Long-Term Care medicines formularies: any reasons for pharmacists' concern?

Abstract This study aimed to characterize and compare medicines formularies (MFs) used in Long-Term Care (LTC) facilities in Portugal, and to identify the prevalence of Potentially Inappropriate Medicines (PIMs). A systematic contact with LTC facilities was undertaken in December 2021. MFs were systematized according to the Anatomical Therapeutical Chemical classification system (ATC), followed by descriptive content analysis. A structured comparison between MFs developed by public organizations and private LTC facilities was performed. After duplicate removal and exclusion of medicines not for systemic use, two explicit criteria - the Algorithm of medication review in frail older people and the EU(7)-PIM list - were employed for PIMs identification. Five MFs were obtained and assessed. The three MFs developed by private institutions covered 23% of the national LTC facilities and approximately 34% of the national total of beds. Heterogeneity was particularly high for the Alimentary tract and metabolism, Blood and blood-forming organs, Musculoskeletal system, and Respiratory system ATC groups. A PIM prevalence of 29,4% was identified. Medicines distribution between the MFs suggests the need to develop national guidelines towards harmonizing medicines usage in LTC. The prevalence of PIMs found highlights the importance of a particular optimized use of this health technology in aged sub-populations

Gestão e liderança na percepção de enfermeiros: um caminhar à luz da burocracia profissional / Gestión y liderazgo en la percepción de los enfermeros: un paseo a la luz de la burocracia profesional / Management and leadership in the nurses' perception: A walk in the light of professional burocracy

Resumo Objetivo analisar os estilos e fatores intervenientes na gestão e liderança de enfermeiros em três países, Brasil, Portugal e Espanha, à luz da Burocracia Profissional. Método estudo exploratório e descritivo de abordagem qualitativa realizado em três hospitais universitários localizados em diferentes países: Brasil, Espanha e Portugal. Participaram da pesquisa 30 enfermeiros. Os dados foram coletados por meio de um roteiro de coleta de dados com questões sociodemográficas e entrevistas analisadas com auxílio do software WebQda. Resultados diferentes percepções sobre os elementos integradores da participação foram reveladas nos três países, destacando-se a comunicação em diversas óticas. Verificou-se algumas convergências em relação ao trabalho em equipe, sendo a confiança o elemento que impulsiona e motiva a equipe. Sinaliza-se para uma relação participativa no desenvolvimento do trabalho. Conclusão e implicações para a prática foi possível identificar, nos três países, a importância da comunicação no processo de gestão, bem como dos estilos de gestão e de liderança, como elementos que oportunizam a atuação da equipe. Também foi evidenciada a presença de fatores intervenientes de relevância, tais como escuta, clima organizacional, relação interpessoal, transparência no trabalho e delegação de funções, os quais envolvem a burocracia profissional em que o conhecimento do enfermeiro possibilita o exercício de suas habilidades de forma horizontalizada e participativa.

Resumen Objetivo analizar los estilos y factores implicados en la gestión y el liderazgo de enfermeros en tres países, Brasil, Portugal y España, a la luz de la Burocracia Profesional. Método estudio descriptivo exploratorio con abordaje cualitativo realizado en tres hospitales universitarios ubicados en diferentes países: Brasil, España y Portugal. Treinta enfermeros participaron en la investigación. Los datos fueron recolectados a través de un script de recopilación de datos con preguntas sociodemográficas y entrevistas analizadas con la utilización del software WebQda. Resultados se revelaron diferentes percepciones sobre los elementos integradores de la participación en los tres países, destacando la comunicación desde diferentes perspectivas. Se constataron algunas convergencias en relación al trabajo en equipo, siendo la confianza el elemento que impulsa y motiva al equipo. Se advierte una relación participativa en el desarrollo del trabajo. Conclusión e implicaciones para la práctica se pudo advertir, en los tres países, la importancia de la comunicación en el proceso de gestión, así como los estilos de gestión y liderazgo, como elementos que permiten mejorar el desempeño del equipo. También se evidenciaron factores intervinientes relevantes, como la escucha, el clima organizacional, la relación interpersonal, la transparencia en el trabajo y la delegación de funciones, que conforman la burocracia profesional en la cual el conocimiento de los enfermos les permite el despliegue de sus competencias de manera horizontal y participativa.

Abstract Objective to analyze the styles and factors involved in nurses' management and leadership in three countries, Brazil, Portugal and Spain, in the light of Professional Bureaucracy. Method a descriptive and exploratory study with a qualitative approach carried out in three university hospitals located in different countries, namely: Brazil, Spain and Portugal. Thirty nurses participated in the research. Data was collected through a collection script with sociodemographic questions and interviews analyzed using the WebQda software. Results different perceptions about the integrating elements of participation in the three countries were revealed, highlighting communication from different perspectives. Some convergences in relation to teamwork were verified, where trust was the element that drives and motivates the team. It is a participatory relationship in the development of work. Conclusion and implications for the practice in the three countries, it was possible to identify the importance of communication in the management process, as well as the management and leadership styles, as elements that favor performance of the team. Presence of relevant intervening factors was also evidenced, such as choice, organizational climate, interpersonal relationships, transparency in work and delegation of functions, which involves professional bureaucracy in which the nurses' knowledge allows them to exercise their skills in a horizontal and participatory manner.

Adherence to the Mediterranean Diet in a Portuguese Immigrant Community in the Central Valley of California.

The Mediterranean Diet (MedDiet) is a healthy eating pattern associated with a better quality of life among older adults and reduced risk of non-communicable diseases. Little is known about the MedDiet in immigrant communities from countries in which the MedDiet is a settled cultural heritage. Thus, we examined MedDiet adherence and perceived knowledge, benefits, and barriers to the MedDiet in a Portuguese immigrant community in Turlock, California. A cross-sectional study was conducted with 208 participants in Turlock and Livermore, California, which was used as a reference population. Univariate, multivariable, and logistic regression models were used for data analysis. Compared to the Livermore group, the Turlock group was younger and less educated, but had a higher average MedDiet score and active adherence to a MedDiet (p < 0.001 for both). In the Turlock group, convenience, sensory appeal, and health were observed to be significant barriers to the MedDiet (p < 0.05), while health, weight loss, natural content, familiarity, price, sensory appeal, and mood were significant benefit factors (p < 0.05). In conclusion, participants in Turlock had greater MedDiet adherence despite lower education attainment. Furthermore, the perceived benefits of the MedDiet were key factors in MedDiet perception and adherence in a Portuguese immigrant community.

Menopause Representations Questionnaire: development and validation with Portuguese women.

OBJECTIVE: This study aimed to develop and validate a Portuguese version of the Menopause Representations Questionnaire (MenoSentations-Q), a self-report measure to assess cognitive appraisal of menopause, based on cognitive components of the Self-Regulation Model and the results from a previous Portuguese qualitative study. METHODS: A total of 309 Portuguese women, aged 45-65 years, completed the questionnaire. Factorial, convergent, discriminant, and criterion validity, as well as reliability and psychometric sensitivity, were studied. RESULTS: MenoSentations-Q has demonstrated acceptable factorial, convergent, and discriminant validity, as well as good values of sensitivity and reliability for the four factors (i.e. identity; positive consequences; negative consequences; and control, awareness, and cause). Criterion validity was only obtained for two factors. CONCLUSIONS: MenoSentations-Q, a brief measure of menopausal representations, in this sample of Portuguese women provides information to inform interventions that might include challenging unhelpful menopausal representations. This instrument could be used in both clinical and community settings.

Back pain attitudes questionnaire: Cross-cultural adaptation to brazilian-portuguese and measurement properties.

BACKGROUND: The Back Pain Attitudes Questionnaire (Back-PAQ) was developed to evaluate attitudes and beliefs of the general public, people with back pain, and healthcare professionals about the spine. OBJECTIVES: To translate and cross-culturally adapt the Back-PAQ (34-item and 10-item versions) into Brazilian-Portuguese (Back-PAQ-Br) and test its measurement properties in a Brazilian sample. METHODS: The cross-cultural adaptation and testing of the measurement properties followed the recommendations of international guidelines. Members of the general public, people with back pain, and healthcare professionals, for a total of 139 individuals, took part in the assessment of internal consistency, construct validity, and ceiling and floor effects. The Hospital Anxiety and Depression Scale (HADS) and the Brazilian-Portuguese version of the Tampa Scale of Kinesiophobia (TSK) were used to evaluate construct validity. Test-retest reproducibility was determined on 77 participants. Retest was performed a minimum of 1 week and a maximum of 2 weeks from the original test. RESULTS: There was very high agreement between translators (88.2%). The Back-PAQ-Br showed excellent internal consistency (Cronbach's alpha 0.92) and excellent reproducibility (ICC 0.94; SEM 5.14 points on a 136 point scale), with a smallest detectable change (90% confidence level) of 11.93 points. There was strong correlation between Back-PAQ-Br and TSK (r = -0.72) and very weak correlation between Back-PAQ-Br and HADS (r = -0.23 for both depression and anxiety domains). No ceiling/floor effects were observed. CONCLUSION: The translation process and cross-cultural adaptation had very high agreement between translators. The Back-PAQ-Br has excellent measurement properties that are similar to the properties of the original version.

Diretrizes brasileiras e portuguesas de proteção à criança vulnerável à violência na pandemia de COVID-19 / Brazilian and Portuguese guidelines for protecting vulnerable children against violence in the COVID-19 pandemic / Directrices brasileñas y portuguesas para la protección de los niños vulnerables a la violencia en la pandemia del COVID-19

Objetivo: identificar e analisar medidas de proteção à criança/adolescente vulnerável à violência na epidemia de COVID-19 no Brasil e em Portugal. Método: implementou-se a pesquisa documental de diretrizes governamentais expedidas entre março e setembro de 2020. A análise hermenêutica fundamentou-se nos preceitos da vulnerabilidade em saúde e da defesa do melhor interesse de crianças/adolescentes. Resultados: recomendaram-se ações articuladas de apoio e parcerias nacionais, locais e interinstitucionais; atuação multiprofissional, intra/intersetorial como medidas de proteção à criança/adolescente vulneráveis à violência intrafamiliar. Destacam-se o estímulo a notificação, investigação, intervenção e acompanhamento de casos. Constatam­se investimentos dos países na ampliação de canais de teleatendimento e estímulo à denúncias pela sociedade e redes sociais. Contudo, há indícios de poucos registros de casos, justificado pelas campanhas publicitárias em Portugal que incentivaram denúncias aos órgãos responsáveis. A proteção à renda e ao trabalho dos provedores da família durante o isolamento social e momento de suspensão das aulas presenciais teve a intenção de protegê-los da insegurança alimentar e do contágio da doença. Conclusão: documentos determinaram ações para instituições, profissionais de saúde, familiares e sociedade no enfrentamento da violência intrafamiliar. Na pandemia de COVID-19, é dever do Estado seguir protegendo o direito à vida e à dignidade da criança e adolescente

Objective: To identify and analyze the protection measures for children/adolescent vulnerable to violence during the COVID-19 epidemic in Brazil and Portugal. Method: This documentary research of government guidelines issued between March and September 2020 was carried out. The hermeneutic analysis was based on the principles of health vulnerability of children/ adolescents. Results: Articulated support actions and partnerships were recommended at the national, local, and interinstitutional levels. A multi-professional intersectoral action was the most recommended measure to protect those children/adolescents more vulnerable to intrafamily violence. Noteworthy are the stimulus warning, investigation, intervention, and monitoring notified cases. In addition, countries' efforts were invested in expanding the call center channels and encouraging notification violence by society members and social networks. However, few cases were notified justified by advertising campaigns in Portugal that encouraged reporting to the responsible childhood agencies. The protection of family providers' income and work during social isolation and suspension of face­to-face classes were intended to protect them from food safety and contagious disease. Conclusion: Official documents determined actions for institutions, health professionals, family members, and society to face intrafamily violence. Regarding the effect of the COVID-19 pandemic on the family nucleus, the State must continue protecting children's and adolescents' rights to life and dignity

Objetivo: identificar y analizar medidas de protección para niños/adolescentes vulnerables a la violencia durante la epidemia del COVID-19 en Brasil y Portugal. Método: se realizó una investigación documental de las directrices gubernamentales emitidas entre marzo y septiembre de 2020. El análisis hermenéutico se basó en los principios de vulnerabilidad en salud en la niñez y la adolescencia. Resultados: se recomendaron acciones de apoyo articuladas y alianzas nacionales, locales e interinstitucionales; acción multiprofesional, intra e intersectorial como medida de protección para niños, niñas y adolescentes vulnerables a la violencia intrafamiliar. Destacan el fomento de la notificación, investigación, intervención y seguimiento de los casos. Hay esfuerzos de ambos países que invertirán en la expansión de los call center y fomentarán las quejas de los miembros de la sociedad y las redes sociales. Sin embargo, hay indicios de pocos casos denunciados, justificados por campañas publicitarias (especialmente en Portugal) que alentaron las denuncias a los órganos responsables. La protección de los ingresos y el trabajo de los proveedores familiares, durante el aislamiento social y en el momento de la suspensión de las clases presenciales tuve la intención de protegerlos del seguridad alimentar y del contagio de la enfermedad. Conclusión: documentos emitidos acciones específicas para instituciones, profesionales de la salud, familiares y sociedad en el abordaje de la violencia intrafamiliar. En la pandemia del COVID-19, es deber del Estado continuar protegiendo el derecho a la vida y la dignidad de los niños, niñas y adolescentes

Esperança e bem-estar psicológico durante a crise sanitária pela COVID-19: estudo com estudantes de enfermagem / Hope and psychological well-being during the sanitary crisis by COVID-19: a study with nursing students / Esperanza y bienestar psicológico durante la crisis sanitaria por COVID-19: estudio con estudiantes de enfermería

Objetivo: analisar as relações entre a esperança e o bem-estar psicológico de estudantes de enfermagem portugueses durante a crise pandêmica pela COVID-19. Método: estudo descritivo-correlacional, com recurso a questionário online para coleta de dados. Participaram 705 estudantes de enfermagem com idade média de 21,74 anos (DP=4,44). Os instrumentos de coleta de dados utilizados foram a Escala de Esperança de Herth (HHI-PT) e a Escala de Medida de Manifestação de Bem-Estar Psicológico (EMMBEP). Foi utilizada a estatística descritiva e inferencial. Resultados: na HHI-PT, o domínio afectivo-comportamental obteve a pontuação média mais alta, 3,30 (DP=0,45); no EMMBEP, foi o domínio sociabilidade, 3,64 (DP=0,77). Havia correlações moderadas a fortes (0,383

Aim: to analyze the relationship between hope and the psychological well-being of Portuguese nursing students during the COVID-19 pandemic crisis. Method: this is a descriptive-correlational study using an online questionnaire for data collection. 705 nursing students participated, with a mean age of 21.74 years (SD=4.44). The data collection instruments used were the Herth Hope Index (HHI-PT) and the Well-Being Manifestations Measure Scale (WBMMS). Descriptive and inferential statistics were used. Results: in the HHI-PT, the affective-behavioral domain had the highest mean score (3.30; SD=0.45), while in the WBMMS, it was the sociability domain, 3.64 (SD=0.77). There were moderate to strong correlations (0.383

Objetivo: analizar la relación entre la esperanza y el bienestar psicológico de los estudiantes portugueses de enfermería durante la crisis pandémica por COVID-19. Método: estudio descriptivo-correlacional mediante cuestionario online para la recogida de datos. Participaron 705 estudiantes de enfermería, con una edad promedio de 21,74 años (DE=4,44). Los instrumentos de recolección de datos utilizados fueron la Escala de Esperanza de Herth (HHI-PT) y la Escala de Medida de Manifestación de Bienestar Psicológico (EMMBEP). Se utilizó estadística descriptiva e inferencial. Resultados: en HHI-PT, fue el dominio afectivoconductual el que obtuvo la puntuación promedio más alta, 3.30 (DE=0.45), en EMMBEP, fue el dominio de sociabilidad, 3.64 (DE=0.77). Hubo correlaciones de moderadas a fuertes (0.383

"The barbarous glebes of Central Brazil:" the hinterlands of Mato Grosso and Goiás in the travel narratives of Hermano Ribeiro da Silva, 1935-1936. / "As glebas bárbaras do Brasil Central": os sertões de Mato Grosso e Goiás nas narrativas de viagem de Hermano Ribeiro da Silva, 1935-1936.

The article analyzes the travel narratives to the hinterlands of the states of Mato Grosso and Goiás published in 1935 and 1936 by the São Paulo-based explorer Hermano Ribeiro da Silva, which proved a great publishing success and had a considerable impact on lettered society in Brazil. The analysis focuses on his ideas about the relationship between the environment in Central Brazil and the man who inhabited it, the potential economic exploitation of the region, and the role of the State in orchestrating initiatives capable of promoting its effective incorporation into the nationhood. It also seeks to understand how he grounded his discourse on generic scientific concepts and schemas endowed with rhetorical and argumentative power.

O artigo analisa as narrativas de viagem ao interior de Mato Grosso e Goiás publicadas em 1935 e 1936 pelo explorador paulista Hermano Ribeiro da Silva, que obtiveram considerável sucesso editorial e impacto no meio letrado brasileiro. Concentramo-nos em suas ideias sobre a relação entre o ambiente do Brasil Central e o homem sertanejo, sobre as potencialidades de exploração econômica da região e sobre o papel do Estado na condução de iniciativas capazes de promover sua incorporação efetiva à nacionalidade. Buscamos também compreender a fundamentação de seu discurso em conceitos e esquemas científicos genéricos dotados de poder retórico e argumentativo.

Aging with health: aging in place strategies of a Portuguese population aged 65 years or older.

OBJECTIVE: To identify the strategies developed by people in the aging process to keep living in their own home, despite the weaknesses and difficulties they face. METHODS: The research was carried out based on a survey of population aged 65 years or older in the Portuguese municipality of Portimão. Data were collected by questionnaire, in 2017, and submitted to statistical and content analysis. RESULTS: Most respondents own their household, where they feel safe and satisfied, and they show awareness and concern about the changes they have to make in their home to stay there. In addition to housing and livability conditions, health, economic resources, social network, and available services play a major role in the community. CONCLUSIONS: We identified several strategies used by older adults to stay in their households as they age and the ways they mobilize their available resources, as well as constraints of aging in place.

"As glebas bárbaras do Brasil Central": os sertões de Mato Grosso e Goiás nas narrativas de viagem de Hermano Ribeiro da Silva, 1935-1936 / "The barbarous glebes of Central Brazil: " the hinterlands of Mato Grosso and Goiás in the travel narratives of Hermano Ribeiro da Silva, 1935-1936

Resumo O artigo analisa as narrativas de viagem ao interior de Mato Grosso e Goiás publicadas em 1935 e 1936 pelo explorador paulista Hermano Ribeiro da Silva, que obtiveram considerável sucesso editorial e impacto no meio letrado brasileiro. Concentramo-nos em suas ideias sobre a relação entre o ambiente do Brasil Central e o homem sertanejo, sobre as potencialidades de exploração econômica da região e sobre o papel do Estado na condução de iniciativas capazes de promover sua incorporação efetiva à nacionalidade. Buscamos também compreender a fundamentação de seu discurso em conceitos e esquemas científicos genéricos dotados de poder retórico e argumentativo.

Abstract The article analyzes the travel narratives to the hinterlands of the states of Mato Grosso and Goiás published in 1935 and 1936 by the São Paulo-based explorer Hermano Ribeiro da Silva, which proved a great publishing success and had a considerable impact on lettered society in Brazil. The analysis focuses on his ideas about the relationship between the environment in Central Brazil and the man who inhabited it, the potential economic exploitation of the region, and the role of the State in orchestrating initiatives capable of promoting its effective incorporation into the nationhood. It also seeks to understand how he grounded his discourse on generic scientific concepts and schemas endowed with rhetorical and argumentative power.

Stories told by plants on graveyards in Northern Angola.

BACKGROUND: Worldwide, different traditions of symbolic statements in graveyards can be found. However, studies on sub-Saharan Africa are rare. For BaKongo cemeteries, it is only known that they traditionally do not exhibit plants for decoration purposes. Our study wanted to inspect the influence of Portuguese culture due to the long shared colonial past. METHODS: During 2015 and 2019, plant use in 87 graveyards in 13 municipalities of the province Uíge was documented. Five expert interviews with the village eldest in five municipalities completed the data collection. RESULTS: While 24% of the graveyards didn´t have any planting, 27 plant species were found in the remaining ones, including a high percentage of alien species (59%), mainly from the Americas. The most abundant plant species are Euphorbia tirucalli (23%) and Agave sisalana (22%). With increasing distance from the city Uíge (especially towards the Democratic Republic of the Congo), the utilization of living plants in cemeteries is decreasing except along the road. In most of the cases, just one plant species per gravesite was found. CONCLUSIONS: This unexpected high number of plants might be interpreted as a strong evidence of outside influence. Cultural symbols of the BaKongo cosmology and Christianism appear to coexist or coalesce. Furthermore, plants are used as a marker for graveyards. Modern influences like the use of concrete in proximity to urban areas indicate a certain wealth.

Molecular Epidemiology of HIV-1 Infected Migrants Followed up in Portugal: Trends between 2001-2017.

Migration is associated with HIV-1 vulnerability. OBJECTIVES: To identify long-term trends in HIV-1 molecular epidemiology and antiretroviral drug resistance (ARV) among migrants followed up in Portugal Methods: 5177 patients were included between 2001 and 2017. Rega, Scuel, Comet, and jPHMM algorithms were used for subtyping. Transmitted drug resistance (TDR) and Acquired drug resistance (ADR) were defined as the presence of surveillance drug resistance mutations (SDRMs) and as mutations of the IAS-USA 2015 algorithm, respectively. Statistical analyses were performed. RESULTS: HIV-1 subtypes infecting migrants were consistent with the ones prevailing in their countries of origin. Over time, overall TDR significantly increased and specifically for Non-nucleoside reverse transcriptase inhibitor (NNRTIs) and Nucleoside reverse transcriptase inhibitor (NRTIs). TDR was higher in patients from Mozambique. Country of origin Mozambique and subtype B were independently associated with TDR. Overall, ADR significantly decreased over time and specifically for NRTIs and Protease Inhibitors (PIs). Age, subtype B, and viral load were independently associated with ADR. CONCLUSIONS: HIV-1 molecular epidemiology in migrants suggests high levels of connectivity with their country of origin. The increasing levels of TDR in migrants could indicate an increase also in their countries of origin, where more efficient surveillance should occur.

Cross-Cultural Adaptation and Face Validity of the Functional Mobility Assessment into Brazilian Portuguese.

Introduction. The Functional Mobility Assessment (FMA) measures satisfaction with mobility devices in daily life. However, in Brazil, there is a lack of instruments which measure functional mobility. OBJECTIVE: We aim to report the cross-cultural adaptation process and face validity of the FMA for use in Brazil. METHODS: Two international guidelines were used in the cross-cultural adaptation process. Two independent translators translated the instrument from English to Brazilian Portuguese, and the two versions were reconciled. Two different translators back translated this reconciled version, and an expert committee analysed the resulting synthesis. For face validity, the FMA was applied with 24 participants, divided into two groups, users with disabilities (n = 12) and occupational therapy students (n = 12) and occupational therapy students (. RESULTS: The cross-cultural adaptation of the FMA was concluded, and its face validity presented that both groups understood most or completely all instrument items. CONCLUSION: The Brazilian version of FMA is now available in Brazilian Portuguese and has face validation. Further studies should test its psychometric properties.

School-Class Co-Ethnic and Immigrant Density and Current Smoking among Immigrant Adolescents.

Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between co-ethnic density (i.e., the share of immigrants belonging to one's own ethnic group) and immigrant density (the share of all immigrants). This is all the more surprising since a high co-ethnic density can be expected to protect against substance use by increasing levels of social support and decreasing acculturative stress, whereas a high immigrant density can be expected to do the opposite by facilitating inter-ethnic conflict and identity threat. This study analyses how co-ethnic density and immigrant density are correlated with smoking among pupils of Portuguese origin in Luxembourg. A multi-level analysis is used to analyze data from the Luxembourg Health Behavior in School-Aged Children study (N = 4268 pupils from 283 classes). High levels of co-ethnic density reduced current smoking. In contrast, high levels of immigrant density increased it. Thus, in research on the health of migrants, the distinction between co-ethnic density and immigrant density should be taken into account, as both may have opposite effects.

Cross-cultural validation and psychometric properties of the Brazilian Portuguese version of the Psoriasis Epidemiology Screening Tool (PEST-bp).

Although the Psoriasis Epidemiology Screening Tool (PEST) questionnaire is a useful tool for screening patients for psoriatic arthritis (PsA), it has not been validated in Portuguese. Our aim was to perform a cross-cultural validation of the PEST for Brazilian Portuguese, as well as to analyse its psychometric properties and to test the association of PEST scores with patient clinical characteristics. The first step was the translation and cross-cultural adaptation of the PEST questionnaire into Brazilian Portuguese, which included forward translation, synthesis, back translation, consolidation with an expert panel and cognitive debriefing with pilot testing. The second step was validation and psychometric testing, in which 124 dermatology patients with no previous PsA diagnosis completed the new adapted questionnaire (PEST-bp). Patients were initially assessed by a dermatologist for clinical characteristics, then they answered the Dermatology Life Quality Index (DLQI) and PEST-bp questionnaires. Afterwards, a rheumatologist, blind to former tests, evaluated the presence of PsA according to CASPAR criteria. The PEST-bp proved to be 0.81 accurate (95% CI: 0.73-0.88) in the ROC curve, indicating a cutoff score ≥ 3 as suggestive of PsA (sensitivity = 84.6%, specificity = 63.3%). The assessment of internal consistency, via the Cronbach test, presented a coefficient of 0.72 (acceptable). A higher PEST-bp score was positively associated with lower quality of life scores and with male patients. In conclusion, the PEST-bp questionnaire proved to be suitable as a screening tool for PsA in patients with psoriasis. Elevated PEST-bp scores are associated with decreased patient quality of life.

ISTAP classification for skin tears: Validation for Brazilian Portuguese.

The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice.

Aging with health: aging in place strategies of a Portuguese population aged 65 years or older / Envelhecer com saúde: estratégias de ageing in place de uma população portuguesa com 65 anos ou mais

ABSTRACT OBJECTIVE: To identify the strategies developed by people in the aging process to keep living in their own home, despite the weaknesses and difficulties they face. METHODS: The research was carried out based on a survey of population aged 65 years or older in the Portuguese municipality of Portimão. Data were collected by questionnaire, in 2017, and submitted to statistical and content analysis. RESULTS: Most respondents own their household, where they feel safe and satisfied, and they show awareness and concern about the changes they have to make in their home to stay there. In addition to housing and livability conditions, health, economic resources, social network, and available services play a major role in the community. CONCLUSIONS: We identified several strategies used by older adults to stay in their households as they age and the ways they mobilize their available resources, as well as constraints of aging in place.

RESUMO OBJETIVO: Identificar as estratégias desenvolvidas por pessoas em processo de envelhecimento para se manter residindo na própria casa, apesar das fragilidades e das dificuldades com que deparam. MÉTODOS: A pesquisa foi realizada a partir de um inquérito a uma população com 65 anos ou mais no município português de Portimão. Os dados foram recolhidos por questionário, em 2017, e submetidos a análise estatística e análise de conteúdo. RESULTADOS: A maioria dos inquiridos tem habitação própria, onde se sente segura e satisfeita, e revela ter consciência e preocupação em relação às alterações que deve executar em sua casa para ali poder permanecer. Além das condições habitacionais e de habitabilidade, as condições de saúde, os recursos económicos, a rede social e os serviços disponíveis assumem um papel preponderante no envelhecimento na comunidade. CONCLUSÕES: Foi possível identificar uma diversidade nas estratégias utilizadas para permanecerem em suas casas à medida que envelhecem e uma multiplicidade de formas como mobilizaram os recursos que têm à disposição, bem como constrições do ageing in place.

Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese.

BACKGROUND: Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese. METHODS: This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed. RESULTS: Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version. CONCLUSION: A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .