Species which may act as vectors or reservoirs of diseases covered by the Animal Health Law: Listed pathogens of fish.

Vector or reservoir species of five fish diseases listed in the Animal Health Law were identified, based on evidence generated through an extensive literature review (ELR), to support a possible updating of Regulation (EU) 2018/1882. Fish species on or in which highly polymorphic region-deleted infectious salmon anaemia virus (HPR∆ ISAV), Koi herpes virus (KHV), epizootic haematopoietic necrosis virus (EHNV), infectious haematopoietic necrosis virus (IHNV) or viral haemorrhagic septicaemia virus (VHSV) were detected, in the field or during experiments, were classified as reservoir species with different levels of certainty depending on the diagnostic tests used. Where experimental evidence indicated transmission of the pathogen from a studied species to another known susceptible species, the studied species was classified as a vector species. Although the quantification of the risk of spread of the pathogens by the vectors or reservoir species was not part of the terms or reference, such risks do exist for the vector species, since transmission from infected vector species to susceptible species was proven. Where evidence for transmission from infected fish was not found, these were defined as reservoirs. Nonetheless, the risk of the spread of the pathogens from infected reservoir species cannot be excluded. Evidence identifying conditions that may prevent transmission by vectors or reservoir fish species during transport was collected from scientific literature. For VHSV, IHNV or HPR∆ ISAV, it was concluded that under transport conditions at temperatures below 25°C, it is likely (66-90%) they will remain infective. Therefore, vector or reservoir species that may have been exposed to these pathogens in an affected area in the wild, aquaculture establishments or through water supply can possibly transmit VHSV, IHNV or HPR∆ ISAV into a non-affected area when transported at a temperature below 25°C. The conclusion was the same for EHN and KHV; however, they are likely to remain infective under all transport temperatures.

Perda, luto e resiliência na pandemia de COVID-19: implicações para a prática com famílias / Loss, grief and resilience amid the COVID-19 pandemic: implications for practice with families

O presente estudo aborda perda, luto e resiliência na pandemia de COVID-19, apresentando considerações sobre a prática sistêmica com famílias. Trata-se de uma revisão narrativa da literatura nacional e internacional, em que foram sumarizados achados empíricos e recomendações para intervenções clínicas, com base na perspectiva sistêmica, face às demandas emergentes no atual contexto e à noção de experiência coletiva. Foram discutidas as múltiplas perdas associadas à COVID-19, as quais impactam estilos de vida, padrões de comportamento e interação, normas culturais e práticas relativas ao processo de morrer e à morte, aumentando potencialmente o risco de luto complicado, durante e após a pandemia. Enfatizou-se também o desenvolvimento adaptativo em meio às circunstâncias difíceis, com destaque à noção de resiliência familiar e a possíveis formas de promovê-la, incluindo a terapia familiar. Ademais, foram abordadas algumas das particularidades do processo clínico junto a famílias que experienciaram perdas na pandemia, incluindo recursos que podem ser utilizados pelo terapeuta, bem como desafios comumente vivenciados pelos profissionais nesse cenário.

The current study addresses loss, grief, and resilience amid the COVID-19 pandemic, presenting implications for systemic practice with families. This is a narrative review of the national (Brazilian) and international literature, in which empirical findings and recommendations for clinical interventions have been summarized, based on a systemic perspective, given the emerging demands in the current scenario and the notion of collective experience. We have discussed the multiple losses associated with COVID-19, which have an impact on lifestyles, patterns of behavior and interaction, and cultural norms and practices related to the process of death and dying, potentially increasing the risk of complicated grieving processes, during and after the outbreak. Adaptive development amid difficult circumstances have also been highlighted, with emphasis on the notion of family resilience and possible ways of promoting it, including family therapy. Furthermore, some of the particularities of the clinical process with families who experienced losses during the pandemic have been addressed, including resources that can be used by the therapist, as well as challenges commonly experienced by professionals in this scenario.

Translation, transcultural adaptation and validation to Brazilian Portuguese of tools for adverse drug reaction assessment in children.

BACKGROUND: Children are more vulnerable to adverse drug reactions (ADRs) due to complex changes in the body during the growth process and lack specific pharmacoepidemiologic studies. Causality and Avoidability assessment of ADRs are relevant to clinical guidelines development and pharmacovigilance. This study aimed to translate and transcultural adapt two new tools-Liverpool Causality Assessment Tool (LCAT) and the Liverpool Avoidability Assessment Tool (LAAT)-to Brazilian-Portuguese and evaluate the psychometric properties of these tools to analyse ADRs in Brazilian children. METHODS: The validation of the cross-cultural adaptation of tools was obtained by the functional (conceptual, semantic, operational, and measurement) equivalence between the original and translated versions of each instrument. The translated version of LCAT and LAAT was applied to assessing the twenty-six case reports of suspected adverse drug reactions in a Brazilian teaching paediatric hospital. The inter-rater reliability (a pharmacist and a physician) was evaluated using Cronbach's alpha. The exact agreement percentages (%EA) and extreme disagreement (%ED) were computed. Overall Kappa index was calculated with a 95% confidence interval. RESULTS: There was a need to modify some terms translated into Portuguese for semantic and conceptual equivalence. The Cronbach's alpha coefficient values obtained were 0.95 and 0.85, and the weighted Kappa (95% confidence interval) were 0.82 (0.67-0.97) and 0.68 (0.45-0.91) for LCAT and LAAT, respectively. The Brazilian-Portuguese versions of the LCAT and LAAT showed reliable and valid tools for the diagnosis and follow-up of ADRs in children. CONCLUSION: The methodological approach allowed the translation, transcultural adaptation, and validation to Brazilian-Portuguese of two easy and quick to perform tools for causality and avoidability of ADRs in children by a multidisciplinary expert specialist committee, including the authors of original tools. We believe these versions may be applied by professionals (patient safety teams) and researchers in Brazil in groups or by a single reviewer. TRIAL REGISTRATION: This study was evaluated and approved by the Research Ethics Committee (Instituto de Pediatria e Puericultura Martagão Gesteira - Federal University of Rio de Janeiro - Number: 3.264.238.

Covid-19 Confinement and Changes of Adolescent's Dietary Trends in Italy, Spain, Chile, Colombia and Brazil.

Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents' poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim was to study nutritional modifications during COVID-19 confinement in adolescents aged 10 to 19 years, compare them with their usual diet and dietary guidelines, and identify variables that may have influenced changes. Data were collected by an anonymous online questionnaire on food intake among 820 adolescents from Spain, Italy, Brazil, Colombia, and Chile. The results show that COVID-19 confinement did influence their dietary habits. In particular, we recorded modified consumption of fried food, sweet food, legumes, vegetables, and fruits. Moreover, gender, family members at home, watching TV during mealtime, country of residence, and maternal education were diversely correlated with adequate nutrition during COVID-19 confinement. Understanding the adolescents' nutrition behavior during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics.

[Semantic and item equivalences of the Brazilian Portuguese version of the Vécu et Santé Perçue de l'Adolescent: an adolescent quality-of-life questionnaire]. / Equivalências semântica e de itens da edição em português do Vécu et Santé Perçue de l'Adolescent: questionário de avaliação da qualidade de vida do adolescente.

In Brazil, no instruments evaluating adolescents' health-related quality of life (HRQoL) have been developed from the adolescents' point of view. The use of an instrument developed in another socio-cultural context requires prior cultural adaptation, including conceptual, item, and semantic equivalence in the process. Vécu et Santé Perçue de l'Adolescent (VSP-A) is a French generic instrument developed to evaluate adolescents' HRQoL. The objective of the study was to evaluate the semantic, item, and conceptual equivalence of a Brazilian Portuguese version of the VSP-A. VSP-A was translated into Portuguese, back-translated (with steps evaluated by experts), and pre-tested in a group of 14 adolescents. Discussion with experts resulted in a final version of the questionnaire, considered semantically and conceptually equivalent to the original, despite the need to modify some items to facilitate use. Pretest results showed that the instrument is easy for adolescents to understand and answer. For use in Brazil, its psychometric properties need to be evaluated.

Equivalências semântica e de itens da edição em português do Vécu et Santé Perçue de l'Adolescent: questionário de avaliação da qualidade de vida do adolescente / Semantic and item equivalences of the Brazilian Portuguese version of the Vécu et Santé Perçue de l'Adolescent: an adolescent quality-of-life questionnaire

No Brasil, não há instrumentos genéricos de avaliação da qualidade de vida relacionada à saúde em adolescentes desenvolvidos com base em seus pontos de vista. A utilização de instrumento concebido em outro contexto sociocultural deve ser precedida de adaptação transcultural, envolvendo avaliação das equivalências semântica, de itens e conceitual. Vécu et Santé Perçue de l'Adolescent (VSP-A) é um instrumento genérico desenvolvido na França para avaliar a qualidade de vida relacionada à saúde de adolescentes. O objetivo deste trabalho foi verificar as equivalências semântica, de itens e conceitual da versão em português do VSP-A. Foram realizadas tradução e retradução do VSP-A, apreciação das equivalências, pré-teste e proposição de versão final a partir de discussão com especialistas. A edição em português do VSP-A mostrou ser semanticamente equivalente à original, apesar da necessidade de modificar alguns itens para facilitar seu uso. Resultados do pré-teste mostraram que o instrumento é facilmente compreendido e respondido pelos adolescentes. Para uso no Brasil, suas propriedades psicométricas necessitam ser avaliadas.

In Brazil, no instruments evaluating adolescents' health-related quality of life (HRQoL) have been developed from the adolescents' point of view. The use of an instrument developed in another socio-cultural context requires prior cultural adaptation, including conceptual, item, and semantic equivalence in the process. Vécu et Santé Perçue de l'Adolescent (VSP-A) is a French generic instrument developed to evaluate adolescents' HRQoL. The objective of the study was to evaluate the semantic, item, and conceptual equivalence of a Brazilian Portuguese version of the VSP-A. VSP-A was translated into Portuguese, back-translated (with steps evaluated by experts), and pre-tested in a group of 14 adolescents. Discussion with experts resulted in a final version of the questionnaire, considered semantically and conceptually equivalent to the original, despite the need to modify some items to facilitate use. Pretest results showed that the instrument is easy for adolescents to understand and answer. For use in Brazil, its psychometric properties need to be evaluated.

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l'Adolescent), a health-related quality of life (HRQoL) instrument for adolescents, in a healthy Brazilian population.

BACKGROUND: Health-related quality of life (HRQoL) assessment, encompassing the adolescents' perceptions of their mental, physical, and social health and well-being is increasingly considered an important outcome to be used to identify population health needs and to provide targeted medical care. Although validated instruments are essential for accurately assessing HRQoL outcomes, there are few cross-culturally adapted tools for use in Brazil, and none designed exclusively for use among adolescents. The Vécu et Santé Perçue de l'Adolescent (VSP-A) is a generic, multidimensional self-reported instrument originally developed and validated in France that evaluates HRQoL of ill and healthy adolescents. PURPOSE: To cross-culturally adapt and validate the Brazilian-Portuguese version of the VSP-A, a generic HRQoL measure for adolescents originally developed in France. METHODS: The VSP-A was translated following a well-validated forward-backward process leading to the Brazilian version. The psychometric evaluation was conducted in a sample of 446 adolescents (14-18 years) attending 2 public high schools of São Gonçalo City. The adolescents self-reported the Brazilian VSP-A, the validated Psychosomatic Symptom Checklist and socio-demographic information. A retest evaluation was carried out on a sub-sample (n = 195) at a two-week interval. The internal construct validity was assessed through confirmatory factor analysis (CFA), multi-trait scaling analyses, Rasch analysis evaluating unidimensionality of each scale and Cronbach's alpha coefficients. The reproducibility was evaluated by intra-class correlation coefficients (ICC). Zumbo's ordinal logistic regression analysis was used to detect differential item functioning (DIF) between the Brazilian and the French items. External construct validity was investigated testing expected differences between groups using one-way analysis of variance (ANOVA), Mann-Whitney tests and the univariate general regression linear model. RESULTS: CFA showed an acceptable fit (RMSEA=0.05; CFI=0.93); 94% of scaling success was found for item-internal consistency and 98% for item discriminant validity. The items showed good fit to the Rasch model except 3 items with an INFIT at the upper threshold. Cronbach's Alpha ranged from 0.60 to 0.85. Test-retest reliability was moderate to good (ICC=0.55-0.82). DIF was evidenced in 4 out of 36 items. Expected patterns of differences were confirmed with significantly lower physical, psychological well being and vitality reported by symptomatic adolescents. CONCLUSIONS: Although DIF in few items and responsiveness must be further explored, the Brazilian version of VSP-A demonstrated an acceptable validity and reliability in adolescents attending school and might serve as a starting point for more specific clinical investigations.

Adaptação transcultural do “Vécu et Santé Perçue de l´adolescent”, um instrumento utilizado para a avaliação da qualidade de vida relacionada à saúde dos adolescentes / Cross-cultural adaptation of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l`adolescent, a health-related quality of life instrument for adolescents

Introdução: Qualidade de vida relacionada à saúde (QVRS) é um importante desfecho na avaliação do cuidado à saúde. Há grande interesse na avaliação da QVRS entre os adolescentes. No Brasil, há poucos dados sobre os diferentes aspectos da QVRS entre os adolescentes, e não há instrumentos genéricos com esta finalidade. Apresentamos a adaptação transcultural do VSP-A (Vécu et Santé Perçue de l´Adolescent), um instrumento genérico de aferição da QVRS desenvolvido na França para adolescentes saudáveis e doentes de 11 a 17 anos de idade. O VSPA consiste de 36 itens divididos em 10 escalas: (1) relacionamento com pais; (2) relacionamento com amigos; (3) relacionamento com professores; (4) bem estar psicológico; (5) bem estar físico; (6) auto-imagem; (7) vitalidade; (8) vida sexual e sentimental; (9) atividades de lazer e (10) desempenho escolar. Métodos: A adaptação transcultural foi feita de acordo com o modelo proposto por Herdman e colaboradores. O instrumento foi traduzido e retraduzido de forma independente, e posteriormente avaliado por um comitê de especialistas. Foram investigadas as equivalências conceitual, de itens, semântica, de mensuração, operacional e funcional da edição traduzida. A aceitação da edição em português do VSP-A foi avaliada através da investigação do efeito piso e teto e do percentual de dados ausentes. A confiabilidade teste-reteste foi examinada numa subamostra de 195 adolescentes que responderam duas vezes ao VSP-A, calculando-se o coeficiente de correlação intra-classe entre os escores das escalas na primeira e segunda aplicações. A consistência interna foi investigada calculando-se o coeficiente alfa de Cronbach...

[Portuguese-language cultural adaptation and translation of "The Bowel Disease Questionnaire" used to assess functional bowel disorders]. / Tradução e adaptação cultural para o português do instrumento "The Bowel Disease Questionnaire", utilizado para a avaliação de doenças gastrointestinais funcionais.

BACKGROUND: Functional bowel disorders are considered a public health problem, but there are a few prevalence studies in Brazil. In 1999, researchers from the Mayo Clinic developed The Bowel Disease Questionnaire with the purpose to evaluate functional bowel disorders. Although this has been used in different studies and population, it is often necessary to perform a cultural adaptation of a questionnaire developed for use in another culture, in order to improve the quality of the information obtained. OBJECTIVE: To translate and adapt the Bowel Disease Questionnaire to Portuguese for its use in adolescents. METHODS: Assessment of conceptual and item equivalence involved evaluation of the pertinence of the concepts in the Brazilian context; translation was evaluated through semantic equivalence between the original instrument and the Portuguese version; measurement equivalence between the original and the Portuguese version was assessed by the intra-observer reliability and internal consistency. RESULTS: The Bowel Disease Questionnaire's concepts were considered pertinent in the Brazilian context; the semantic equivalence between the original and the Portuguese version were high; reliability ranged from moderate to almost perfect; internal consistency of the scales ranged from 0,66 to 0,74. CONCLUSION: The Portuguese version of the Bowel Disease Questionnaire seems to be semantically and culturally equivalent to the original version and might be useful for measuring functional bowel disorders among Brazilian adolescents.

Tradução e adaptação cultural para o português do instrumento "The Bowel Disease Questionnaire", utilizado para a avaliação de doenças gastrointestinais funcionais / Portuguese-language cultural adaptation and translation of The Bowel Disease Questionnaire used to assess functional bowel disorders

RACIONAL: As doenças gastrointestinais funcionais são reconhecidas como um problema de saúde pública e sua prevalência é pouco estudada no nosso meio. Em 1989, pesquisadores da Mayo Clinic elaboraram e validaram um questionário para a avaliação das doenças gastrointestinais funcionais denominado "The Bowel Disease Questionnaire". Apesar de ter sido utilizado em diferentes populações, sua aplicação em um contexto sociocultural diferente daquele para o qual foi desenvolvido, necessita de prévia adaptação para garantir a qualidade das informações a serem captadas. OBJETIVO: Realizar a tradução e a adaptação cultural do "The Bowel Disease Questionnaire" para o português com a finalidade de aplicação a uma população de adolescentes do Rio de Janeiro. MÉTODOS: Foram avaliadas as equivalências conceitual e de itens através de revisão bibliográfica e de reuniões com especialistas. A avaliação da igualdade semântica constou de julgamento acerca das equivalências de significado referencial e geral entre a retradução e o original e entre esta e a edição em português, respectivamente. A equivalência de mensuração foi avaliada através da confiabilidade e da consistência interna. RESULTADOS: Os conceitos abarcados pelo questionário original foram considerados pertinentes no nosso meio. O significado geral e referencial das palavras/termos se manteve na maioria das questões. A confiabilidade variou de razoável a quase perfeita, enquanto os grupos de questões referentes às doenças gastrointestinais funcionais mostraram consistência interna variando de 0,66 a 0,74. CONCLUSÃO: A versão em português do "The Bowel Disease Questionnaire" parece ser semântica e de conceito equivalente ao original e avaliar adequadamente as doenças gastrointestinais funcionais. O instrumento resultante da adaptação pode ser útil para avaliar as doenças gastrointestinais funcionais em populações de adolescentes no contexto brasileiro.

BACKGROUND: Functional bowel disorders are considered a public health problem, but there are a few prevalence studies in Brazil. In 1999, researchers from the Mayo Clinic developed The Bowel Disease Questionnaire with the purpose to evaluate functional bowel disorders. Although this has been used in different studies and population, it is often necessary to perform a cultural adaptation of a questionnaire developed for use in another culture, in order to improve the quality of the information obtained. OBJECTIVE: To translate and adapt the Bowel Disease Questionnaire to Portuguese for its use in adolescents. METHODS: Assessment of conceptual and item equivalence involved evaluation of the pertinence of the concepts in the Brazilian context; translation was evaluated through semantic equivalence between the original instrument and the Portuguese version; measurement equivalence between the original and the Portuguese version was assessed by the intra-observer reliability and internal consistency. RESULTS: The Bowel Disease Questionnaire's concepts were considered pertinent in the Brazilian context; the semantic equivalence between the original and the Portuguese version were high; reliability ranged from moderate to almost perfect; internal consistency of the scales ranged from 0,66 to 0,74. CONCLUSION: The Portuguese version of the Bowel Disease Questionnaire seems to be semantically and culturally equivalent to the original version and might be useful for measuring functional bowel disorders among Brazilian adolescents.

[Safe school]. / Escola segura.

OBJECTIVE: To review the strategies to make school a safe environment. The paper first addresses the social context of accidents and violence in the school environment, and makes recommendations, based on the literature data, for the implementation of safe schools. SOURCE OF DATA: Articles published between 1993 and 2005 in the MEDLINE database. Brazilian epidemiological and literature data have also been searched. SUMMARY OF THE FINDINGS: There is growing evidence that intervention has multiple components, focusing on health education practices, with the participation of the whole community. The aim of those interventions is to help students and community members to adopt healthy and safe behaviors. Schools are taking on an increasing role in health promotion, disease prevention, and injury prevention. In the context of prevention of external causes of morbidity and mortality, it is important to recognize a risky environment, places, and risk behaviors as favorable to injury and violence, as well as the concept of accident as something one can avoid. CONCLUSION: Implementation of safe schools represents a promising new direction for school-based preventive work. It is important to note that a safe school should intervene not only in its physical structure, but it should also make it as safe as possible by gathering the school community through health education, and mainly encouraging healthy behavior.

Escola segura / Safe school

OBJETIVO: Revisão das estratégias para tornar o ambiente escolar seguro. Inicialmente os autores contextualizam a violência e os acidentes no ambiente escolar e fazem recomendações, baseadas em dados da literatura, para a implantação de escolas seguras. FONTE DE DADOS: Artigos publicados entre 1993 e 2005 na base de dados MEDLINE. Dados nacionais epidemiológicos e da literatura também foram pesquisados. SíNTESE DOS DADOS: Há evidência crescente de que a intervenção tem múltiplos componentes. O foco político é a prática em educação em saúde com o envolvimento de toda a comunidade. O norte dessas intervenções é ajudar estudantes e toda a comunidade a adotar um comportamento seguro e saudável. As escolas estão assumindo um envolvimento crescente na promoção da saúde, prevenção de doenças e prevenção de trauma. Nesse contexto de prevenção de causas externas de morbimortalidade, é importante reconhecer o risco ambiental, locais e comportamentos de risco como favoráveis ao trauma e à violência, além de um novo conceito de acidentes como algo que possa ser evitado. CONCLUSÃO: A implementação da escola segura representa uma nova direção promissora para o trabalho preventivo baseado na escola. É importante notar que uma escola segura deve intervir não meramente na sua estrutura física, mas também torná-la tão segura quanto possível, trabalhando com a comunidade escolar por meio de educação em saúde, discutindo principalmente o comportamento saudável.