Bottom-up parameterization of enzyme rate constants: Reconciling inconsistent data.

Kinetic models of metabolism are promising platforms for studying complex metabolic systems and designing production strains. Given the availability of enzyme kinetic data from historical experiments and machine learning estimation tools, a straightforward modeling approach is to assemble kinetic data enzyme by enzyme until a desired scale is reached. However, this type of 'bottom up' parameterization of kinetic models has been difficult due to a number of issues including gaps in kinetic parameters, the complexity of enzyme mechanisms, inconsistencies between parameters obtained from different sources, and in vitro-in vivo differences. Here, we present a computational workflow for the robust estimation of kinetic parameters for detailed mass action enzyme models while taking into account parameter uncertainty. The resulting software package, termed MASSef (the Mass Action Stoichiometry Simulation Enzyme Fitting package), can handle standard 'macroscopic' kinetic parameters, including Km, kcat, Ki, Keq, and nh, as well as diverse reaction mechanisms defined in terms of mass action reactions and 'microscopic' rate constants. We provide three enzyme case studies demonstrating that this approach can identify and reconcile inconsistent data either within in vitro experiments or between in vitro and in vivo enzyme function. We further demonstrate how parameterized enzyme modules can be used to assemble pathway-scale kinetic models consistent with in vivo behavior. This work builds on the legacy of knowledge on kinetic behavior of enzymes by enabling robust parameterization of enzyme kinetic models at scale utilizing the abundance of historical literature data and machine learning parameter estimates.

Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study.

OBJECTIVE: Received social support undermining engagement in life activities of individuals with chronic pain (e.g., solicitousness, support for functional dependence) is consistently correlated with worse physical functioning, pain severity, and disability. Whether such responses lead to worse pain outcomes (operant model of pain) or the latter lead to more supportive responses undermining activity engagement (social communication and empathy models of pain) is unknown, given the lack of cross-lagged panel studies. Furthermore, the mediating role of activity patterns in such relationships over time is entirely unclear. This study aimed to bridge these gaps. METHOD: This was a 3-month prospective study with three waves of data collection (T1-T3; 6-week lag in-between), including 130 older adults (71% women; Mage = 78.26) with musculoskeletal chronic pain attending day-care centers. At every time point, participants filled out self-report measures of staff social support for functional dependence, activity patterns, physical functioning, pain severity, and interference. Scales showed good/very good test-retest reliability (ICC = .74-.96) and internal consistency (all α > .90). RESULTS: Parsimonious cross-lagged panel mediation models showed the best fit (χ²/df < 2.44; CFI > .96; GFI > .93; RMSEA < .09). Bidirectional effects were found over time, but poorer pain outcomes at T1 (higher pain severity/interference, lower physical functioning) more consistently predicted higher social support for functional dependence than vice versa. Poorer pain outcomes (T1) predicted more avoidance/less overdoing (T3), via increased received support for functional dependence (T2). CONCLUSION: Further research on the cyclical relationships between the study variables across chronic pain trajectories is needed to harness the power of interpersonal relationships in future self-management interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Helpful social support for chronic pain in long-term care residents: "With a little help I manage on my own".

AIMS AND OBJECTIVES: To understand older adults' experiences of receiving formal pain-related social support and to identify which caregivers' responses are perceived as (un)helpful to chronic pain adjustment. BACKGROUND: Chronic pain is highly prevalent in long-term care residents, negatively impacting their psychological, physical and social functioning. However, research has lacked to address the extent to which residents' experiences with staff responses, to their pain, may influence chronic pain outcomes. DESIGN: Qualitative study. METHODS: Twenty-nine older adults (7 men, 22 women, Mage = 87.7) were interviewed online through semi-structured interviews, and a thematic analysis was conducted. COREQ guidelines were followed. RESULTS: Two main themes emerged: (1) support during a pain crisis aiming at its relief and (2) support with daily activities because of pain to overcome pain interference. Findings indicate pain-related support is helpful when residents feel their psychological and functional autonomy is protected, and the interactions convey connection and intimacy. Furthermore, residents actively try to shape the support to be received. Also, gender roles and expectations seem to influence pain-related supportive interactions. CONCLUSION: Pain-related social support may contribute to the maintenance of older adults' health status and autonomy, ensuring a fulfilling and healthy aging process despite chronic pain. RELEVANCE TO CLINICAL PRACTICE: Findings can inform effective pain-related care practices in long-term care, regarding (1) how residents can shape the support they need; (2) which kind of support should be provided, and (3) how caregivers and organizations should provide pain-related support. PATIENT OR PUBLIC CONTRIBUTION: Older adults who participated in the study were recruited from 3 long-term care facilities in Lisbon, in which they resided for longer than 3 months, had persistent/intermittent pain for more than 3 months; were able to maintain a conversation, recollect real episodes, and to fully provide informed consent to participate.

Omics data for sampling thermodynamically feasible kinetic models.

Kinetic models are key to understanding and predicting the dynamic behaviour of metabolic systems. Traditional models require kinetic parameters which are not always available and are often estimated in vitro. Ensemble models overcome this challenge by sampling thermodynamically feasible models around a measured reference point. However, it is unclear if the convenient distributions used to generate the ensemble produce a natural distribution of model parameters and hence if the model predictions are reasonable. In this paper, we produced a detailed kinetic model for the central carbon metabolism of Escherichia coli. The model consists of 82 reactions (including 13 reactions with allosteric regulation) and 79 metabolites. To sample the model, we used metabolomic and fluxomic data from a single steady-state time point for E. coli K-12 MG1655 growing on glucose minimal M9 medium (average sampling time for 1000 models: 11.21 ± 0.14 min). Afterwards, in order to examine whether our sampled models are biologically sound, we calculated Km, Vmax and kcat for the reactions and compared them to previously published values. Finally, we used metabolic control analysis to identify enzymes with high control over the fluxes in the central carbon metabolism. Our analyses demonstrate that our platform samples thermodynamically feasible kinetic models, which are in agreement with previously published experimental results and can be used to investigate metabolic control patterns within cells. This renders it a valuable tool for the study of cellular metabolism and the design of metabolic pathways.

[Intrahospital Protocol for the Management of COVID-19 Disease in Adults]. / Protocolo Intra-Hospitalar para Abordagem da Doença COVID-19 no Adulto.

The COVID-19 pandemic is currently responsible for over 526 million infections and over 6.3 million deaths. As a new disease, the number of papers on the subject is extensive, motivating considerable heterogeneity in its approach. Despite some medicines having sound evidence of benefit, new interventions and strategies continue to be proposed, and some still lack scientific evidence, which hinders a uniform and consensual approach. This article aims to standardize healthcare to adult patients with moderate-to-critical COVID-19, from the emergency department to hospitalization, either in a general ward or in level 2 or level 3 intensive care units, based on the best and most updated scientific evidence available. This protocol presents recommendations for the stratification of adult patients with COVID-19 disease, adequate workup at admission and during hospitalization, inpatient treatment criteria, general treatment measures, pharmacological treatment, management of complications such as organizing pneumonia and bacterial superinfection, thromboprophylaxis, special considerations on pregnancy and breastfeeding and possible future therapies.

A pandemia de COVID-19 é, atualmente, responsável por mais de 526 milhões de infeções e mais de 6,3 milhões de mortes. Como nova doença, é extenso o número de publicações sobre o tema, motivando uma considerável heterogeneidade na sua abordagem. Apesar de existirem terapêuticas com benefício comprovado, continuam a ser propostas novas intervenções e estratégias, algumas das quais carecendo ainda de suporte científico, dificultando assim uma abordagem uniforme e consensual. Este documento tem como objetivo uniformizar, baseando-se na melhor e mais atualizada evidência científica disponível, a prestação de cuidados aos doentes adultos com COVID-19 moderada a crítica, desde o serviço de urgência até à hospitalização, quer em enfermarias gerais, quer em enfermarias de cuidados intensivos de nível 2 e 3. Este protocolo apresenta recomendações para a estratificação da doença COVID-19, critérios de hospitalização, meios complementares de diagnóstico adequados à admissão e durante a hospitalização, medidas terapêuticas gerais e terapêutica farmacológica dirigida, gestão de complicações como pneumonia organizativa e sobreinfeção bacteriana, tromboprofilaxia, considerações especiais na gravidez e amamentação, e possíveis opções terapêuticas futuras.

Path analysis from COVID-19 perceptions to psychological health: The roles of critical distance and mastery.

OBJECTIVE: The Coronavirus disease 2019 (COVID-19) pandemic was previously associated with psychopathological symptoms. However, the psychological mechanisms underlying these associations are largely unexplored. Previous studies suggested associations between metacognitive abilities (e.g., mastery) and symptomatology, which may have impacts on COVID-19 perceptions. This study aims to explore, using path analysis, the mediational role of Critical Distance (differentiation and decentration abilities) and Mastery on the relationships between COVID-19 perceptions and psychological well-being and distress. METHODS: In a cross-sectional design, 227 participants (M = 34.21, SD = 10.9) filled self-report questionnaires. RESULTS: Metacognitive abilities were negatively correlated with psychopathological symptoms. Both Critical Distance and Mastery mediated the path from COVID-19 perceived severity and anxiety to psychological distress and well-being. Critical Distance seems to augment Mastery which tends to increase psychological well-being and limited psychological distress. CONCLUSIONS: Metacognition seems to play a mediational role on the relationship between COVID-19 perceptions and mental health. Clinical psychologists and psychotherapists may enhance psychological interventions regarding COVID-19 psychopathological symptomatology by working on metacognitive Critical Distance and Mastery abilities.

GRASP: a computational platform for building kinetic models of cellular metabolism.

Summary: Kinetic models of metabolism are crucial to understand the inner workings of cell metabolism. By taking into account enzyme regulation, detailed kinetic models can provide accurate predictions of metabolic fluxes. Comprehensive consideration of kinetic regulation requires highly parameterized non-linear models, which are challenging to build and fit using available modelling tools. Here, we present a computational package implementing the GRASP framework for building detailed kinetic models of cellular metabolism. By defining the mechanisms of enzyme regulation and a reference state described by reaction fluxes and their corresponding Gibbs free energy ranges, GRASP can efficiently sample an arbitrarily large population of thermodynamically feasible kinetic models. If additional experimental data are available (fluxes, enzyme and metabolite concentrations), these can be integrated to generate models that closely reproduce these observations using an approximate Bayesian computation fitting framework. Within the same framework, model selection tasks can be readily performed. Availability and implementation: GRASP is implemented as an open-source package in the MATLAB environment. The software runs in Windows, macOS and Linux, is documented (graspk.readthedocs.io) and unit-tested. GRASP is freely available at github.com/biosustain/GRASP. Supplementary information: Supplementary data are available at Bioinformatics Advances online.

COVID-19 Inventory and Mental Health: Preliminary Analysis.

OBJECTIVE: The COVID-19 pandemic imposed a set of drastic worldwide changes to and restrictions on daily life. Despite predictions of the harmful impacts of the pandemic on mental health, empirical data are lacking. This study sought to examine the relationship between individuals' perceptions about COVID-19 and scores on mental health indexes. METHODS: In this cross-sectional study, 183 individuals answered self-report questionnaires. A new inventory based on the health belief model (HBM) developed in Portugal was explored with a factor analysis, which revealed two significant factors: COVID-19 anxiety and perceived severity of the disease. RESULTS: Results showed that anxiety about COVID-19 was positively correlated with psychological distress, somatization, and paranoid ideation and was negatively correlated with psychological well-being. COVID-19 anxiety mediated the relationship between symptomatology and mental health. CONCLUSIONS: Perceptions about COVID-19 seem to play pivotal roles in mental health. These results may inform interventions focused on reducing psychological distress and symptomatology and on increasing psychological well-being.

Model-guided dynamic control of essential metabolic nodes boosts acetyl-coenzyme A-dependent bioproduction in rewired Pseudomonas putida.

Pseudomonas putida is evolutionarily endowed with features relevant for bioproduction, especially under harsh operating conditions. The rich metabolic versatility of this species, however, comes at the price of limited formation of acetyl-coenzyme A (CoA) from sugar substrates. Since acetyl-CoA is a key metabolic precursor for a number of added-value products, in this work we deployed an in silico-guided rewiring program of central carbon metabolism for upgrading P. putida as a host for acetyl-CoA-dependent bioproduction. An updated kinetic model, integrating fluxomics and metabolomics datasets in addition to manually-curated information of enzyme mechanisms, identified targets that would lead to increased acetyl-CoA levels. Based on these predictions, a set of plasmids based on clustered regularly interspaced short palindromic repeats (CRISPR) and dead CRISPR-associated protein 9 (dCas9) was constructed to silence genes by CRISPR interference (CRISPRi). Dynamic reduction of gene expression of two key targets (gltA, encoding citrate synthase, and the essential accA gene, encoding subunit A of the acetyl-CoA carboxylase complex) mediated an 8-fold increase in the acetyl-CoA content of rewired P. putida. Poly(3-hydroxybutyrate) (PHB) was adopted as a proxy of acetyl-CoA availability, and two synthetic pathways were engineered for biopolymer accumulation. By including cell morphology as an extra target for the CRISPRi approach, fully rewired P. putida strains programmed for PHB accumulation had a 5-fold increase in PHB titers in bioreactor cultures using glucose. Thus, the strategy described herein allowed for rationally redirecting metabolic fluxes in P. putida from central metabolism towards product biosynthesis-especially relevant when deletion of essential pathways is not an option.

Cultural adaptation and psychometric validation of the Portuguese breakthrough pain assessment tool with cancer patients.

OBJECTIVES: Breakthrough cancer pain (BTcP) is a transient exacerbation of pain that occurs over persistent, stable, and adequately controlled cancer background pain. It is prevalent and bears severe consequences to patients' quality-of-life. The effective management of BTcP depends on fast and reliable (re)assessment. The Breakthrough pain Assessment Tool (BAT) is one of the most concise and reliable self-report instruments adapted to clinical contexts so far, showing good psychometric qualities in the United Kingdom, the Netherlands, and South Korea. As to promote the effective management of BTcP in Portuguese-speaking communities this study, first aimed to culturally adapt and validate the Portuguese version of the BAT (BAT-Pt). Second, and most importantly, it sought to provide novel evidence on its criterion validity by investigating its association with measures of psychological distress, which has not been yet investigated. METHODS: The BAT was translated into European Portuguese, using the back-translation method, and culturally adapted. Its psychometric properties (factor structure, internal consistency, construct and criterion validity) were analyzed in a cross-sectional multicenter study, with a sample of 65 cancer patients (49.2% women) recruited from eight hospitals in mainland Portugal (a priori power analysis determined a minimum sample of 50). Health professionals collected patients' clinical information, assessed their functional disability (ECOG Performance Status) and the adequacy of pain control. In addition to the Portuguese version of the BAT (BAT_Pt), patients completed the Portuguese versions of the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, a Distress Thermometer and answered questions about the adequacy of pain control. RESULTS: The BAT-Pt was very well accepted by experts and patients. As hypothesized, a Principal Axis Factor Analysis revealed two underlying factors accounting for 55.2% of the variance: (1) Pain Severity and Impact of BTcP and (2) Duration of BTcP and Medication Inefficacy. Two items (on episode frequency and medication efficacy) were analyzed separately given their lower/cross loadings. The BAT-Pt showed good internal consistency overall (α=0.79) and for each sub-scale, namely, Pain Severity and Impact of BTcP (n=5 items; α=0.86) and Duration of BTcP and Medication Inefficacy (n=2 items; rsb=0.62). The BAT-Pt showed good convergent validity, being moderately to strongly associated with overall pain severity and interference (0.46

Metabolic Modelling as a Framework for Metabolomics Data Integration and Analysis.

Metabolic networks are regulated to ensure the dynamic adaptation of biochemical reaction fluxes to maintain cell homeostasis and optimal metabolic fitness in response to endogenous and exogenous perturbations. To this end, metabolism is tightly controlled by dynamic and intricate regulatory mechanisms involving allostery, enzyme abundance and post-translational modifications. The study of the molecular entities involved in these complex mechanisms has been boosted by the advent of high-throughput technologies. The so-called omics enable the quantification of the different molecular entities at different system layers, connecting the genotype with the phenotype. Therefore, the study of the overall behavior of a metabolic network and the omics data integration and analysis must be approached from a holistic perspective. Due to the close relationship between metabolism and cellular phenotype, metabolic modelling has emerged as a valuable tool to decipher the underlying mechanisms governing cell phenotype. Constraint-based modelling and kinetic modelling are among the most widely used methods to study cell metabolism at different scales, ranging from cells to tissues and organisms. These approaches enable integrating metabolomic data, among others, to enhance model predictive capabilities. In this review, we describe the current state of the art in metabolic modelling and discuss future perspectives and current challenges in the field.

Combined In-Cell NMR and Simulation Approach to Probe Redox-Dependent Pathway Control.

Dynamic response of intracellular reaction cascades to changing environments is a hallmark of living systems. As metabolism is complex, mechanistic models have gained popularity for describing the dynamic response of cellular metabolism and for identifying target genes for engineering. At the same time, the detailed tracking of transient metabolism in living cells on the subminute time scale has become amenable using dynamic nuclear polarization-enhanced 13C NMR. Here, we suggest an approach combining in-cell NMR spectroscopy with perturbation experiments and modeling to obtain evidence that the bottlenecks of yeast glycolysis depend on intracellular redox state. In pre-steady-state glycolysis, pathway bottlenecks shift from downstream to upstream reactions within a few seconds, consistent with a rapid decline in the NAD+/NADH ratio. Simulations using mechanistic models reproduce the experimentally observed response and help identify unforeseen biochemical events. Remaining inaccuracies in the computational models can be identified experimentally. The combined use of rapid injection NMR spectroscopy and in silico simulations provides a promising method for characterizing cellular reactions with increasing mechanistic detail.

Older adults' preferences for formal social support of autonomy and dependence in pain: development and validation of a scale.

Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain (Mage = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors (r = .56): (a) preferences for autonomy support (α = .99) and (b) preferences for dependence support (α = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence (r = .33) and the lower the desire for independence (r = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.

Why and when social support predicts older adults' pain-related disability: a longitudinal study.

Pain-related social support has been shown to be directly associated with pain-related disability, depending on whether it promotes functional autonomy or dependence. However, previous studies mostly relied on cross-sectional methods, precluding conclusions on the temporal relationship between pain-related social support and disability. Also, research on the behavioral and psychological processes that account for such a relationship is scarce. Therefore, this study aimed at investigating the following longitudinally: (1) direct effects of social support for functional autonomy/dependence on pain-related disability, (2) mediating role of physical functioning, pain-related self-efficacy, and fear, and (3) whether pain duration and pain intensity moderate such mediating processes. A total of 168 older adults (Mage = 78.3; SDage = 8.7) participated in a 3-month prospective design, with 3 moments of measurement, with a 6-week lag between them. Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the 36-SF Health Survey, behavioral tasks from the Senior Fitness Test, the Pain Self-Efficacy Questionnaire, and the Tampa Scale for Kinesiophobia. Moderated mediation analyses showed that formal social support for functional dependence (T1) predicted an increase in pain-related disability (T3), that was mediated by self-reported physical functioning (T2) and by pain-related self-efficacy (T2) at short to moderate pain duration and at low to moderate pain intensity, but not at higher levels. Findings emphasized that social support for functional dependence is a risk factor for pain-related disability and uncovered the "why" and "when" of this relationship. Implications for the design of social support interventions aiming at promoting older adults' healthy aging despite chronic pain are drawn.

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults' chronic pain experiences.

OBJECTIVE: This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. METHOD: One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. RESULTS: Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. CONCLUSIONS: These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record

The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning.

Chronic pain is prevalent among older adults and is usually associated with high levels of functional disability. Social support for the promotion of functional autonomy and dependence has been associated with pain-related disability and self-reported physical functioning. Nevertheless, these relationships need further inquiry. Our aims were to investigate: (1) the relationship between perceived promotion of autonomy/dependence and pain-related disability and (2) the extent to which self-reported physical functioning mediated these relationships. 118 older adults (Mage = 81.0) with musculoskeletal chronic pain completed the Portuguese versions of the revised formal social support for Autonomy and Dependence in Pain Inventory, the pain severity and interference scales of the Brief Pain Inventory, and the physical functioning scale of the Medical Outcomes Study-Short-Form 36 v2. Higher levels of perceived promotion of autonomy were associated with lower pain-related disability; this relationship was partially mediated by self-reported physical functioning (B = -.767, p < .001 decreasing to B' = -.485, p < .01). Higher perceived promotion of dependence was associated with higher pain-related disability; this effect was also partially accounted for by self-reported physical functioning (B = .889, p < .01 decreasing to B' = .597, p < .05). These results highlight the importance of perceived promotion of autonomy and dependence for managing older adults' experience of chronic pain.

lpNet: a linear programming approach to reconstruct signal transduction networks.

UNLABELLED: With the widespread availability of high-throughput experimental technologies it has become possible to study hundreds to thousands of cellular factors simultaneously, such as coding- or non-coding mRNA or protein concentrations. Still, extracting information about the underlying regulatory or signaling interactions from these data remains a difficult challenge. We present a flexible approach towards network inference based on linear programming. Our method reconstructs the interactions of factors from a combination of perturbation/non-perturbation and steady-state/time-series data. We show both on simulated and real data that our methods are able to reconstruct the underlying networks fast and efficiently, thus shedding new light on biological processes and, in particular, into disease's mechanisms of action. We have implemented the approach as an R package available through bioconductor. AVAILABILITY AND IMPLEMENTATION: This R package is freely available under the Gnu Public License (GPL-3) from bioconductor.org (http://bioconductor.org/packages/release/bioc/html/lpNet.html) and is compatible with most operating systems (Windows, Linux, Mac OS) and hardware architectures. CONTACT: bettina.knapp@helmholtz-muenchen.de SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

The Revised Formal Social Support for Autonomy and Dependence in Pain Inventory (FSSADI_PAIN): Confirmatory Factor Analysis and Validity.

UNLABELLED: Pain among older adults is common and generally associated with high levels of functional disability. Despite its important role in elders' pain experiences, perceived (formal) social support (PSS) has shown inconsistent effects on their functional autonomy. This suggests a moderator role of 2 recently conceptualized functions of PSS: perceived promotion of dependence versus autonomy. The present study aimed at revising and further validating the Formal Social Support for Autonomy and Dependence in Pain Inventory (FSSADI_PAIN), which measures these 2 PSS functions among institutionalized elders in pain. Two hundred fifty older adults (mean age = 81.36 years, 75.2% women) completed the revised FSSADI_PAIN along with measures of physical functioning (ie, Medical Outcome Study Short Form-36) and informal PSS (ie, Social Support Scale of Medical Outcomes Study). Confirmatory factor analyses showed a good fit for a 2-factor structure: 1) perceived promotion of autonomy (n = 4 items; α = .89), and 2) perceived promotion of dependence (n = 4 items; α = .85). The revised FSSADI_PAIN showed good content, discriminant, and criterion-related validity; it discriminated the PSS of male and female older adults and also of elders with different levels of physical functioning. In conclusion, the revised FSSADI_PAIN is an innovative, valid, and reliable tool that allows us to assess 2 important functions of PSS, which may play a relevant role in the prevention and reduction of pain-related physical disability and functional dependence among institutionalized older adults. PERSPECTIVE: This article presents a revised version of the FSSADI_PAIN that assesses elders' perceived promotion of functional autonomy/dependence as 2 independent functions of perceived social support. This measure may contribute to future research on the role of close interpersonal contexts on the promotion of active aging among elders with chronic pain.

Qualidade Vida do Idoso Institucionalizados / Quality of Life of Institutionalized Elderly

O processo de envelhecimento da sociedade a nível mundial apresenta consequências e repercussões em todos os domínios da vida quotidiana. Este envelhecimento tem um impacto direto nas relações no seio familiar, na equidade intergeracional, no estilo de vida, na união familiar e apresenta, cada vez mais, repercussões no plano económico, no plano da saúde e por conseguinte no plano político. A qualidade de vida tem um significado que abrange e reflete o conhecimento, a experiência e os valores que o indivíduo adquire ao longo da sua vida. Na velhice, a qualidade de vida é avaliada de forma multidimensional, relacionada com critérios sociais e normativos, bem com intrapessoais, e que dizem respeito às relações atuais, passadas e prospetivas, entre o idoso, muitas vezes institucionalizado e o meio que o rodeia. A presente investigação teve como principal objetivo determinar a perceção que os idosos institucionalizados têm da sua qualidade de vida. Trata-se de um estudo de natureza quantitativa, não experimental, transversal e descritivo-correlacional, em que a amostra foi constituída por 90 idosos institucionalizados no concelho da Guarda. Para a recolha dos dados, utilizou-se um formulário de caraterização sociodemográfica, o Índice de Barthel e a Escala WHOQOL ­ Bref. Com o presente estudo, pudemos constatar que os idosos percecionam melhor qualidade de vida no Domínio Social, seguindo-se o Domínio Ambiental, o Domínio Psicológico e por último o Domínio Físico. Como fatores determinantes da qualidade de vida dos idosos, identificámos a idade, o género, as habilitações literárias, a iniciativa da institucionalização, o tempo de institucionalização, o facto de receber visitas e o nível de independência que estes apresentam. Para aumentar a qualidade de vida do idoso institucionalizado é essencial, o bem estar fisico, psicológico e social. Assim, as instituições devem encarar o idoso como ser único, abordando-o de forma individual, permitindo que este se adapte à instituição nos seus timings e assim possa viver com qualidade de vida; a promoção da participação da família nas diferentes fases do processo de adaptação à institucionalização e a criação de programas e atividades para os idosos institucionalizados, de forma a manter a saúde, a independência, a autonomia, a auto-estima e por conseguinte, a qualidade de vida.

The process of aging in modern societies all over the world presents consequences and repercussions in all plans of everyday life. Aging has a direct impact in relationships within families, in intergenerational equity, in the way of life, in familiar ties. It also has more and more reflections on economical, health and political fields. The quality in ways of living has a meaning which reflects the knowledge, the experience and the values acquired along a life time. In old age, wellbeing is evaluated in a multidimensional way related to social, normative and interpersonal criteria, concerning present, past and prospective relationships between the old person ­ commonly institutionalized ­ and his/her background. The main target of this work is to determine the perception institutionalized elderly have of their own quality of life. It conveys a quantitative non-experimental transversal and descriptive correlational study, within a sample of 90 institutionalized old people in the region of Guarda. It was used a formulary of socio demographic characteristics ­ Barthel indices and WHOQOL scale - BREF. So, it was showed that old people have a better perception of their wellbeing in the social domain, followed by the background, the psychological and finally the physical one. As determinant factors of wellbeing, they were identified age, gender, academic degree, initiative and time of institutionalization, visitors and independency level. To increase quality of life among institutionalized old people, physical, psychological and social wellbeing is needed. Thus, institutions should face each old person as a unique being, approaching him/her in an individual way, allowing him/her to adapt the institution in his/her own timing, so that each of them could live with the desired quality of life. In the same way, promoting families´ participation in the different steps of adaptation to the institution as well as the creation of programmes and activities for institutionalized elderly should be achieved to keep their health, independence, autonomy, self-esteem and, therefore, quality of life.

The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): a preliminary validation study.

OBJECTIVES: Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN). METHODS: One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions--day care centre (33.1%), nursing home (36.4%) and senior university (30.5%)--were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163). RESULTS: The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution. CONCLUSIONS: These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts.