A cross-sectoral approach to utilizing health claims data for quality assurance in medical rehabilitation: study protocol of a combined prospective longitudinal and retrospective cohort study.

BACKGROUND: Measuring the quality of provided healthcare presents many challenges, especially in the context of medical rehabilitation. Rehabilitation is based on a holistic biopsychosocial model of health that includes a person's long-term functioning; hence, outcome domains are very diverse. In Germany, rehabilitation outcomes are currently assessed via patient and physician surveys. Health insurance claims data has the potential to simplify current quality assurance procedures in Germany, since its comprehensive collection is federally mandated from every healthcare provider. By using a cross-sectoral approach, quality assessments in rehabilitation can be adjusted for the quality provided in previous sectors and individual patient risk factors. METHODS: SEQUAR combines two studies: In a prospective longitudinal study, 600 orthopedic rehabilitation patients and their physicians are surveyed at 4 and 2 time points, respectively, throughout rehabilitation and a follow-up period of 6 months. The questionnaires include validated instruments used in the current best-practice quality assurance procedures. In a retrospective cohort study, a nationwide claims database with more than 312,000 orthopedic rehabilitation patients will be used to perform exploratory analysis for the identification of quality indicators. The identified SEQUAR claims data quality indicators will be calculated for our prospective study participants and tested for their ability to approximate or replace the currently used, best-practice quality indicators based on primary data. DISCUSSION: The identified SEQUAR quality indicators will be used to draft a novel, state-of-the-art quality assurance procedure that reduces the administrative burden of current procedures. Further research into the applicability to other indications of rehabilitation is required. TRIAL REGISTRATION: WHO UTN: U1111-1276-7141; DRKS-ID: DRKS00028747 (Date of Registration in DRKS: 2022/08/10).

A psychometric study of an executive function assessment instrument (TDI-FE).

BACKGROUND: This study aims to present and discuss the psychometric properties of executive functions, which were measured using the TDI-FE instrument. The analysis encompasses its internal structure, potential sensitivity to fatigue factors, relationships with external criteria, and diagnostic accuracy. METHODS: The study sample comprised 382 students from Brazil, aged 6-8 years. Child development variables were screened using the TDI-FE and gold standard tests (Cancellation Attention and Trail Making Tests). The proposed scale comprised four activities: a test with fruit images with three tasks, and one memory game. RESULTS: The one-factor model of EF of the TDI-FE failed to fit to the data. However, fit substantially improved once a latent fatigue factor was controlled in the model. The latent factor of EF assessed by the TDI-FE tasks was coherently associated with a series of external variables, including two popular collateral measures of EF. The diagnostic accuracy was reasonable, and a cut-off of 37 points produced 70% of sensitivity and 60% of specificity. CONCLUSION: Results indicated that the TDI-FE demonstrated sound psychometric properties and diagnostic accuracy, then consisting of an efficient alternative for the assessment of EFs in early childhood education. The study also proved the need to control for response biases such as fatigue in the latent variable models of EF. The TDI-FE is notable because of its low cost and easy application, and it might fulfill a need for instruments for individuals from different contexts at this stage of development in Brazil.

[Facilitating Interprofessional Collaboration in Nursing Homes: Effects of a Complex Model Intervention (CoCare) to Improve On-Site Medical Care. Results of a Controlled Study with Pre-Post Measurement]. / Können die Maßnahmen der komplexen Modellintervention CoCare die Zusammenarbeit von Pflegekräften und Ärzt*innen in Pflegeheimen verbessern? Ergebnisse einer kontrollierten Studie mit Prä-Post-Messung.

AIM: The model project "CoCare - Extended coordinated medical care in long-term care homes" (funding: Innovation Committee of the Federal Joint Committee) aspired to improve on-site medical care in nursing homes by introducing a new form of care. Participating nursing homes implemented a number of intervention elements designed to facilitate interprofessional collaboration. We surveyed nursing staff and attending physicians as part of the project's summative evaluation. METHODS: The intervention group (IG) participated in our survey once before the implementation of the intervention (T0) as well as 12 months after implementation had started (T1). The control group (CG), in which residents received usual treatment ("usual care"), completed one survey. We investigated whether IG participants rated interprofessional collaboration more positively after the intervention, and attempted to detect advantages in their assessment at T1 as compared to the CG. Additionally, we analyzed if IG participants perceived improvements in on-site medical care from T0 to T1 and to what extent they evaluated the intervention and its components as beneficial. RESULTS: N=836 participants (678 nursing staff and 158 physicians) took part in the surveys. IG nursing staff demonstrated significant improvements in assessment of interprofessional collaboration from T0 to T1, while we found only partially significant improvements among IG physicians. Additionally, IG nursing staff rated interprofessional collaboration significantly better at T1 as compared to the CG. No such differences were found in the physician sample. Both nursing staff and physicians in the IG indicated significant improvements in on-site medical care after the intervention was implemented. They rated the overall intervention as overwhelmingly beneficial. Both professions found the regularly scheduled, weekly ward rounds and the appointment of fixed contact points particularly valuable. CONCLUSION: The implementation of the "CoCare" measures can improve nursing staff's and physicians' assessments of interprofessional collaboration and on-site medical care. However, participation in the survey was limited, especially among physicians, which reduced the statistical power of calculations.

TIDE: evidências de validade baseadas em critérios externos / TIDE: evidence of validity based on external criteria / TIDE: evidencia de validez basada en criterios externos

Objetivou-se buscar evidências de validade baseadas em critérios externos do Teste Informatizado e Dinâmico de Escrita - TIDE, em relação à ortografia e cognição. Participaram 304 alunos, entre 10 e 17 anos. Foram utilizados o TIDE, o instrumento Ditado Balanceado de Moojen e os subtestes: "Dígitos, Informação, Compreensão e Vocabulário" do WISC III. Em relação ao critério ortográfico, o módulo pré-teste esteve negativamente associado aos erros do Ditado, com exceção dos erros relacionados a irregularidades da língua. O módulo instrucional correlacionou-se de forma significativa negativa com os três tipos de erro do ditado. Em relação aos aspectos cognitivos, o módulo pré-teste não esteve associado. O módulo instrucional correlacionou-se com os quatro subtestes do WISC-III, demonstrando relação com aspectos cognitivos, memória, atenção, julgamento e o conhecimento lexical dos sujeitos. (AU)

The aim of this study was to investigate evidence of validity based on external criteria for the Computerized and Dynamic Writing Test - TIDE, in relation to spelling and cognition. Participants were 304 students, aged between 10 and 17 years. The TIDE, the Moojen Balanced Dictation instrument and the "Digits, Information, Understanding and Vocabulary" subtests of the WISC III were used. Regarding the orthographic criterion, the TIDE pre-test module was negatively associated with Dictation errors, with the exception of errors related to language irregularities. The instructional module presented significant negative correlations with the three types of dictation error. The pre-test module was not associated with the cognitive aspects. The instructional module correlated with the four WISC-III subtests, demonstrating a relation with cognitive aspects, memory, attention, judgment and the lexical knowledge of the subjects. (AU)

Se objetivó buscar evidencias de validez basadas en criterios externos del Test de Escritura Computarizada y Dinámica - TIDE, con relación a la ortografía y la cognición. Participaron 304 estudiantes, entre 10 y 17 años. Se utilizaron TIDE, el instrumento de Dictado Equilibrado de Moojen y las subpruebas "Dígitos, Información, Comprensión y Vocabulario" de WISC III. En cuanto a los criterios ortográficos, el módulo de prueba previa se asoció negativamente con los errores del Dictado, a excepción de los errores relacionados con las irregularidades del idioma. El módulo de instrucción se correlacionó significativamente de manera negativa con los tres tipos de errores del dictado. Con respecto a los aspectos cognitivos, el módulo de prueba previa no se ha asociado. El módulo de instrucción se correlacionó con las cuatro subpruebas de WISC-III, demostrando una relación con los aspectos cognitivos, la memoria, la atención, el juicio y el conocimiento léxico de los sujetos. (AU)

Barriers and facilitators for implementation of a complex health services intervention in long-term care homes: a qualitative study using focus groups.

BACKGROUND: With rising numbers of elderly people living in nursing homes in Germany, the need for on-site primary care is increasing. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. The project CoCare ("coordinated medical care") has therefore implemented a complex health intervention in nursing homes, using inter alia, regular medical rounds, a shared patient medical record and medication checks, with the aim of improving the coordination of medical care. This study reports upon the results of a qualitative study assessing the perceived barriers and facilitators of the implementation of CoCare by stakeholders. METHODS: Focus group interviews were held between October 2018 and November 2019 with nurses, general practitioners and GP's assistants working or consulting in a participating nursing home. A semi-structured modular guideline was used to ask participants for their opinion on different aspects of CoCare and which barriers and facilitators they perceived. Focus groups were analyzed using qualitative content analysis. RESULTS: In total, N = 11 focus group interviews with N = 74 participants were conducted. We found six themes describing barriers and facilitators in respect of the implementation of CoCare: understaffing, bureaucracy, complexity, structural barriers, financial compensation, communication and collaboration. Furthermore, participants described the incorporation of the intervention into standard care. CONCLUSION: Barriers perceived by stakeholders are well known in the literature (e.g. understaffing and complexity). However, CoCare provides a good structure to overcome barriers and some barriers will dissolve after implementation into routine care (e.g. bureaucracy). In contrast, especially communication and collaboration were perceived as facilitators in CoCare, with the project being received as a team building intervention itself. TRIAL REGISTRATION: WHO UTN: U1111-1196-6611; DRKS-ID: DRKS00012703 (Date of Registration in DRKS: 2017 Aug 23).

Viral infections shared between water buffaloes and small ruminants in Switzerland.

Importation of exotic animals that may harbor infectious agents poses risks for native species with potentially severe impacts on animal health and animal production. Although the Asian water buffalo (Bubalus bubalis) population in Europe is steadily increasing, its susceptibility to viral infections and its role for interspecies transmission is largely unknown. To identify viral infections that are shared between exotic water buffaloes and native small ruminants, we collected blood samples from 3 Swiss farms on which water buffaloes were kept either without, or together with, sheep or goats. These samples were analyzed by next-generation sequencing (NGS) as well as by selected conventional tests, including PCR, ELISA, and in some cases a virus neutralization test. By NGS, a novel virus of the genus Gemykrogvirus (GyKV; Genomoviridae) was first detected in the buffaloes on one farm, and subsequently confirmed by PCR, and was also detected in the co-housed sheep. In contrast, this virus was not detected in buffaloes on the farms without sheep. Moreover, conventional methods identified a number of viral infections that were not shared between the exotic and the native animals, and provided evidence for potential roles of water buffaloes in the epidemiology of ruminant pestiviruses, especially bovine viral diarrhea virus, bluetongue virus, and possibly bovine alphaherpesvirus 2. Our results clearly indicate that water buffaloes are susceptible to interspecies viral transmission and may act as intermediate hosts, or even as reservoirs, for these viruses.

Teste Informatizado e Dinâmico de Escrita: evidências de validade baseadas na TRI / Computerized and Dynamic Writing Test: evidence of validity based on IRT / Test Informatizado y Dinámico de Escritura: evidencias de validez con base en la TRI

Este estudo objetiva buscar evidências de precisão e de validade com base na estrutura interna do Teste Informatizado e Dinâmico de Escrita, utilizando a Teoria de Resposta ao Item. Foram incluídos 304 participantes de Porto Alegre, entre 10 e 17 anos. Utilizou-se o TIDE, cujo objetivo é avaliar o potencial de aprendizagem em escrita narrativa de adolescentes. Verificou-se a dimensionalidade dos módulos em análise por meio de análise fatorial, satisfazendo critério para a realização das análises por meio da TRI. O módulo pré-teste foi ajustado para o modelo Logístico de dois parâmetros, com alfa de Cronbach de 0,82. Todos os itens apresentaram valores adequados de discriminação, entre 1,88 e 3,49. A dificuldade dos itens variou de -0,01 a 1,27. O módulo instrucional foi ajustado pelo modelo de resposta gradual de Samejima, apresentando alfa de Cronbach foi de 0,91. Observou-se, portanto, evidências de validade com base na estrutura interna do TIDE. (AU)

This study aimed to investigate evidence of accuracy and validity based on the internal structure of the Computerized and Dynamic Writing Test, using the Item Response Theory. A total of 304 participants from Porto Alegre, aged between 10 and 17 years, were included. The aim of this study was to evaluate the adolescents' potential for learning in narrative writing. The dimensionality of the modules under analysis was verified by means of factorial analysis, satisfying criterion for the accomplishment of the analyses through IRT. The pre-test module was adjusted for the two-parameter logistic model, with Cronbach's Alpha of .82. All items presented adequate discrimination values ​​between 1.88 and 3.49. The difficulty of the items ranged from -0.01 to 1.27. The instructional module was adjusted using Samejima's graded response model, presenting a Cronbach's alpha of .91. Accordingly, evidence of validity based on the internal structure of the CDWT was observed. (AU)

Este estudio objetiva buscar evidencias de precisión y de validez con base en la estructura interna del Test Informatizado y Dinámico de Escritura, utilizando la Teoría de Respuesta al Ítem. Participaron 304 participantes de Porto Alegre, entre 10 y 17 años. El TIDE fue utilizado con el objetivo de evaluar el potencial de aprendizaje en la escritura narrativa de adolescentes. La dimensionalidad de los módulos en análisis se averiguó por medio de análisis factorial, satisfaciendo los criterios para la realización de los análisis por medio de la TRI. El módulo pre-test se ajustó al modelo Logístico de dos parámetros, con Alpha de Cronbach de 0,82. Todos los ítems presentaron valores adecuados de discriminación, entre 1,88 y 3,49. La dificultad de los ítems sufrió variación de -0,01 a 1,27. El módulo instruccional fue ajustado por el modelo de respuesta gradual de Samejima, presentando Alpha de Cronbach de 0,91. Por lo tanto, se observaron evidencias de validez con base en la estructura interna del TIDE. (AU)

The prefrontal cortex conscious and unconscious response to social/emotional facial expressions involve sex, hemispheric laterality, and selective activation of the central cardiac modulation.

The human prefrontal cortex (PFC) processes complex sensory information for the elaboration of social behaviors. The non-invasive neuroimaging technique near-infrared spectroscopy (NIRS) identifies hemodynamic changes and concentration of oxygenated (HbO2) and deoxygenated (HHb) hemoglobin in the cerebral cortex. We studied the responses detected by NIRS in the right and left PFC activation of 28 participants (n = 14 adult young females and males) while processing social/emotional facial expressions, i.e., in conscious perception of different expressions (neutral, happy, sad, angry, disgust, and fearful) and in unconscious/masked perception of negative expressions (fearful and disgust overlapped by neutral). The power spectral analysis from concomitant ECG signals revealed the sympathetic and parasympathetic modulation of cardiac responses. We found higher HbO2 values in the right PFC of females than in males during, and in the left PFC after, following the conscious perception of the happy face. In males, the left PFC increased and the right PFC decreased HbO2 while viewing the happy expression. In both sexes, HHb values were higher during the masked presentation of disgust than fearful expression, and after the masked presentation of fearful expression than during it. Higher sympathetic and lower parasympathetic activity (LF/ HF components) occurred in females when consciously and unconsciously processing negative emotions (p < 0.05 in all cases). These results demonstrate that the human PFC displays a selective activation depending on sex, hemispheric laterality, attention, time for responding to conscious and unconscious emotionally loaded stimuli with simulataneous centrally modulated cardiovascular responses.

Contributions of Positive Psychology in Self-Regulated Learning: A Study With Brazilian Undergraduate Students.

Self-regulated learning (SRL) is an important factor for academic success. The present study aimed to investigate the relationship between constructs typical of positive psychology (PP; self-esteem, self-efficacy, affects, life satisfaction, optimism, and hope) and SRL while indicating the explained variance of these constructs in an SRL model. The study comprised 1,046 undergraduate students from 63 public higher education institutions from all demographic regions of Brazil. Significant correlations (p < 0.01) were found between SRL and all PP variables. Moderate correlations were found with self-efficacy and positive affects. The linear regression analysis indicated that one model explains 41.9% of the variance in SRL. The data are discussed based on the potential of PP and SRL interventions to improve academic performance and student adaptation to higher education environments.

Análise de manuais de testes psicológicos aprovados pelo Satepsi para avaliação de adultos / Analysis of psychological test manuals approved by Satepsi for adult assessment / Análisis de manuales de pruebas psicológicas aprobados por el Satepsi para evaluación de adultos

Neste artigo, os manuais de testes psicológicos considerados favoráveis pelo Satepsi para avaliação, em adultos, de personalidade, atributos emocionais/sociais ou aspectos profissionais/laborais foram analisados em relação à indicação de uso, autoria, editora, estudos normativos e construtos cobertos. Dos 173 testes listados no Satepsi em julho de 2017, 65 foram incluídos: 33 destinados à avaliação de personalidade (19 escalas/inventários e 14 testes projetivos), 20 voltados à avaliação de atributos emocionais/sociais e 12 relacionados à orientação profissional ou ao contexto laboral. A maioria dos testes apresenta em seus manuais as informações investigadas. Apesar de haver, em alguns casos, discrepâncias entre a indicação de uso do teste e a idade das amostras de normatização brasileira, os achados levam à conclusão de que a qualidade das informações consultadas nos manuais representa um avanço em relação ao panorama descrito por pesquisadores da área nas décadas de 1990 e 2000.

In this article, the psychological test manuals considered favorable by Satepsi to assessment of personality, emotional/social attributes or professional/work-related aspects in adults were analyzed in relation to the indication of use, authorship, publisher, normative studies and constructs. Of the 173 tests listed in the Satepsi in July 2017, 65 were included: 33 are intended for personality assessment (19 scales/inventories and 14 projective tests), 20 to assessment of emotional/social attributes and 12 related to professional orientation or work context. Most of the tests present in their manuals the information investigated. Although there are in some cases discrepancies between the indication of use of the test and the age of Brazilian standardization samples, the data lead to the conclusion that the quality of the information consulted in the manuals represents an advance in relation to the panorama described by researchers of the area in the 1990s and 2000s.

En este artículo, los manuales de pruebas psicológicas consideradas favorables por el Satepsi para evaluación, en adultos, de personalidad, atributos emocionales/sociales o factores profesionales/laborales fueron analizados en relación a la indicación de uso, autoría, editora, estudios normativos y construcciones. De los 173 tests listados en el Satepsi en julio de 2017, 65 fueron incluidos: 33 destinados a la evaluación de personalidad (19 escalas/inventarios y 14 pruebas proyectivas), 20 a la evaluación de atributos emocionales/sociales y 12 relacionados a la orientación profesional o al contexto laboral. La mayoría de las pruebas presentan en sus manuales la información investigada. A pesar de haber, en algunos casos, discrepancias entre la indicación de uso y la edad de las muestras de normatización brasilena, los datos evidencian que la calidad de la información de los manuales representa un avance en relación al panorama descrito por investigadores del área en las décadas de 1990 y 2000.

Avaliação de aspectos cognitivos em adultos: análise de manuais de instrumentos aprovados / Assessment of cognitive aspects in adults: Analysis of the manuals of approved tests / Evaluación de los aspectos cognitivos en adultos: análisis de lós manuales de los instrumentos aprobados

A avaliação psicológica é uma prática especializada do profissional psicólogo, contudo, para adequada realização, são necessários instrumentos que contemplem requisitos mínimos, tais como estudos psicométricos de validade e precisão dos instrumentos e referencial teórico robusto. Além disso, é preciso a aprovação do Sistema de Avaliação de Testes Psicológicos (SATEPSI) para sua utilização profissional. O objetivo deste estudo foi realizar uma análise dos testes de avaliação cognitiva voltados para adultos disponíveis e aprovados pelo SATEPSI, a fim de apresentar dados sobre os aspectos cognitivos avaliados, suas propriedades psicométricas e a qualidade das informações contidas em seu manual. No total, 57 instrumentos que avaliam aspectos cognitivos em adultos foram incluídos, sendo inteligência e atenção os construtos mais estudados. A maior parte apresentava adequada relação entre estudos psicométricos e critérios de indicação do teste. Ressalta-se a importância de serem construídos mais instrumentos destinados à avaliação de processos cognitivos distintos, além de uma apresentação mais clara das características dos instrumentos nos manuais comercializados.(AU)

Psychological assessment is a specialized practice of professional psychologist. However, for its proper conduct, instruments dealing with minimum requirements are necessary, such as complete psychometric studies of validity and accuracy of instruments and robust theoretical framework. In addition, approval of the Sistema de Avaliação de Testes Psicológicos (SATEPSI) for your professional use is required. The aim of this study was to conduct an analysis of cognitive assessment tests available on the market and approved by SATEPSI in order to present data on the cognitive aspects that these instruments assess, its psychometric properties and the quality of the information contained in your manual. A total of 57 instruments that assess cognitive aspects in adults were included, intelligence and attention the most studied constructs. Most had adequate relationship between psychometric studies and test indication criteria. It emphasizes the importance of being built more instruments for the assessment of different cognitive processes, as well as a clearer presentation characteristics of the instruments traded in the manuals.(AU)

La evaluación psicológica es una práctica especializada del profesional de la psicología, sin embargo, para el correcto desarrollo, son necesarios instrumentos que se ocupan de los requisitos mínimos, como los estudios psicométricos de validez y exactitud de los instrumentos y marco teórico robusto. Por otra parte, es necesario la aprobación de SATEPSI para su uso profesional. El objetivo de este estudio fue realizar un análisis de las pruebas de evaluación cognitivos disponibles en el mercado y aprobado por SATEPSI con el fin de presentar los datos sobre los aspectos cognitivos que estos instrumentos evalúan, sus propiedades psicométricas y la calidad de la información contenida en el manual . Se incluyeron un total de 57 instrumentos que evalúan aspectos cognitivos en adultos, la inteligencia y la atención de las construcciones más estudiados. La mayoría tenía relación adecuada entre los estudios psicométricos y criterios de indicación de pruebas. Se hace hincapié en la importancia de que se está construyendo más instrumentos para la evaluación de diferentes procesos cognitivos, así como unas claras características de presentación de los instrumentos negociados en los manuales.(AU)

Visual-Motor Maturity and Executive Functions in Schoolchildren / Maturidade Visomotora e Funções Executivas em Escolares / Madurez Visomotora y Funciones Ejecutivas en Escolares

Abstract Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Raven's Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative (r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score (r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.(AU)

Resumo A maturidade visomotora e as funções executivas estão intimamente relacionadas no processo de desenvolvimento infantil. O objetivo deste estudo foi investigar a relação entre habilidades visomotoras e funções executivas em 83 crianças hígidas, de 7 a 10 anos. Os instrumentos utilizados foram Teste Gestáltico Visomotor de Bender - Sistema de Pontuação Gradual (B-GSS), Teste Wisconsin de Classificação de Cartas (WCST), Matrizes Progressivas de Raven (RPM) e Rey- Osterrieth Figura Complexa Test (ROCF). A correlação entre os escores de B-GSS e WCST foi negativa e significativa (r = 0,23, p < 0,033) e variáveis do ROCF, como Cópia Total e Memória Total apresentaram correlação moderada e significativa com o escore total do B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Os resultados evidenciam empiricamente a relação entre funções executivas e maturidade visomotora e são discutidos à luz da neuropsicologia do desenvolvimento.(AU)

Resumen La madurez visual-motora y las funciones ejecutivas están estrechamente relacionados en el proceso de desarrollo del niño. El objetivo de este estudio fue investigar la relación entre habilidades visomotoras y funciones ejecutivas en 83 niños sanos, de 7-10 años. Los instrumentos utilizados fueron Prueba Gestáltica Visomotora de Bender - Sistema de Puntuación Gradual (B-GSS), Prueba Wisconsin de Clasificación de Cartas (WCST), Matrices Progresivas de Raven (RPM) y Prueba Rey- Osterrieth Figura Compleja (ROCF). La correlación entre las puntuaciones B-GSS y WCST fue negativa y significativa (r = 0,23, p < 0,033) y ROCF variables, como Copiar y Memoria Total mostraron correlación moderada y significativa con la puntuación total de la B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Los resultados demuestran empíricamente la relación entre las funciones ejecutivas y la madurez visomotora y se discuten a la luz de la neuropsicología del desarrollo.(AU)

Visual-motor maturity and executive functions in schoolchildren / Maturidade visomotora e funções executivas em escolares / Madurez visomotora y funciones ejecutivas en escolares

Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Raven's Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative (r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score (r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.

A maturidade visomotora e as funções executivas estão intimamente relacionadas no processo de desenvolvimento infantil. O objetivo deste estudo foi investigar a relação entre habilidades visomotoras e funções executivas em 83 crianças hígidas, de 7 a 10 anos. Os instrumentos utilizados foram Teste Gestáltico Visomotor de Bender - Sistema de Pontuação Gradual (B-GSS), Teste Wisconsin de Classificação de Cartas (WCST), Matrizes Progressivas de Raven (RPM) e Rey- Osterrieth Figura Complexa Test (ROCF). A correlação entre os escores de B-GSS e WCST foi negativa e significativa (r = 0,23, p < 0,033) e variáveis do ROCF, como Cópia Total e Memória Total apresentaram correlação moderada e significativa com o escore total do B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Os resultados evidenciam empiricamente a relação entre funções executivas e maturidade visomotora e são discutidos à luz da neuropsicologia do desenvolvimento.

La madurez visual-motora y las funciones ejecutivas están estrechamente relacionados en el proceso de desarrollo del niño. El objetivo de este estudio fue investigar la relación entre habilidades visomotoras y funciones ejecutivas en 83 niños sanos, de 7-10 años. Los instrumentos utilizados fueron Prueba Gestáltica Visomotora de Bender - Sistema de Puntuación Gradual (B-GSS), Prueba Wisconsin de Clasificación de Cartas (WCST), Matrices Progresivas de Raven (RPM) y Prueba Rey- Osterrieth Figura Compleja (ROCF). La correlación entre las puntuaciones B-GSS y WCST fue negativa y significativa (r = 0,23, p < 0,033) y ROCF variables, como Copiar y Memoria Total mostraron correlación moderada y significativa con la puntuación total de la B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Los resultados demuestran empíricamente la relación entre las funciones ejecutivas y la madurez visomotora y se discuten a la luz de la neuropsicología del desarrollo.

Media-fill simulation tests in manual and robotic aseptic preparation of injection solutions in syringes.

OBJECTIVE: The purpose of this study was to evaluate the contamination rate of media-fill products either prepared automated with a robotic system (APOTECAchemo™) or prepared manually at cytotoxic workbenches in the same cleanroom environment and by experienced operators. Media fills were completed by microbiological environmental control in the critical zones and used to validate the cleaning and disinfection procedures of the robotic system. METHODS: The aseptic preparation of patient individual ready-to-use injection solutions was simulated by using double concentrated tryptic soy broth as growth medium, water for injection and plastic syringes as primary packaging materials. Media fills were either prepared automated (500 units) in the robot or manually (500 units) in cytotoxic workbenches in the same cleanroom over a period of 18 working days. The test solutions were incubated at room temperature (22℃) over 4 weeks. Products were visually inspected for turbidity after a 2-week and 4-week period. Following incubation, growth promotion tests were performed with Staphylococcus epidermidis. During the media-fill procedures, passive air monitoring was performed with settle plates and surface monitoring with contact plates on predefined locations as well as fingerprints. The plates got incubated for 5-7 days at room temperature, followed by 2-3 days at 30-35℃ and the colony forming units (cfu) counted after both periods. The robot was cleaned and disinfected according to the established standard operating procedure on two working days prior to the media-fill session, while on six other working days only six critical components were sanitized at the end of the media-fill sessions. Every day UV irradiation was operated for 4 h after finishing work. RESULTS: None of the 1000 media-fill products prepared in the two different settings showed turbidity after the incubation period thereby indicating no contamination with microorganisms. All products remained uniform, clear, and light-amber solutions. In addition, the reliability of the nutrient medium and the process was demonstrated by positive growth promotion tests with S. epidermidis. During automated preparation the recommended limits < 1 cfu per settle/contact plate set for cleanroom Grade A zones were not succeeded in the carousel and working area, but in the loading area of the robot. During manual preparation, the number of cfus detected on settle/contact plates inside the workbenches lay far below the limits. The number of cfus detected on fingertips succeeded several times the limit during manual preparation but not during automated preparation. There was no difference in the microbial contamination rate depending on the extent of cleaning and disinfection of the robot. CONCLUSION: Extensive media-fill tests simulating manual and automated preparation of ready-to-use cytotoxic injection solutions revealed the same level of sterility for both procedures. The results of supplemental environmental controls confirmed that the aseptic procedures are well controlled. As there was no difference in the microbial contamination rates of the media preparations depending on the extent of cleaning and disinfection of the robot, the results were used to adapt the respective standard operating procedures.

A busca de evidências de validade no desenvolvimento de instrumentos em Fonoaudiologia: revisão sistemática / The search for validity evidence in the development of instruments in speech therapy: a systematic review

RESUMO Objetivo: Identificar, na literatura, o uso da Psicometria na área da Fonoaudiologia e os processos utilizados para a busca de evidências de validade dos instrumentos da área. Estratégia de pesquisa: As bases pesquisadas foram MEDLINE (acessado via PubMed), LILACS, Scopus e SciELO. Os descritores foram “Validation studies”, “Validity of tests”, “Speech, Language and Hearing Sciences” e “Valid” (seguido de elemento de truncagem), em português, inglês e espanhol. Critérios de seleção: Foram incluídos os estudos que realizavam algum tipo de validação de testes referentes a áreas da Fonoaudiologia. Resultados: Foram encontrados 296 artigos e destes, apenas 48 foram incluídos. A maioria dos estudos foi publicada por periódicos internacionais, da área da Fonoaudiologia e com amostra de ampla faixa etária. A principal área avaliada pelos instrumentos foi linguagem (20 estudos), seguida por audiologia (13 estudos). O ano de maior publicação foi 2014 e o principal tipo de busca de evidências de validade foi com base na estrutura interna. Conclusão: O uso dos princípios de busca de evidências de validade de instrumentos da área fonoaudiológica ainda é escasso. Porém, observa-se que a maior parte dos estudos foi desenvolvida nos últimos anos, demonstrando tendência atual para atenção à necessidade de aprimoramento dos instrumentos.

ABSTRACT Purpose: To identify in the literature the use of psychometry in Speech Therapy, besides the processes used in the search for validity evidence for the instruments in that field. Research strategy: The databases investigated were MEDLINE (accessed via PubMed), LILACS, Scopus, and SciELO. The descriptors used were “Validation studies,” “Validity of tests,” “Speech, Language and Hearing Sciences,” and “Valid” (followed by a truncation element) in Portuguese, English, and Spanish. Selection criteria: The review included studies that performed some type of validation of tests in Speech Therapy. The survey found 296 papers, 48 of which were included. Most studies were published by international journals in Speech Therapy and with broad-age-group samples. Results: The main area assessed by the instruments was language (20 studies), followed by audiology (13 studies). The year with the highest number of publications was 2014 and the main type of search for validity evidence was based on the internal structure. Conclusion: The principles of search for validity evidence are still scarcely used for instruments in Speech Therapy. However, most studies were developed in recent years, which shows the current trend for focusing on the need for enhancing the instruments.