The Brazilian version of the work role functioning questionnaire 2.0 with 5 items (WRFQ-5) has adequate measurement properties.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an important instrument within the context of occupational health, consisting of 27 items and 5 domains. In addition, a short version of WRFQ 2.0 with 5 items (WRFQ-5) was proposed, showing agreement with the long version. Thus, we aimed to confirm the number of factors of the WRFQ-5 short version and to verify the structural, construct, and criterion validity, reliability, internal consistency, and analysis of ceiling and floor effects of the Brazilian version of the WRFQ-5 in a general workers population. METHODS: A questionnaire validation and measurement properties study. We evaluated the internal structure of the WRFQ-5 by means of confirmatory factor analysis. Construct validity was assessed by correlating the WRFQ-5 with the Numerical Pain Rating Scale (NPRS), Work Ability Index (WAI), and Self-Estimated Functional Inability because of Pain (SEFIP-work). Criterion validity was assessed by correlating the WRFQ-5 with the 5 domains of the WRFQ 2.0. Test-retest reliability and internal consistency were also evaluated. RESULTS: We observed positive correlations (p < .05) between the WRFQ-5 and the WAI (rho = 0.161 to 0.308) and negative correlations (p < .05) between the WRFQ-5 and the SEFIP-work (rho = -0.293). The WRFQ-5 significantly and positively correlates with the 5 domains of WRFQ 2.0 (rho = 0.742 to 0.830). The test-retest reliability of the WRFQ-5 was excellent (ICC2,1 = 0.935) and the internal consistency was adequate (Cronbach's alpha = 0.938). We did not observe ceiling and floor effects. CONCLUSION: The one-dimensional internal structure of the WRFQ-5 in Brazilian Portuguese has a valid internal structure and construct, as well as adequate reliability and internal consistency.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

Deaths by COVID-19 in a hospital from a city from Legal Amazon region: what lessons could be learned? / Mortes por COVID-19 em um hospital de uma cidade da região da Amazônia Legal: que lições podem ser aprendidas?

Objective: Describe the epidemiology of COVID-19 deaths within a hospital in the Amazon region in a period of 64 days, which corresponds to the growth curve of the COVID-19 first-wave pandemic in 2020. Methods: The data were obtained from medical records of 152 deaths registered for adults and elderly hospitalized. The data were also compared with the number of deaths in previous years during the same period studied to assess the impact of the pandemic on this hospital. The study also assesses the impact of intra-hospital transfers, accounting for the number of times patients who died performed transfers between sectors of the hospital. Results: During the period analyzed, there was an increase in deaths compared to the previous years. The majority of dead patients were male, aged between 34 and 96 years. The deaths were associated comorbidities such as arterial hypertension, diabetes mellitus, and kidney disease. The SARS-CoV-2 infection was confirmed in 91 cases. Among them, 15 individuals were admitted without conditions related to SARS-CoV-2 infection; they had a three-fold higher number of hospital transfers than those admitted with SARS-CoV-2 infection symptoms. Sixteen patients with SARS-CoV-2 infection developed respiratory symptoms just after hospitalization. The diagnostic exam for SARS-CoV-2 infection was performed on average 4 (± 6) days after the onset of symptoms and 6 (± 6) days after admission, and the average time from the onset of respiratory symptoms to death was 4 (± 6) days. Conclusions: These data suggest the high presence of hospital infection by SARS-CoV-2 in the Brazilian Amazon region, which may be related to the number of sectorial transfers, delay in confirming the diagnosis, and lack of management. We report a serious public health problem, as it demonstrates the fragility of healthcare institutions in the hospital environmen (AU).

Objetivo: Descrever a epidemiologia de mortes por COVID-19 em um hospital na região da Amazônia em um período de 64 dias, que corresponde à curva de crescimento da primeira onda da pandemia de COVID-19 em 2020. Métodos: Os dados foram obtidos de 152 óbitos registrados em prontuários de adultos e idosos hospitalizados. Os dados foram também comparados com o número de óbitos em anos anteriores, no mesmo período estudado, de forma a avaliar o impacto da pandemia neste hospital. O estudo também avalia o impacto das transferências intra-hospitalares, contabilizando o número de vezes que os pacientes que faleceram realizaram transferências entre setores do hospital. Resultados: No período analisado, houve aumento de óbitos em relação aos anos anteriores. A maioria dos pacientes mortos era do sexo masculino, com idade entre 34 e 96 anos. Os óbitos foram associados a comorbidades como hipertensão arterial, diabetes mellitus e doença renal. A infecção por SARS-CoV-2 foi confirmada em 91 casos. Entre eles, 15 indivíduos foram internados sem condições relacionadas à infecção por SARS-CoV-2; eles tiveram um número três vezes maior de transferências hospitalares do que aqueles admitidos com sintomas de infecção por SARS-CoV-2. Dezesseis pacientes com infecção por SARS-CoV-2 desenvolveram sintomas respiratórios logo após a hospitalização. O exame diagnóstico para infecção por SARS-CoV-2 foi realizado em média 4 (± 6) dias após o início dos sintomas e 6 (± 6) dias após a admissão, e o tempo médio do início dos sintomas respiratórios até o óbito foi de 4 ( ± 6) dias. Conclusões: Esses dados sugerem alta presença de infecção hospitalar por SARS-CoV-2 na região amazônica brasileira, o que pode estar relacionado ao número de transferências setoriais, demora na confirmação do diagnóstico e falta de manejo. Relatamos um grave problema de saúde pública, pois demonstra a fragilidade das instituições de saúde no ambiente hospitalar (AU).

Internação hospitalar por transtornos mentais e comportamentais em adolescentes no Brasil, 2008-2017 / Hospitalization for mental and behavioral disorders in adolescents in Brazil, 2008-2017

Resumo Introdução Internações por transtornos mentais e comportamentais não são ocorrências raras em adolescentes. Estima-se que aproximadamente 30% dos adolescentes brasileiros sejam acometidos por transtornos mentais. Objetivo Analisar a evolução das internações por transtornos mentais e comportamentais em adolescentes brasileiros de 2008 a 2017. Método Estudo ecológico de séries temporais utilizando dados do Sistema de Informações Hospitalares do Sistema Único de Saúde e do IBGE. As variáveis utilizadas foram regiões de residência, sexo, faixa etária e grupos de diagnósticos. A tendência do coeficiente de internação foi analisada através da regressão de Prais-Winsten utilizando o Stata 14.0. Resultados Houve 152.465 internações no período; o coeficiente de internação hospitalar reduziu na região Nordeste de 27,75 a 23,16 por 100 mil habitantes (Coef = -0,0070; -1,6%), aumentou de 13,70 a 21,61 por 100 mil habitantes no Norte (Coef = 0,0192; 4,5%) e nas regiões Sul, Sudeste e Centro-oeste houve tendência estável. Verificou-se tendência crescente de internações entre as mulheres (Coef = 0,0136; 3,2%), e por transtornos do humor [afetivos] (0,0266; 6,33%) e outros transtornos mentais e comportamentais (0,0295; 7,03%). Conclusão Estudos epidemiológicos como este ajudam a fornecer informações úteis para o planejamento de serviços de prevenção e tratamento primário, secundário e terciário voltados à saúde mental, especialmente entre crianças e adolescentes.

Abstract Background Hospitalizations for mental and behavioral disorders are not rare occurrences in adolescents. It is estimated that approximately 30% of Brazilian adolescents are affected by mental disorders. Objective To analyze the evolution of hospitalizations for mental and behavioral disorders in Brazilian adolescents from 2008 to 2017. Method Ecological study of time series using data from the hospital information system collected of the Unified Health System (SUS) and IBGE was carried out. The variables used were regions of residence, gender, age group, and groups of diagnoses. The trend of the hospitalization coefficient was analyzed using the Prais-Winsten regression, by Stata 14.0. Results There were 152,465 hospitalizations in the period; the hospitalization coefficient decreased in the Northeast region from 27.75 to 23.16 per 100 thousand inhabitants (Coef. = -0.0070; -1.6%), increased from 13.70 to 21.61 per 100 thousand inhabitants in the North (Coef. = 0.0192; 4.5%) and in the South, Southeast and Midwest regions, had a stable trend. There was an increasing trend of hospitalizations among women (Coef. = 0.0136; 3.2%) and concerning affective mood disorders (0.0266; 6.33%), besides other mental and behavioral disorders (0.00295; 7.0 3%). Conclusion Epidemiological studies such as this service provide useful information for planning primary, secondary and tertiary prevention, and treatment services aimed at mental health, especially among children and adolescents.

Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

BACKGROUND: Delirium is an underdiagnosed condition and this may be related, among other causes, to the incorrect use of assessment tools due to lack of knowledge about cognitive assessment and lack of training of the care team. The aim of this study was to investigate the difficulties encountered by the nursing team in the application of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in patients on mechanical ventilation. METHODS: This is descriptive study with a qualitative approach in a private tertiary hospital located in northeast Brazil. Data collection took place from July 2018 to January 2019. We included 32 nurses and used face-to-face semi-structured interviews. The recorded data were analysed using content analysis. This study followed the recommendations of the Standards for Reporting Qualitative Research (SRQR). RESULTS: We identified three major categories: lack of knowledge of professionals, subdivided into deficit in academic formation, difficulty in the differential diagnosis of delirium and delusion, and lack of knowledge about the steps of the CAM-ICU; difficulty in patient cooperation; and lack of adequate training to apply the CAM-ICU. CONCLUSION: Nurses have a deficit in academic formation on delirium and need adequate training for the correct and frequent use of the CAM-ICU.

Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

Braden scale has low reliability in different patients under care in intensive care unit.

OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20-30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06-0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48-0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Braden scale has low reliability in different patients under care in intensive care unit

SUMMARY OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20-30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06-0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48-0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Association between the total of falls reported and the number of home ergonomic barriers / Associação entre o total de quedas relatadas e o número de barreiras ergonômicas domiciliares

Objective: To investigate the association between the total number of falls in the last year and the number of home ergonomic barriers (HEB). Method: Cross-sectional study, Volunteers aged ≥60 years were included in the study. The history of falls and the number of HEBs were evaluated via a questionnaire. vulnerability through the Vulnerable Elders Survey 13 (VES-13) and fear of falling observed by the Falls Efficacy Scale - International- Brazilian (FES-I-BR). Data normality was verified with the Kolmogorov-Smirnov test, the correlation between total falls and the number of ergonomic barriers was verified with the Spearman test and the association between ergonomic barriers and groups with and without a history of falls, in the last year, through bivariate logistic regression and the chi-square test, the significance level of p≤ 0.05 was adopted. Results: Of the 123 individuals evaluated, 48% had a history of falls, with a mean of 3.83±1.96. The lack of support bars was considered protective [OR= 0.30; p= 0.042] and the absence of uniform floors and well-fixed mats were considered as risk factors for falls [OR= 3.71; p= 0.004]. Elderly people with a history of falls with ≥ 04 HEB, presented a greater risk of falls [OR= 5.98 p<0.0001]. Conclusion: The amount ≥ 04 HEB is associated with a history of falls, the absence of handrails is a protective factor, and uneven or slippery floors are risk factors for falls.

Objetivo: Investigar a associação entre o número total de quedas no último ano e o número de barreiras ergonômicas domiciliares (BED). Método: Estudo transversal, voluntários com idade ≥60 anos foram incluídos no estudo. A história de quedas e o número de BED foram avaliados por meio de um questionário, a vulnerabilidade através do Vulnerable Elders Survey 13 (VES-13) e o medo de cair observado pela Falls Efficacy Scale - International- Brazilian (FES-I-BR). A normalidade dos dados foi verificada com o teste de Kolmogorov-Smirnov, a correlação entre total de quedas e a quantidade de barreiras ergonômicas foi verificada com teste de Spearman e associação entre as barreiras ergonômicas e os grupos com e sem histórico de quedas no último ano, através da regressão logística bivariada e pelo teste de Qui-quadrado, o nível de significância de p≤ 0,05 foi adotado. Resultados: Dos 123 indivíduos avaliados, 48% tinham histórico de quedas, com média de 3,83±1,96. A falta de barras de apoio foi considerada protetora [OR= 0,30; p= 0,042] e a ausência de pisos uniformes e tapetes bem fixados foram considerados fatores de risco para quedas [OR= 3,71; p= 0,004]. Idosos com histórico de quedas com ≥ 04 BED, apresentaram maior risco de quedas [OR= 5,98 p<0,0001]. Conclusão: A quantidade ≥ 04 BED está associada a histórico de quedas, a ausência de corrimão é fator de proteção e pisos irregulares ou escorregadios são fatores de risco para quedas.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults.

OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults

SUMMARY OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

Ethyl Acetate Fraction of Bixa orellana and Its Component Ellagic Acid Exert Antibacterial and Anti-Inflammatory Properties against Mycobacterium abscessus subsp. massiliense.

Mycobacterium abscessus subsp. massiliense (Mabs) causes chronic infections, which has led to the need for new antimycobacterial agents. In this study, we investigated the antimycobacterial and anti-inflammatory activities of the ethyl acetate fraction of Bixa orellana leaves (BoEA) and ellagic acid (ElAc). In silico analysis predicted that ElAc had low toxicity, was not mutagenic or carcinogenic, and had antimicrobial and anti-inflammatory activities. Apparently, ElAc can interact with COX2 and Dihydrofolate reductase (DHFR) enzymes, which could explain both activities. In vitro analysis showed that BoEA and ElAc exerted antimicrobial activity against Mabs (minimum inhibitory concentration of 1.56, 1.56 mg/mL and bactericidal concentration of 6.25, 3.12 mg/mL, respectively. Clarithromycin showed MIC and MBC of 1 and 6 µg/mL). Treatment with BoEA or ElAc increased survival of Tenebrio molitor larvae after lethal infection with Mabs and reduced carrageenan-induced paw edema in mice, around 40% of edema volume after the fourth hour, similarly to diclofenac. In conclusion, BoEA and ElAc exert antimicrobial effects against Mabs and have anti-inflammatory effects, making them potential sources of antimycobacterial drugs. The biological activities of ElAc may be due to its high binding affinities predicted for COX2 and DHFR enzymes.

Translation, cross-cultural adaptation and validation of the Work Role Functioning Questionnaire 2.0 into Brazilian Portuguese in a general population.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an instrument that measures the difficulties perceived by workers in meeting work demands, given their physical or emotional health, but it has not yet been adapted for Brazil. Thus, this study aimed to translate, cross-culturally adapt and assess the psychometric properties of the WRFQ 2.0 into Brazilian Portuguese. METHODS: This is an observational study. Initially, translation and cross-cultural adaptation into Brazilian Portuguese was carried out. After that, this version was submitted to an evaluation of its internal structure. The internal consistency and test-retest reliability were assessed. To determine the construct validity, Spearman's correlation coefficient (rho) was used to determine the magnitude of correlation between the WRFQ 2.0 and the Work Ability Index (WAI), Numerical Pain Rating Scale (NPRS) and Self -Estimated Functional Inability because of Pain (SEFIP-work). RESULTS: The internal structure with five domains and 27 items presented adequate fit indices for the Brazilian version of the WRFQ 2.0. Adequate correlations of the five domains of the WRFQ 2.0 with the NPRS, WAI and SEFIP-work were found (rho ranged between 0.145 and 0.338). The test-retest reliability of the WRFQ 2.0 ranged from substantial to excellent (intraclass correlation coefficient ≥ 0.785) and internal consistency was adequate (Cronbach's alpha ≥ 0.852). CONCLUSION: The Brazilian Portuguese version of the WRFQ 2.0 presents valid internal structure with five domains and 27 items, adequate construct based on correlations with other instruments, and acceptable test-retest reliability and internal consistency.

Unplanned Pregnancy and Depressive Symptoms during the COVID-19 Pandemic.

This is a cross-sectional study conducted with pregnant women who underwent prenatal care at basic health units in São Luís City, Maranhão State, Brazil. The authors used a semistructured questionnaire to assess the socioeconomic, demographic, and clinical characteristics of pregnant women as well as the Edinburgh Scale to investigate depressive symptoms. In order to assess the association between the explanatory variable and the outcome variable, Poisson logistic regression was performed with statistical significance at p < 0.05. A total of 205 women were interviewed, most aged between 18 and 29 years (66.83%). Of this total, 74.63% had not planned their pregnancy and 26.67% had depressive symptoms. The variables unplanned pregnancy (PR = 1.41; CI = 0.99−2.00; p = 0.05) and not undergoing psychological counseling (PR = 1.42; CI = 0.51−0.83; p ≤ 0.01) correlated with depressive symptoms during pregnancy. It is thus possible to link the variables unplanned pregnancy (p > 0.05) and not undergoing psychological counseling (p = 0.001) to depression. Therefore, it is important to monitor the mental health of pregnant women, especially in situations of vulnerability.

Translation, cross-cultural adaptation, and validation of the Canadian Diabetes Risk Questionnaire for the Brazilian population.

OBJECTIVE: The aim of this study was to translate, cross-culturally adapt, and validate the Canadian Diabetes Risk Questionnaire for use in Brazilian Portuguese. METHODS: This is a Questionnaire validity study conducted at a private university. The Brazilian version of the Canadian Diabetes Risk Questionnaire was developed by means of the processes of translation, back-translation, committee review, and pretesting. Test-retest reliability was measured using the intraclass correlation coefficient and kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total score of the Canadian Diabetes Risk Questionnaire was correlated with the Diabetes Knowledge Scale and the Diabetes Mellitus Risk Questionnaire. Ceiling and floor effects were also evaluated in the present study. RESULTS: For construct validity and floor and ceiling effect measurements, a total sample of 100 participants was used. For reliability, a subsample of 34 participants out of the total sample was used. We identified adequate values for reliability (kappa between 0.46-1.00 and ICC 0.96) and internal consistency (Cronbach's alpha 0.80). There were significant correlations between the Canadian Diabetes Risk Questionnaire and the Diabetes Mellitus Risk Questionnaire (rs=0.370, p<0.001), but not the Diabetes Knowledge Scale (rs= -0.162). No ceiling or floor effects were found. CONCLUSION: We concluded that in accordance with the best international recommendations, the Brazilian version of the Canadian Diabetes Risk Questionnaire has adequate psychometric properties.

Relationship between obstructive sleep apnea syndrome and functional capacity in patients with diabetes mellitus type 2: an observational transversal study.

OBJECTIVE: The aim of this study was to verify the association among obstructive sleep apnea, functional capacity, and metabolic control. METHODS: This was a cross-sectional study involving individuals of both sexes with clinical diagnosis of diabetes mellitus type 2 who were above 18 years of age. The assessment consisted of a volunteer identification form, a 2-minute step test, and the Stop-Bang questionnaire. In order to assess metabolic control, HbA1c and fasting glucose data were collected from medical records. RESULTS: A total of 100 individuals with diabetes mellitus type 2, of whom 61% were women, were included in this study. According to the Stop-Bang instrument, 26, 57, and 17% of patients had low, intermediate, and high risk of developing OSA, respectively. There was no association between the 2-minute step test and metabolic variables and diabetes mellitus type 2 chronicity with Stop-Bang. CONCLUSIONS: We concluded that there is no association among obstructive sleep apnea measured by means of Stop-Bang instrument, functional capacity measured by means of 2-minute step test, and metabolic variables in individuals with diabetes mellitus type 2.

Relationship between obstructive sleep apnea syndrome and functional capacity in patients with diabetes mellitus type 2: an observational transversal study

SUMMARY OBJECTIVE: The aim of this study was to verify the association among obstructive sleep apnea, functional capacity, and metabolic control. METHODS: This was a cross-sectional study involving individuals of both sexes with clinical diagnosis of diabetes mellitus type 2 who were above 18 years of age. The assessment consisted of a volunteer identification form, a 2-minute step test, and the Stop-Bang questionnaire. In order to assess metabolic control, HbA1c and fasting glucose data were collected from medical records. RESULTS: A total of 100 individuals with diabetes mellitus type 2, of whom 61% were women, were included in this study. According to the Stop-Bang instrument, 26, 57, and 17% of patients had low, intermediate, and high risk of developing OSA, respectively. There was no association between the 2-minute step test and metabolic variables and diabetes mellitus type 2 chronicity with Stop-Bang. CONCLUSIONS: We concluded that there is no association among obstructive sleep apnea measured by means of Stop-Bang instrument, functional capacity measured by means of 2-minute step test, and metabolic variables in individuals with diabetes mellitus type 2.

Prevalence and factors associated to dysphonia and laryngeal lesions: a study among teachers in a region of the Brazilian Legal Amazon / Prevalência e fatores associados à disfonia e lesões laríngeas: um estudo entre professores de uma região da Amazônia Legal Brasileira

Objective: to investigate the prevalence and factors associated with dysphonia and laryngeal lesions at elementary public school teachers in a region of the Amazonian region. Methodology: cross-sectional study with collection of sociodemographic, occupational, environmental, and clinics variables. Dysphonia and laryngeal lesions were evaluated using three methods: self-perceptions, diagnostic criteria and video-assisted laryngoscopy. Logistic regression was used to determine factors associated. Results: the prevalence of self-reported dysphonia was 68.9%, diagnosed dysphonia was 59.1% and laryngeal lesions, 53.3%. There was association between selfreported dysphonia and respiratory problems (OR=3.00; CI95%=1.25-7.22), use of drugs (OR= 2.31, CI95%= 1.19-4.49) and noise in the internal environment (OR= 2.43; CI95%=1.24-4.73). Easy access to water was a protection factor against self-reported dysphonia (OR=0.09; CI95%: 0.01-0.79). We found a significant association between dysphonia diagnosed and digestive problems (OR= 5.35; CI95%=2.39-11.96), external noise (OR=4.89, CI95%=1.87-12.78) and inadequate ventilation (OR=3.56; CI95%=1.46-8.62). The variables associated with higher chance of laryngeal lesions in dysphonic teachers were lighting (OR=3.74; CI95%=1.15-12.14%), acoustics (OR= 4.14; CI95%=1.32-12.95) and inadequate room size (OR= 3.76; CI95%=1.29-10.91). The use of drugs (OR=0.34; CI95%=0.12-0.92), respiratory problems (OR=0.21; CI95%=0.06-0.76) and easy access to water (OR= 0.12; CI95%=0.04-0.38) were protection factors for laryngeal lesions. Conclusion: occupational environmental factors aggravated the vocal health of this professional category. Access to water in the work impacted positively.

Objetivo: investigar a prevalência e fatores associados à disfonia e lesões laríngeas em professores do ensino fundamental de um município da Amazônia Legal. Metodologia: estudo transversal com coleta de variáveis sociodemográficas, ocupacionais, ambientais e clínicas. Disfonia e lesões laríngeas foram avaliadas com a utilização de três métodos: autopercepção, critérios diagnósticos e laringoscopia assistida por vídeo. Utilizou-se modelo de regressão logística para determinação dos fatores associados. Resultados: a prevalência da disfonia autorreferida foi 68,9%, da disfonia diagnosticada foi 59,1% e das lesões laríngeas, 53,3%. Houve associação entre disfonia autorreferida e problemas respiratórios (OR=3,00; IC95%=1,25-7,22), uso de medicamentos (OR=2,31; IC95%=1,19- 4,49) e ruído interno no ambiente (OR=2,43; IC95%=1,24-4,73). Teve associação protetora entre disfonia autorreferida e facilidade do acesso à água (OR=0,09; IC95%=0,01-0,79). Encontrou-se associação significativa entre disfonia diagnosticada e problemas digestivos (OR=5,35; IC95%=2,39-11,96), ruído externo (OR=4,89; IC95%=1,87-12,78) e ventilação inadequada (OR=3,56; IC95%=1,46-8,62). As variáveis associadas à maior chance de lesões laríngeas em docentes disfônicos foram iluminação (OR=3,74; IC95%=1,15-12,14), acústica (OR=4,14; IC95%=1,32-12,95) e tamanho da sala inadequados (OR=3,76; IC95%=1,29-10,91). Uso de medicação (OR=0,34; IC95%=0,12-0,92), problemas respiratórios (OR=0,21; IC95%=0,06-0,76) e facilidade de acesso à água (OR=0,12; IC95%=0,04-0,38) mostraram-se fatores de proteção para lesões laríngeas. Conclusão: fatores ambientais ocupacionais agravaram a saúde vocal desta categoria profissional. O acesso à água no ambiente de trabalho impactou positivamente.

Short-form quality care questionnaire-palliative care has acceptable measurement properties in Brazilian cancer patients.

BACKGROUND: Our objective was to perform the translation, cross-cultural adaptation, and validation of the Quality Care Questionnaire-Palliative Care (QCQ-PC) into Brazilian Portuguese for cancer patients in palliative care. The translation and cross-cultural adaptation comprised the following stages: translation, synthesis of translations, back-translation, analysis by a committee of experts, testing of the pre-final version, and definition of the final version. The evaluated measurement properties were: structural validity using factor analysis, test-retest reliability using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's alpha, and construct validity using the correlations between the QCQ-PC and other questionnaires already validated in Brazil. RESULTS: Two hundred and twenty-five cancer patients were included for validity analyses, and a subsample of 30 patients was used for test-retest reliability. The most adequate fit indexes were for the short version of the QCQ-PC (SF-QCQ-PC), with two domains and 12 items. There was adequate reliability and internal consistency, with values of the ICC ≥ 0.83 and Cronbach's alpha ≥0.82. There were correlations > 0.30 between the SF-QCQ-PC and the Karnofsky Performance Scale, the Palliative Prognostic Index, the sadness domain of the Edmonton Symptom Assessment System, the Barthel Index, and all domains related to the McGill Quality of Life Questionnaire and the European Organization for Research in the Treatment of Cancer Questionnaire-core. CONCLUSION: The short version of the SF-QCQ-PC has acceptable psychometric properties for use in Brazil.

Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester.

BACKGROUND: Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change. OBJECTIVE: Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy. METHODS: This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation. RESULTS: Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot. CONCLUSION: There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.