Professionals' and Patients' Perspectives on Criteria for Referring Hypertensive Patients to Comprehensive Medication Management Services in Public Primary Health Care.

Patient prioritization in comprehensive medication management services allows coordinating care and guiding patients according to their clinical profile and their medication use. The aim of the study is to identify and describe factors that indicate the need for comprehensive medication management services among primary care hypertension patients within a public health system from the perspective of patients, pharmacists, nurses and physicians. A qualitative study was carried out with interviews with nurses, pharmacists and physicians (n = 20), and two focus groups with hypertensive patients (n = 12) at primary health care facilities and a public outdoor fitness area between January and February 2019 in Brazil. All interviews were transcribed and analyzed using the Atlas.ti® software. The data analysis revealed the following factors indicative of the need to refer hypertension patients to a pharmacist: lifestyle habits, comorbidities, health care utilization and medication use. The issues identified and the information obtained from the qualitative research and compared with literature studies reviewed allowed defining dimensions that should be considered as an aid in the selection of uncontrolled hypertensive patients for comprehensive medication management services.

Food intake behaviors change as a function of maternal diet and time-restricted feeding / Las conductas de ingesta de alimentos se alteran en función de la dieta materna y la alimentación limitada en el tiempo

Introduction: changes in dietary/energetic composition during the critical period of development (pregnancy/lactation) or even during meal times may contribute to changes in metabolic and behavioral parameters such as feeding behavior. Objective: the study aimed to examine the repercussions of time-restricted feeding on feeding behavior and on some parameters of glycemic and lipemic metabolism of the offspring of adult rats whose mothers were fed a westernized diet during pregnancy and lactation. Methods: initially, 43 male Wistar rats were used. At 60 days of life, the rats were divided into 4 groups: C: control group; RC: control group with time-restricted feeding; W: westernized diet during pregnancy/lactation group; RW: westernized diet group during pregnancy/lactation group with time-restricted feeding. The following parameters were evaluated: behavioral sequence of satiety (BSS), biochemical parameters, and abdominal fat. Results: findings highlighted a high level of abdominal fat in the groups whose mothers were submitted to a westernized diet, as well as hypertriglyceridemia, and clear differences in feed rate and meal length. This study showed that the westernized diet ingested by mothers during pregnancy and lactation induced hyperlipidemia and changes in the feeding behavior of their adult offspring. Conclusions: these changes may be responsible for eating disorders and risk factors for metabolism disturbance-related diseases. (AU)

Introducción: los cambios en la composición dietética/energética durante el período crítico de desarrollo (embarazo/lactancia) o incluso durante las comidas pueden contribuir a cambios en los parámetros metabólicos y conductuales como el comportamiento alimentario. Objetivo: el estudio tuvo como objetivo examinar las repercusiones de la alimentación restringida en el tiempo sobre el comportamiento alimentario y sobre algunos parámetros del metabolismo glucémico y lipémico de crías de ratas adultas cuyas madres fueron alimentadas con una dieta occidentalizada durante el embarazo y la lactancia. Métodos: inicialmente se utilizaron 43 ratas Wistar macho. A los 60 días de vida, las ratas se agruparon en 4 grupos: C: grupo de control; RC: grupo de control con alimentación restringida en el tiempo; W: grupo de dieta occidentalizada durante el embarazo/lactancia; RW: grupo de dieta occidentalizada durante el embarazo y la lactancia con alimentación restringida en el tiempo. Se evaluaron los siguientes parámetros: secuencia conductual de saciedad (BSS), parámetros bioquímicos y grasa abdominal. Resultados: destacó una grasa abdominal elevada en los grupos cuyas madres fueron sometidas a una dieta occidentalizada, así como hipertrigliceridemia y una diferencia evidente en la tasa de alimentación y la duración de la comida. Este estudio demostró que la dieta occidentalizada ingerida por las madres durante el embarazo y la lactancia induce hiperlipidemia y cambios en el comportamiento alimentario de las crías adultas. Conclusiones: estos cambios pueden ser responsables de trastornos alimentarios y factores de riesgo de enfermedades relacionadas con alteraciones del metabolismo. (AU)

Food intake behaviors change as a function of maternal diet and time-restricted feeding.

Introduction: Introduction: changes in dietary/energetic composition during the critical period of development (pregnancy/lactation) or even during meal times may contribute to changes in metabolic and behavioral parameters such as feeding behavior. Objective: the study aimed to examine the repercussions of time-restricted feeding on feeding behavior and on some parameters of glycemic and lipemic metabolism of the offspring of adult rats whose mothers were fed a westernized diet during pregnancy and lactation. Methods: initially, 43 male Wistar rats were used. At 60 days of life, the rats were divided into 4 groups: C: control group; RC: control group with time-restricted feeding; W: westernized diet during pregnancy/lactation group; RW: westernized diet group during pregnancy/lactation group with time-restricted feeding. The following parameters were evaluated: behavioral sequence of satiety (BSS), biochemical parameters, and abdominal fat. Results: findings highlighted a high level of abdominal fat in the groups whose mothers were submitted to a westernized diet, as well as hypertriglyceridemia, and clear differences in feed rate and meal length. This study showed that the westernized diet ingested by mothers during pregnancy and lactation induced hyperlipidemia and changes in the feeding behavior of their adult offspring. Conclusions: these changes may be responsible for eating disorders and risk factors for metabolism disturbance-related diseases.

Introducción: Introducción: los cambios en la composición dietética/energética durante el período crítico de desarrollo (embarazo/lactancia) o incluso durante las comidas pueden contribuir a cambios en los parámetros metabólicos y conductuales como el comportamiento alimentario. Objetivo: el estudio tuvo como objetivo examinar las repercusiones de la alimentación restringida en el tiempo sobre el comportamiento alimentario y sobre algunos parámetros del metabolismo glucémico y lipémico de crías de ratas adultas cuyas madres fueron alimentadas con una dieta occidentalizada durante el embarazo y la lactancia. Métodos: inicialmente se utilizaron 43 ratas Wistar macho. A los 60 días de vida, las ratas se agruparon en 4 grupos: C: grupo de control; RC: grupo de control con alimentación restringida en el tiempo; W: grupo de dieta occidentalizada durante el embarazo/lactancia; RW: grupo de dieta occidentalizada durante el embarazo y la lactancia con alimentación restringida en el tiempo. Se evaluaron los siguientes parámetros: secuencia conductual de saciedad (BSS), parámetros bioquímicos y grasa abdominal. Resultados: destacó una grasa abdominal elevada en los grupos cuyas madres fueron sometidas a una dieta occidentalizada, así como hipertrigliceridemia y una diferencia evidente en la tasa de alimentación y la duración de la comida. Este estudio demostró que la dieta occidentalizada ingerida por las madres durante el embarazo y la lactancia induce hiperlipidemia y cambios en el comportamiento alimentario de las crías adultas. Conclusiones: estos cambios pueden ser responsables de trastornos alimentarios y factores de riesgo de enfermedades relacionadas con alteraciones del metabolismo.

Medication literacy: A conceptual model.

BACKGROUND: Medication literacy reflects the specific literacy skills necessary to act on medication-related information. A comprehensive and clear conceptual model that reflects medication literacy is lacking. Conceptual models describe the components that represent a construct, allowing for its understanding and providing a rationale for its measurement. OBJECTIVES: To propose a conceptual model to support the development of an instrument to measure medication literacy. METHODS: This is a three-phase methodological study. A literature review was conducted to identify the components that should be part of the preliminary conceptual model. Subsequently, the importance of its components was judged on a Likert-5 scale. Then, the model was refined, and the dimensions and subdimensions of medication literacy were defined. RESULTS: Forty-five experts were included, with a mean age of 39.9 (SD = 10.5) years, most of them females (86.7%) and pharmacists (80%). All components of the preliminary conceptual model were considered important to extremely important by most experts. "Dosing information", "medication name", and "processing the information received about their medication and acting upon medication instructions" were the components considered most important. In the refinement phase, we identified that the construct has four dimensions - functional literacy, communicative literacy, critical literacy, and numeracy, which include the subdimensions to access, understand, evaluate, calculate, and communicate medication-related information. CONCLUSIONS: The conceptual model allowed identifying the components that represent medication literacy, which will support the development of an instrument for measuring the construct in Brazil.

Time-restricted feeding in dark phase of circadian cycle and/or westernized diet cause mixed hyperlipidemia in rats / La alimentación con restricción de tiempo en la fase oscura del ciclo circadiano y/o la dieta occidentalizada causan hiperlipidemia mixta en las ratas

BACKGROUND: the dietary pattern that characterizes western diet is strongly associated with metabolic diseases and excess weight, as well as chronic illnesses. Misaligned feeding schedules can lead to or aggravate the development of such conditions. AIM: this study evaluated the influence of dietary composition and/or time-restricted feeding on the anthropometric and biochemical profile of adult rats. METHODS: forty male rats, at 60 days of life, were divided into the following groups: Control (C), Restricted Control (RC), Westernized (W), and Restricted Westernized (RW). RESULTS: westernized groups, in spite of a low energy intake (C = 5399 ± 401.2 kcal; RC = 4279.0 ± 476.2 kcal; W = 4302 ± 619.8 kcal; RW = 4081.0 ± 404.4 kcal, p < 0.001), had a higher body weight (C = 404.6 ± 39.1 g; RC = 335.1 ± 36.5 g; W = 488.9 ± 51.2 g; RW = 438.8 ± 36.5 g, p < 0.001) as compared to their paired controls (RC and C) - around 30 % and 20 % more for RW and W, respectively. The westernized diet caused glucose intolerance and mixed hyperlipidemia, characterized by higher concentrations of cholesterol (C = 40.8 ± 7.4 mg/dL; RC = 76.7 ± 10.8 mg/dL; W = 61.3 ± 20.2 mg/dL; RW = 42.2 ± 8.2 mg/dL), LDLc (C = 17.4 ± 7.5 mg/dL; RC = 38.8 ± 7.2 mg/dL ; W = 45.3 ± 15.8 mg/dL; RW = 11.0 ± 5.8 mg/dL), and triacylglycerol (C = 45.2 ± 15.0 mg/dL; RC = 73.2 ± 21.5 mg/dL ; W = 83.6 ± 23.4 mg/dL; RW = 57.5 ± 13.6 mg/dL) in the serum (p < 0.05). CONCLUSION: the effect of time-restricted feeding on body weight was strongly dependent on diet composition. The glucose tolerance test showed an influence of the circadian cycle phase. Mixed hyperlipidemia varied according to the presence of westernized diet and/or time-restricted food

ANTECEDENTES: el patrón dietético que caracteriza a la dieta occidental está fuertemente asociado con las enfermedades metabólicas, así como con el sobrepeso y las enfermedades crónicas. Los horarios de alimentación desorganizados pueden conducir o agravar el desarrollo de tales trastornos. OBJETIVO: este estudio evaluó la influencia de la composición dietética y/o la alimentación restringida en el perfil antropométrico y bioquímico de ratas adultas. MÉTODOS: cuarenta ratas macho, a los 60 días de vida, se dividieron en los seguientes grupos: control (C); control restringido (RC); occidentalizado (W) y occidentalizado restringido (RW). RESULTADOS: los grupos occidentalizados, a pesar de la baja ingesta energética (C = 5399 ± 401,2 kcal; RC = 4279,0 ± 476,2 kcal; W = 4302 ± 619,8 kcal; RW = 4081,0 ± 404,4 kcal, p < 0,001), tuvieron mayor peso corporal (C = 404,6 ± 39,1 g; RC = 335,1 ± 36,5 g; W = 488,9 ± 51,2 g; RW = 438,8 ± 36,5 g, p < 0,001) que los respectivos grupos de control (RC y C): alrededor de un 30 % y un 20 % más para RW y W, respectivamente. La dieta occidentalizada provocó intolerancia a la glucosa e hiperlipidemia mixta, caracterizada por una mayor concentración de colesterol (C = 40,8 ± 7,4 mg/dL; RC = 76,7 ± 10,8 mg/dL; W = 61,3 ± 20,2 mg/dL; RW = 42,2 ± 8,2 mg/dL), cLDL (C = 17,4 ± 7,5 mg/dL; RC = 38,8 ± 7,2 mg/dL; W = 45,3 ± 15,8 mg/dL; RW = 11,0 ± 5,8 mg/dL) y triacilglicerol (C = 45,2 ± 15,0 mg/dL; RC = 73,2 ± 21,5 mg/dL; W = 83,6 ± 23,4 mg/dL; RW = 57,5 ± 13,6 mg/dL) en el suero (p < 0,05). CONCLUSIÓN: el efecto de la alimentación restringida en el tiempo sobre el peso corporal fue muy dependiente de la composición de la dieta. La prueba de tolerancia a la glucosa mostró la influencia de la fase del ciclo circadiano. La hiperlipidemia mixta varió según la presencia de la dieta occidentalizada y/o la comida con restricción de tiempo

Crescimento pós-traumático em profissionais de emergências: uma revisão sistemática de estudos observacionais / Posttraumatic growth among emergency workers: a systematic review of observational studies / Crecimiento post-traumático en profesionales de servicios de urgencia: una revisión sistemática de estudios observacionales

A exposição a eventos traumáticos pode gerar Crescimento Pós-Traumático (CPT). O objetivo do presente estudo foi realizar uma revisão sistemática das publicações sobre prevalência de CPT e sua associação com estressores ocupacionais entre profissionais de emergências. A revisão foi baseada no método PRISMA e previamente registrada no PROSPERO. A busca foi realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (ScIELO). Dentre os resultados, não foi possível identificar a prevalência de CPT. Estressores operacionais foram associados ao CPT. Estressores organizacionais foram raramente investigados. Concluiu-se que o CPT é um dos focos em estudos sobre reações pós-traumáticas entre profissionais de emergências e está associado a estressores ocupacionais. Por isso, trata-se de um construto importante para compreender a saúde mental desses profissionais, dada a organização e a natureza de suas tarefas no trabalho. (AU)

Exposure to traumatic events can lead to Posttraumatic Growth (PTG). The present study aimed to was to conduct a systematic review of publications on the prevalence of PTG and its association with occupational stressors among emergency professionals. The review was based on the PRISMA method and previously registered in PROSPERO. The search was conducted in following eletronic databases: Medical Literature Analysis and Retrieval System Online (Mediline), Latin American and Caribbean Literature in Health Sciences (Lilacs), and Scientific Electronic Library Online (Scielo). It was not possible to identify the prevalence of The prevalence of PTG was not identified among emergency professionals. Operational stressors were associated with to PTG. Organizational stressors were rarely investigated. We concluded that PTG is one of the focuses in studies on post-traumatic reactions among emergency professionals and it is associated with occupational stressors. Therefore, it is an important construct to understand the mental health of these professionals given the organization and the nature of their occupational tasks. (AU)

La exposición a eventos traumáticos puede generar Crecimiento Post-Traumático (CPT). El objetivo del presente estudio fue realizar una revisión sistemática de las publicaciones sobre predominio del CPT y su asociación con estresores ocupacionales entre profesionales de servicios de urgencia. La revisión fue basada en el método PRISMA y previamente registrada en el PROSPERO. La búsqueda se llevó a cabo en las bases de datos de Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (Scielo). Entre los resultados, no fue posible identificar el predominio del CPT. Estresores operativos se asociaron con el CPT y estresores organizacionales fueron raramente investigados. Se concluyó que el CPT es el foco principal en los estudios sobre reacciones postraumáticas entre los profesionales de servicios de urgencia y está asociado a estresores ocupacionales. Por eso, se trata de un constructo importante para comprender la salud mental de esos profesionales dada la organización y la naturaleza de sus tareas en el trabajo. (AU)

Instrumentos para avaliação do ambiente domiciliar de idosos: uma revisão sistemática / Older adults home environment evaluanting toolds: a systematic review

O objetivo deste estudo foi identificar instrumentos utilizados por profissionais e pesquisadores para avaliação do ambiente domiciliar de idosos, bem como descrever propriedades psicométricas e dimensões avaliadas por estes instrumentos e locais da realização dos estudos. Trata-se de uma revisão sistemática da literatura, na qual foram revisados estudos publicados no período de 2006 a 2017, nos idiomas inglês, espanhol e/ou português e que tinham como público-alvo idosos com 60 anos ou mais residentes na comunidade. Foram excluídos estudos que avaliavam, exclusivamente, o ambiente externo, instituições de longa permanência para idosos e os que abordavam questões não gerontológicas. Foram encontrados 1.270 artigos, dos quais 34 foram selecionados para revisão. Verificou-se predomínio do uso de instrumentos padronizados, com evidências de validade e precisão, sendo o Housing Enabler o mais utilizado. Embora haja essa predominância, alguns estudos incluíram instrumentos que buscavam a percepção do indivíduo sobre o ambiente. As dimensões mais amplamente avaliadas foram as barreiras ambientais e as adaptações. Conclui-se que instrumentos objetivos para avaliação do ambiente estão sendo produzidos, o que pode facilitar a elaboração de estratégias de monitoramento e de implantação de mudanças no ambiente capazes de interferir positivamente na saúde de idosos. Ressalta-se também a importância de integrar a avaliação dos aspectos objetivos às necessidades subjetivas dos indivíduos em relação ao ambiente.(AU)

The objective of this study was to identify instruments used by health experts to assess the home environment of older adults, describe the psychometric properties and environment dimensions targeted in these evaluations and the local of the publications. This is a system- atic literature review, in which studies published between 2006 and 2017 in English, Spanish and/or Portuguese were reviewed, and with a target age group of 60 and over who lived in the community. Studies that exclusively evaluated the external environment, Long- -term institution and studies addressing non-gerontological issues were excluded. There were 1,270 articles found, of which 34 were selected for review. It was verified that there is a predominance of standardized instruments use for environmental evaluation, as the Housing Enabler is the most used and environmental barriers and adaptations are the most evaluated dimensions. Although there is this predominance, some studies have included instruments that sought the perception of the individual about the environment. It is concluded that objective means of evaluating environment are being produced, which may facilitate strategies for monitoring and implementing systematic changes in external factors capable of interfering in the health of older patients. It is also important to consider the qualitative evaluation of the environment to guide interventions not only in the objective aspects, but also in the subjective needs of individuals in relation to the environment.(AU)

New patient-reported outcome measure to assess perceived barriers to antiretroviral therapy adherence: the PEDIA scale.

This study sought to develop and evaluate a new patient-reported outcome measure to assess perceived barriers to antiretroviral therapy (ART) adherence. The Perceived Barriers to Antiretroviral Therapy Adherence (PEDIA) scale was developed based on individual interviews with patients. After pilot testing and assessing the evidence based on content analysis, the scale's revisions resulted in a 40-item version. The PEDIA was applied to 415 HIV-infected adults receiving ART for a maximum of 180 days, recruited from three healthcare facilities of reference in the city of Belo Horizonte, Minas Gerais State, Brazil. The analyses included exploratory factor analysis, internal consistency, item response theory, temporal stability, and predictive test-criterion relationship. The scale's final version contains 18 items distributed in three dimensions, as follows: cognitive and routine problems (4 items); medication and health concerns (6 items); and patient's fears and feelings (8 items). The results of McDonald's omega and temporal stability demonstrate that the PEDIA is internally consistent and yields stable scores over time. The assessment of the information's functions suggested that the three dimensions were informative for assessing a broad range of latent traits. Evidence concerning the test-criterion relationship confirmed that the PEDIA was able to predict non-adherence three months later. Our findings suggest that the PEDIA is a psychometrically adequate tool for evaluating perceived barriers in adult patients initiating ART. It could be used in both research and clinical practice for the early detection of patients at risk of non-adherence and for the identification of potentially modifiable barriers.

Resiliência psicológica: da primeira fase às abordagens baseadas em trajetória / Psychological resilience: from the first phase to trajectory-based approaches

O presente trabalho é um estudo teórico que tem por objetivo traçar um panorama do campo de pesquisas sobre resiliência para situar as contribuições atuais das investigações realizadas a partir das Abordagens baseadas em Trajetórias. São retomadas quatro fases das pesquisas e discutidos conceitos relevantes associados a cada uma delas, como adversidades e risco; fatores de resiliência; coping; critérios de avaliação, como competência ou ausência de psicopatologia; e trajetórias de enfrentamento. Considerações são apresentadas sobre as diferenças entre os estudos que focalizam os enfrentamentos de condições estressantes crônicas e aqueles que abordam os enfrentamentos de adversidades pontuais agudas, discutindo as implicações dessas diferenças para os estudos sobre resiliência. Por fim, são discutidas as contribuições que as chamadas Abordagens baseadas em Trajetórias oferecem, com a explanação acerca das várias possibilidades de trajetórias percorridas pelos sujeitos antes e após o enfrentamento de adversidades

The present work is a theoretical study which aims to outline the field of research on resilience, to locate the current contributions of the investigations carried out using the trajectories-based o approaches. Four phases of research are taken up and the associated relevant concepts were discussed, such as adversity and risk; resilience factors; coping; evaluation criteria of competence or of the absenceof psychopathology; and coping trajectories. We present considerations on the differences between studies that focus on coping with chronic stress conditions, and those which focus on coping strategies for acute adversities. We also discuss the implications of these differences for resilience studies. Finally, the contributions of the so-called Trajectories-based Approaches are explored, with an explanation of the various possibilities of trajectories covered by the subjects before and after facing adversities

Comparison of the predictive performance of adherence measures for virologic failure detection in people living with HIV: a systematic review and pairwise meta-analysis.

A critical feature of an adherence assessment tool is its ability to predict virologic failure in people living with HIV (PLHIV). We, therefore, aimed to compare the predictive performance of commonly used adherence measures. We systematically searched MEDLINE, Embase and LILACS up to February 2018, to identify relevant observational studies comparing the effects of any two of the following adherence measurements on virologic outcomes: electronic monitoring, pill count, pharmacy refill, self-report and physician assessment. We analyzed data by pairwise meta-analyzes with a random-effects model. The proportion of virologic failures among non-adherent participants in each adherence measure was used to calculate the odds ratio (OR), with 95% Confidence Intervals (95%CI). Heterogeneity was assessed, with potential causes identified by sensitivity and subgroup analysis. We included 38 studies with individual patient data for 18,010 patients. All possible comparisons between pairs of the five adherence measures were considered and a total of nine comparison groups could be established. Meta-analysis suggested that self-report was a better predictor of virologic failure than pill count when the recall period was within one week (OR: 2.35, 95%CI: 1.07-5.18, p = 0.03). Physician assessment had higher odds of predicting virologic failure than did either self-report (OR: 2.63, 95%CI: 1.37-5.26, p < 0.01) or pharmacy refill (OR: 3.57, 95%CI: 1.69-7.14, p < 0.001). There was no difference in the predictive performance between any of the other measures that we were able to compare (p > 0.05). The combination of multiple measures did not increase the predictive value when compared to any of the measures alone. Low-cost and simple adherence measures such as self-report predict virologic failure better than or equally well as objective measures. Our results suggest that there is no need to use expensive or time-consuming adherence measures when the objective is to identify PLHIV at risk of treatment failure.

New patient-reported outcome measure to assess perceived barriers to antiretroviral therapy adherence: the PEDIA scale / Uma nova medida de desfecho relatada pelo paciente para avaliar barreiras percebidas à adesão à terapia antirretroviral: a escala PEDIA / Una nueva medida de resultados apreciados por pacientes para evaluar los obstáculos percibidos en la adherencia a la terapia antirretroviral: la escala PEDIA

Abstract: This study sought to develop and evaluate a new patient-reported outcome measure to assess perceived barriers to antiretroviral therapy (ART) adherence. The Perceived Barriers to Antiretroviral Therapy Adherence (PEDIA) scale was developed based on individual interviews with patients. After pilot testing and assessing the evidence based on content analysis, the scale's revisions resulted in a 40-item version. The PEDIA was applied to 415 HIV-infected adults receiving ART for a maximum of 180 days, recruited from three healthcare facilities of reference in the city of Belo Horizonte, Minas Gerais State, Brazil. The analyses included exploratory factor analysis, internal consistency, item response theory, temporal stability, and predictive test-criterion relationship. The scale's final version contains 18 items distributed in three dimensions, as follows: cognitive and routine problems (4 items); medication and health concerns (6 items); and patient's fears and feelings (8 items). The results of McDonald's omega and temporal stability demonstrate that the PEDIA is internally consistent and yields stable scores over time. The assessment of the information's functions suggested that the three dimensions were informative for assessing a broad range of latent traits. Evidence concerning the test-criterion relationship confirmed that the PEDIA was able to predict non-adherence three months later. Our findings suggest that the PEDIA is a psychometrically adequate tool for evaluating perceived barriers in adult patients initiating ART. It could be used in both research and clinical practice for the early detection of patients at risk of non-adherence and for the identification of potentially modifiable barriers.

Resumo: Este estudo teve por objetivo o desenvolvimento e avaliação de uma nova medida de desfecho relatada pelo paciente para avaliar barreiras percebidas à adesão à terapia antirretroviral (TARV). A escala Percepção de Dificuldades com o Tratamento Antirretroviral (PEDIA) foi desenvolvida com base em entrevistas com pacientes. Após teste piloto e avaliação de evidências com base no conteúdo do teste, revisões da escala resultaram em uma versão com 40 itens. A PEDIA foi aplicada em 415 adultos soropositivos para HIV que receberam TARV por um máximo de 180 dias, recrutados de três unidades de saúde de referência na cidade de Belo Horizonte, Minas Gerais, Brasil. As análises incluíram análise fatorial exploratória, consistência interna, teoria da resposta ao item, estabilidade temporal, e relação preditiva teste-critério. A versão final da escala contém 18 itens distribuídos em três dimensões, no caso: problemas cognitivos e de rotina (4 itens); preocupações com medicamentos e saúde (6 itens); e medos e sentimentos do paciente (8 itens). Resultados do ômega de McDonald e estabilidade temporal demonstram que a PEDIA é internamente consistente e produz escores estáveis ao longo do tempo. As funções de informação do teste sugerem que as três dimensões foram informativas na avaliação de uma ampla gama do traço latente. Evidências relacionadas à relação teste-critério confirmaram que a PEDIA foi capaz de prever não-adesão três meses depois. Nossos resultados sugerem que a PEDIA é uma ferramenta robusta do ponto de vista psicométrico para a avaliação das barreiras percebidas por pacientes adultos que iniciam TARV. Ela pode ser usada em contextos clínicos e de pesquisa para a detecção precoce de pacientes em risco de não-adesão e para a identificação de barreiras potencialmente modificáveis.

Resumen: Este estudio se propone desarrollar y evaluar una nueva medida de resultados informados por los pacientes para evaluar los obstáculos percibidos en la adherencia a la terapia antirretroviral (ARV). Las barreras percibidas para la adherencia a la terapia antirretroviral según la escala Percepción de Dificuldades con el Tratamiento Antirretroviral (PEDIA) se desarrollaron basándose en entrevistas a pacientes individuales. Tras unas pruebas piloto, y evaluando evidencias basadas en el contenido de las pruebas, las revisiones de la escala resultaron en una versión de 40 ítems. PEDIA se administró a 415 adultos infectados de VIH que recibían ARV durante un máximo de 180 días, captados en tres centros de salud de referencia en la ciudad de Belo Horizonte, Minas Gerais, Brasil. Los análisis incluyeron el análisis exploratorio factorial, la consistencia interna, la teoría de respuesta al ítem, estabilidad temporal, y validez de criterio en las pruebas predictivas. La versión final de la escala final cuenta con 18 ítems distribuidos en las siguientes tres dimensiones: problemas cognitivos y rutinarios (4 ítems); medicación y problemas de salud (6 ítems); además de miedos y sentimientos del paciente (8 ítems). Los resultados del omega McDonald y la estabilidad temporal demuestran que PEDIA es internamente consistente y obtiene puntuaciones estables en marcadores con el paso de los años. Las pruebas de información sugirieron que las tres dimensiones fueron informativas, evaluando un amplio abanico de características latentes. Las evidencias respecto a la relación entre las pruebas y los criterios confirmaron que PEDIA era capaz de predecir la no-adherencia tres meses después. Nuestros resultados sugieren que PEDIA es una herramienta psicométrica para evaluar los obstáculos percibidos en pacientes adultos que comienzan una ARV. Se puede utilizar tanto en el entorno de investigación, como en el de la práctica clínica para una detección temprana de pacientes con riesgo de no adherencia y la identificación de obstáculos potencialmente modificables.

Daytime increase in caloric intake without change in total 24-h caloric intake can increase adiposity but not total bodyweight in rats with inverted feeding pattern.

The goal of this study was to evaluate the effect of the food availability period on body weight, self-selection of macronutrients, adiposity, lipoprotein, and serum glucose profiles without changing energy intake. Young male rats were divided into 2 groups according to the availability of food during the light and dark phases of the cycle, forming 2 groups: control group (CG) and group with inverted feeding pattern (IFPG). Before inversion of food availability on the 80th day, circadian food intake was measured every 4 h over 24 h during 3 days. The glycemic curve, an oral test for glucose tolerance, and self-selection of macronutrients were evaluated. Blood samples were collected for analysis of fasting glucose, triglycerides, and total cholesterol fractions. The IFPG showed an increase in fasting glucose in the dark phase of the cycle, changes in the glycemic curve, and oral glucose tolerance test. It also showed increased abdominal and liver fat and distinct choice of macronutrients compared with the CG. A change in the availability of food according to the phase of the circadian cycle produces changes in glucose and feeding circadian rhythm culminating in increased abdominal and hepatic fat. These effects can increase the risk of metabolic disorders and installation of chronic diseases.

Relationship between Personality Traits and Counterproductive Work Behaviors / Relação entre os Fatores de Personalidade e Comportamentos Contraproducentes no Trabalho / Relación entre Rasgos de Personalidad y Comportamientos Contraproducentes en el Trabajo

Following the growing interest in identifying whether personality traits are associated with employee's inclination toward counterproductive work behavior (CWB), the objective of this study was to investigate the relationship between personality traits based on the five-factor model with CWB. Study participants were 381 workers from different socioeconomic and educational levels in public and private organizations, from two Brazilian regions. Agreeableness, conscientiousness and neuroticism factors had statistically significant associations with three CWB dimensions. Linear regression analysis revealed all five personality traits contributed to prediction of CWB dimensions. These findings are discussed in light of international literature.

Acompanhando o crescente interesse em identificar se traços de personalidade estão associados com a propensão para engajar em comportamentos contraproducentes no trabalho (CCTs), o objetivo deste estudo foi investigar a relação entre traços de personalidade segundo o modelo dos cinco grandes fatores (CGF) e CCTs. Participaram do estudo 381 trabalhadores, com diferentes níveis socioeconômicos e de escolaridade, de organizações públicas e privadas, provenientes de duas regiões do país. Os fatores amabilidade, conscienciosidade e neuroticismo apresentaram correlações estatisticamente significativas com três dimensiones de CCT. Análises de regressão linear revelaram que todos os cinco traços de personalidade contribuíram para a predição das dimensões de CCT. Os resultados são discutidos à luz da literatura internacional.

Siguiendo el creciente interés en identificar si los rasgos de personalidad están asociados con la propensión a participar en comportamientos contraproducentes en el trabajo (CCTs), el objetivo de este estudio fue investigar la relación entre rasgos de personalidad según el modelo de los cinco grandes factores (CGF) y CCTs. Los participantes del estudio fueron 381 trabajadores, con diferentes niveles socioeconómicos y educativos, de organizaciones públicas y privadas, provenientes de dos regiones del país. Los factores amabilidad, escrupulosidad e inestabilidad emocional presentan correlaciones estadísticamente significativas con tres dimensiones del CCT. Análisis de regresión lineal revelaron que los cinco rasgos de personalidad contribuyeron para la predicción de las dimensiones del CCT. Los resultados son discutidos con base en la literatura internacional.

Relationship between personality traits and counterproductive work behaviors / Relação entre os fatores de personalidade e comportamentos contraproducentes no trabalho / Relación entre rasgos de personalidad y comportamientos contraproducentes en el trabajo

Following the growing interest in identifying whether personality traits are associated with employee's inclination toward counterproductive work behavior (CWB), the objective of this study was to investigate the relationship between personality traits based on the five-factor model with CWB. Study participants were 381 workers from different socioeconomic and educational levels in public and private organizations, from two Brazilian regions. Agreeableness, conscientiousness and neuroticism factors had statistically significant associations with three CWB dimensions. Linear regression analysis revealed all five personality traits contributed to prediction of CWB dimensions. These findings are discussed in light of international literature.

Acompanhando o crescente interesse em identificar se traços de personalidade estão associados com a propensão para engajar em comportamentos contraproducentes no trabalho (CCTs), o objetivo deste estudo foi investigar a relação entre traços de personalidade segundo o modelo dos cinco grandes fatores (CGF) e CCTs. Participaram do estudo 381 trabalhadores, com diferentes níveis socioeconômicos e de escolaridade, de organizações públicas e privadas, provenientes de duas regiões do país. Os fatores amabilidade, conscienciosidade e neuroticismo apresentaram correlações estatisticamente significativas com três dimensiones de CCT. Análises de regressão linear revelaram que todos os cinco traços de personalidade contribuíram para a predição das dimensões de CCT. Os resultados são discutidos à luz da literatura internacional.

Siguiendo el creciente interés en identificar si los rasgos de personalidad están asociados con la propensión a participar en comportamientos contraproducentes en el trabajo (CCTs), el objetivo de este estudio fue investigar la relación entre rasgos de personalidad según el modelo de los cinco grandes factores (CGF) y CCTs. Los participantes del estudio fueron 381 trabajadores, con diferentes niveles socioeconómicos y educativos, de organizaciones públicas y privadas, provenientes de dos regiones del país. Los factores amabilidad, escrupulosidad e inestabilidad emocional presentan correlaciones estadísticamente significativas con tres dimensiones del CCT. Análisis de regresión lineal revelaron que los cinco rasgos de personalidad contribuyeron para la predicción de las dimensiones del CCT. Los resultados son discutidos con base en la literatura internacional.

Cross-cultural adaptation of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) and Life Events Checklist 5 (LEC-5) for the Brazilian context / Adaptação transcultural da Posttraumatic Stress Disorder Checklist 5 (PCL-5) e da Life Events Checklist 5 (LEC-5) para o contexto brasileiro

Abstract Objective: To describe the process of cross-cultural adaptation of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) and the Life Events Checklist 5 (LEC-5) for the Brazilian sociolinguistic context. Method: The adaptation process sought to establish conceptual, semantic, and operational equivalence between the original items of the questionnaire and their translated versions, following standardized protocols. Initially, two researchers translated the original version of the scale into Brazilian Portuguese. Next, a native English speaker performed the back-translation. Quantitative and qualitative criteria were used to evaluate the intelligibility of items. Five specialists compared the original and translated versions and assessed the degree of equivalence between them in terms of semantic, idiomatic, cultural and conceptual aspects. The degree of agreement between the specialists was measured using the content validity coefficient (CVC). Finally, 28 volunteers from the target population were interviewed in order to assess their level of comprehension of the items. Results: CVCs for items from both scales were satisfactory for all criteria. The mean comprehension scores were above the cutoff point established. Overall, the results showed that the adapted versions' items had adequate rates of equivalence in terms of concepts and semantics. Conclusions: The translation and adaptation processes were successful for both scales, resulting in versions that are not only equivalent to the originals, but are also intelligible for the population at large.

Resumo Objetivo: Descrever o processo de adaptação transcultural das escalas Posttraumatic Stress Disorder Checklist 5 (PCL-5) e Life Events Checklist 5 (LEC-5) para o contexto sociolinguístico brasileiro. Método: A adaptação das escalas buscou estabelecer a equivalência conceitual, semântica e operacional entre os itens originais das escalas e suas versões traduzidas, por meio de um protocolo padronizado. Inicialmente, dois pesquisadores traduziram as versões originais para o português. Na sequência, um falante nativo de língua inglesa realizou a tradução reversa. A inteligibilidade dos itens foi analisada por meio de critérios quantitativos e qualitativos. Cinco especialistas compararam as versões originais e traduzidas e avaliaram o grau de equivalência entre elas nos quesitos semântico, idiomático, cultural e conceitual. O grau de concordância entre os especialistas foi medido pelo coeficiente de validade de conteúdo (CVC). Por fim, 28 voluntários da população-alvo foram entrevistados para verificar o nível de compreensão dos itens. Resultados: Os itens das duas escalas apresentaram CVCs satisfatórios em todos os quesitos. Os escores médios referentes ao grau de compreensão dos itens foram acima do ponto de corte estabelecido. No conjunto, os resultados indicaram índices adequados de equivalência conceitual e semântica para os itens das versões adaptadas. Conclusão: O processo de tradução e adaptação foi bem-sucedido para as duas escalas, resultando em versões não apenas equivalentes às originais, mas também compreensíveis para a população-alvo em geral.

Teoria Motivacional do Coping: um modelo hierárquico e desenvolvimental / Motivational Coping Theory: A hierarchical and developmental model / Teoría de Motivación del coping: un modelo jerárquico y de desarrollo

Os estudos sobre coping comumente são baseados na proposta cognitivista de Richard Lazarus e Susan Folkman. Entretanto, há outras abordagens teóricas que tratam o tema. Entre elas, ressalta-se a Teoria Motivacional do Coping (TMC) desenvolvida por Ellen Skinner e colaboradores na década de 1990. A presente revisão integrativa teve como objetivo sistematizar os elementos que compõem a rede nomológica do coping conforme proposta pela TMC. Critérios de inclusão e exclusão dos artigos foram utilizados. Os resultados foram organizados em três seções. Na primeira, foram discutidos os elementos antecedentes que influenciam o processo de enfrentamento. Na segunda seção, foi apresentada a estrutura hierárquica do construto. Finalmente, foi discutida a relação entre o coping e os desfechos adaptativos. Conclui-se que a TMC é uma abordagem desenvolvimental promissora. Novos estudos devem ser realizados a fim de levantar evidências para a validação empírica do modelo

Research on coping is commonly based on the cognitive model developed by Richard Lazarus and Susan Folkman. However, other theoretical approaches also discuss the subject. Among them, we highlight the Motivational Theory of Coping (MTC) developed by Ellen Skinner and colleagues in the 1990s. This integrative review aimed to systematize the elements of the nomological network of coping, as proposed by the MTC. Inclusion and exclusion criteria were applied to the selection of articles. Results were organized into three sections. In the first, we discuss elements that influence coping. In the second section, we show the hierarchical framework of coping. Finally, we discussed the relationship between the coping and the adaptive outcomes. We conclude that the MTC is a promising developmental approach. Further studies should be conducted to gather empirical evidence of the model

Los estudios sobre coping se basan comúnmente en la propuesta cognitiva de Richard Lazarus y Susan Folkman. Pese a eso, hay otros abordajes teóricos que tratan el tema. Entre ellos, destacamos la Teoría Motivacional del Coping (TMC) desarrollada por Ellen Skinner y colaboradores, en la década de 1990. El objetivo de esta revisión integrativa es sistematizar los elementos que componen la red nomológica del coping según la propuesta de la TMC. Fueron utilizados criterios de inclusión y exclusión de los artículos. Los resultados fueron organizados en tres secciones. En la primera sección se discutieron los elementos anteriores que influyen en el proceso de coping. En la segunda sección fue presentada la estructura jerárquica del constructo. Finalmente, fue discutida la relación entre coping y los resultados de adaptación. Se concluye que la TMC es un abordaje de desarrollo prometedor. Nuevos estudios deben ser realizados con el fin de reunir evidencias para la validez empírica del modelo

Teoria motivacional do coping: um modelo hierárquico e desenvolvimental / Motivational coping theory: A hierarchical and developmental model / Teoría de motivación del coping: un modelo jerárquico y de desarrollo

Os estudos sobre coping comumente são baseados na proposta cognitivista de Richard Lazarus e Susan Folkman. Entretanto, há outras abordagens teóricas que tratam o tema. Entre elas, ressalta-se a Teoria Motivacional do Coping (TMC) desenvolvida por Ellen Skinner e colaboradores na década de 1990. A presente revisão integrativa teve como objetivo sistematizar os elementos que compõem a rede nomológica do coping conforme proposta pela TMC. Critérios de inclusão e exclusão dos artigos foram utilizados. Os resultados foram organizados em três seções. Na primeira, foram discutidos os elementos antecedentes que influenciam o processo de enfrentamento. Na segunda seção, foi apresentada a estrutura hierárquica do construto. Finalmente, foi discutida a relação entre o coping e os desfechos adaptativos. Conclui-se que a TMC é uma abordagem desenvolvimental promissora. Novos estudos devem ser realizados a fim de levantar evidências para a validação empírica do modelo

Research on coping is commonly based on the cognitive model developed by Richard Lazarus and Susan Folkman. However, other theoretical approaches also discuss the subject. Among them, we highlight the Motivational Theory of Coping (MTC) developed by Ellen Skinner and colleagues in the 1990s. This integrative review aimed to systematize the elements of the nomological network of coping, as proposed by the MTC. Inclusion and exclusion criteria were applied to the selection of articles. Results were organized into three sections. In the first, we discuss elements that influence coping. In the second section, we show the hierarchical framework of coping. Finally, we discussed the relationship between the coping and the adaptive outcomes. We conclude that the MTC is a promising developmental approach. Further studies should be conducted to gather empirical evidence of the model

Los estudios sobre coping se basan comúnmente en la propuesta cognitiva de Richard Lazarus y Susan Folkman. Pese a eso, hay otros abordajes teóricos que tratan el tema. Entre ellos, destacamos la Teoría Motivacional del Coping (TMC) desarrollada por Ellen Skinner y colaboradores, en la década de 1990. El objetivo de esta revisión integrativa es sistematizar los elementos que componen la red nomológica del coping según la propuesta de la TMC. Fueron utilizados criterios de inclusión y exclusión de los artículos. Los resultados fueron organizados en tres secciones. En la primera sección se discutieron los elementos anteriores que influyen en el proceso de coping. En la segunda sección fue presentada la estructura jerárquica del constructo. Finalmente, fue discutida la relación entre coping y los resultados de adaptación. Se concluye que la TMC es un abordaje de desarrollo prometedor. Nuevos estudios deben ser realizados con el fin de reunir evidencias para la validez empírica del modelo

O percurso da avaliação psicológica nos Simpósios da ANPEPP / The path of psychological assessment in ANPEPP Symposiums / La ruta de evaluación psicológica en Simposios ANPEPP

Será apresentado, em uma perspectiva histórica, a participação da área da avaliação psicológica (AP) nas edições do Simpósio Bienal de Pesquisa e Intercâmbio Científico da Associação Nacional de Pesquisa e Pós-Graduação em Psicologia (ANPEPP). Tais Simpósios constituem em uma das principais ações dessa Associação, contribuindo para o intercâmbio e a cooperação entre os centros de pesquisa e pesquisadores. Constatou-se a presença da AP desde a primeira edição do simpósio, ocorrido em 1988. Enquanto, nas décadas de 1990 e 2000, um único grupo de trabalho (GT) reunia pesquisadores de AP, na virada da década passada para a atual, o número de GTs de AP aumentou de três para cinco. A criação desses novos GTs reflete a expansão dessa área no âmbito da pesquisa, tanto pelo número de pesquisadores envolvidos quanto pela diversidade de temas relacionados à AP. Produções científicas advindas dos GTs têm contribuído substantivamente para o desenvolvimento da Psicologia no Brasil.(AU)

We present here, in a historical perspective, the participation of area of psychological assessment (PA) in the editions of the Biennial Symposium on Research and Scientific Exchange of the National Association for Research and Graduate Studies in Psychology (ANPEPP). These Symposiums constitute one of the primary actions of this Association, contributing to the exchange and cooperation between research centers and researchers. The presence of PA dates back to the first edition of the symposium in 1988. In the 1990s and 2000s, there was only one PA work group. However, from 2000 to the present, the number of work groups increased from three to five. The creation of these additional work groups reflects the expansion of the area under research, both in number of researchers involved and in the diversity of issues related to PA. Scientific production resulting from these work groups has contributed substantially to the development of psychology in Brazil.(AU)

Presentamos en una perspectiva histórica la participación del área de Evaluación Psicológica (EP) en las ediciones del Simposio Bienal de Asociación Nacional de Investigaciones y Postgrado en Psicología (ANPEPP). Tales Simposios se constituyen en una de las principales acciones de esta Asociación, que contribuyen para intercambio y cooperación entre centros de investigación e investigadores. Se constató la presencia de la EP desde la primera edición del Simposio en 1988. En las década de 1990 a 2000, un solo grupo de trabajo (GT) reunió investigadores de EP. Desde el comienzo del año 2000 hasta la actualidad, el número de GTs aumentó de tres a cinco. La creación de estos nuevos GTs refleja la expansión de esa área en el ámbito de la investigación, tanto por el número de investigadores como por la diversidad de temas relacionados con la EP. Las producciones científicas provenientes de los GTs han contribuído sustancialmente para el desarrollo de la Psicología en Brasil.(AU)