questionnaire development and psychometric testing. Three independent samples were recruited for the phases of item generation, pilot testing, and evaluation of psychometric properties. An initial 97-item questionnaire was constructed. Test-retest reliability was assessed for the indirect subscales; six items were found unreliable and removed. For the direct subscales, seven items with item-to-total correlations <0.30 were removed. The final version consisted of 84 items, with Cronbach's α ranging from 0.65 to 0.89. Construct validity was demonstrated by significant, fair-to-moderate correlations of all but one of the direct subscales and the multiplied scores of the indirect subscales of similar constructs.