Estudo-piloto de validação do instrumento Cartoon Test no contexto brasileiro / Pilot study for the validation of the Cartoon Test for the Brazilian context / Estudio piloto de validación del instrumento Cartoon Test en el contexto brasileño

O Cartoon Test é um instrumento que analisa a percepção de crianças e adolescentes acerca do significado de bullying por meio de cenas de interação entre pares no ambiente escolar. Este estudo qualitativo exploratório constitui a segunda etapa de validação do instrumento no Brasil, com os objetivos de verificar se os participantes compreendem as imagens e legendas dos cartoons e que palavras são utilizadas para descrever os comportamentos inadequados. Foram realizados oito grupos focais, com 52 alunos, com idades de oito e 14 anos, de duas cidades do Rio Grande do Sul. Os instrumentos utilizados foram: Questionário sociodemográfico, Folha de registro do pesquisador e Cartoon Test. Realizou-se análise de conteúdo para tratamento dos dados. Os resultados indicaram que o instrumento foi compreendido pelos participantes e o termo bullying foi o mais utilizado para descrever situações agressivas. Para as crianças, sugere-se a redução no número de cartoons, visando evitar a exaustão.(AU)

The Cartoon Test is an instrument that analyzes the perception of children and adolescents about the meaning of bullying through scenes of interaction between peers in the school environment. This qualitative exploratory study is the second phase of validation of the instrument in Brazil. The aim is to verify whether the participants understand both the images and captions of the cartoons and to record the words used to describe the inappropriate behaviors. Eight focus groups were carried out, with 52 students, aged between eight and 14 years, from two cities in Rio Grande do Sul. The instruments used were: sociodemographic questionnaire, record sheet and Cartoon Test. Content analysis was performed. The results showed that the instrument was understood by all the participants and bullying was the word most used to describe the aggressive situations. A reduction in the number of cartoons administered to children is suggested, in order to avoid exhaustion.(AU)

El Cartoon Test es un instrumento que analiza la percepción de niños y adolescentes a respeto del significado de bullying por medio de una escena de interacción entre pares en el ambiente escolar. Este estudio cualitativo exploratorio constituye la segunda etapa de validación del instrumento en Brasil, con el objetivo de verificar que los participantes comprenden las imágenes y leyendas de los cartoons y qué palabras son utilizadas para describir comportamientos inapropiados. Fueron realizados ocho grupos focales, con 52 alumnos, con edades entre ocho y 14 años, de dos ciudades de Rio Grande do Sul. Los instrumentos utilizados fueron: Cuestionario Sociodemográfico, Ficha de Registro del Investigador y Cartoon Test. Se llevo a cabo un análisis de contenido para procesar los datos. Los resultados indicaron que el instrumento fue comprendido por los participantes y el termo bullying fue lo más empleado para describir situaciones agresivas. Para los niños, se sugiere la reducción en el número de cartoons, para evitar el agotamiento.(AU)

Cheating Motivation Scale: evidence of validity and reliability / Escala de Motivação para Trapacear: evidências de validade e confiabilidade / Escala de Motivación para Engañar: evidencias de validez y fiabilidad

This study aimed to adapt the Motivation to Cheat Scale (MCS) to the Brazilian student context, gathering evidence of validity based on its internal structure. Two studies were carried out. In Study 1, the 20 items of the MCS were translated into Portuguese and evaluated semantically by ten students, who consider them sufficiently understandable. Subsequently, seeking to know the internal structure of the measure, there was the participation of 212 high school students (M = 16.10 years; SD = 1.02). An exploratory factor analysis indicated the existence of two factors (search for success and moral initiation), which were saturated 18 items. O Study 2 aimed to verify this factorial structure. Logo, the 18 items answered by 229 high school students (M = 16.20 years; SD = 1.23). A confirmatory factorial analysis confirmed bifactorial adjustment. MCS has evidence of validity based on internal structure, which can be used in research outside of Brazil. (AU)

Objetivou-se adaptar a Escala de Motivação para Trapacear (EMT) para o contexto estudantil brasileiro, reunindo evidências de validade baseadas em sua estrutura interna. Realizaram-se dois estudos. No Estudo 1, os 20 itens da EMT foram traduzidos para o português e submetidos à avaliação semântica de dez estudantes, que os consideraram suficientemente compreensíveis. Posteriormente, buscando-se conhecer a estrutura interna da medida, contou-se com a participação de 212 estudantes do Ensino Médio (M = 16,10 anos; DP = 1,02). Uma análise fatorial exploratória indicou a existência de dois fatores (busca de realização e inibição moral), nos quais saturaram 18 itens. O Estudo 2 visou comprovar essa estrutura fatorial. Logo, os 18 itens foram respondidos por 229 estudantes do Ensino Médio (M = 16,20 anos; DP = 1,23). Uma análise fatorial confirmatória comprovou o ajuste bifatorial. A EMT apresentou evidências de validade baseadas na estrutura interna, podendo ser utilizada em pesquisas no Brasil. (AU)

Este estudio tuvo como objetivo adecuar la Escala de Motivación para Engañar (EME) al contexto estudiantil brasileño, recogiendo evidencias de validez a partir de su estructura interna. Se realizaron dos estudios. En el Estudio 1, los 20 ítems de la EME fueron traducidos al portugués y sometidos a la evaluación semántica por parte de diez estudiantes, quienes los consideraron suficientemente comprensibles. Posteriormente, buscando comprender la estructura interna de la medida, participaron 212 estudiantes de la Educación Secundaria (M = 16,10 años; DS = 1,02). Un análisis factorial exploratorio indicó la existencia de dos factores (búsqueda de realización e inhibición moral), en los que se saturaron 18 ítems. El Estudio 2 tuvo como objetivo verificar esta estructura factorial. Por lo que, los 18 ítems fueron respondidos por 229 estudiantes de Secundaria (M = 16,20 años; DS = 1,23). Un análisis factorial confirmatorio demostró la adecuación bifactorial. La EME ha revelado evidencias de validez basadas en la estructura interna, pudiendo ser utilizada en investigaciones brasileñas. (AU)

Estudio piloto sobre el efecto de la telerehabilitación en la calidad de vida de personas mayores con deterioro cognitivo / Pilot study on the effect of telerehabilitation in quality of life among elderly people with cognitive impairment

Introducción: Los procesos de atención a personas mayores han presentado cambios debido al confinamiento sanitario causado por el COVID-19, por esta razón la telerehabilitación se impulsa como una estrategia para continuar los procesos de rehabilitación cognitiva a personas mayores. Objetivo: evaluar la percepción de la calidad de vida de personas mayores con deterioro cognitivo que se encuentran en telerehabilitación, comparado con la calidad de vida de personas mayores con deterioro cognitivo sin telerehabilitación. Método: se realizó un estudio descriptivo para identificar los cambios en la calidad de vida de personas mayores con procesos de telerehabilitación. Se emplearon los instrumentos Quality of Life in Alzheimer's Disease y la escala GENCAT. Resultados: el estudio descriptivo mostró cambios favorables en la calidad de vida de las personas mayores que estuvieron en el proceso de telerehabilitación, mientras que el grupo control presentó cambios negativos. Conclusiones: este estudio permite evidenciar los cambios en la calidad de vida de personas mayores con deterioro cognitivo que participa en un proceso de telerehabilitación durante el confinamiento sanitario. Estos cambios favorables se presentaron en las dimensiones de bienestar emocional, bienestar material, inclusión social y derechos.

Introduction: the processes of care for elderly have presented changes, due to the sanitary confinement caused by COVID-19 pandemic. For this reason, telerehabilitation is promoted as a strategy to continue the processes of cognitive rehabilitation for the elderly. Aim: To evaluate quality of life perceptions among older people with cognitive impairment, who received telerehabilitation, compared with quality of life of older people with cognitive impairment without Telerehabilitation. Method: a descriptive study to identify changes in quality of life of older people receiving tele-rehabilitation processes. Assessment instruments used were: Quality of Life in Alzheimer's Disease and the GENCAT scale. Results: this descriptive study showed favorable changes in quality of life of the elderly who were in the telerehabilitation process, while the control group presented negative changes. Conclusions: this study offers evidence on the changes in the quality of life for elderly people with cognitive impairment who participate in a telerehabilitation process during sanitary confinement. These favorable changes occurred in the dimensions of emotional well-being, material well-being, social inclusion and rights.

Implementation of a Telecardiology Service in a Health Unit in the City of Porto Alegre, Brazil: A Pilot Study

Abstract Background: The implementation of Telecardiology in primary care in the city of Porto Alegre, Brazil, is a viable and promising strategy. It would decrease the distance between patient and specialized professional services by reducing unnecessary referrals and improving the quality of primary care and satisfaction of patients and health professionals. Objective: To implement a Telecardiology service and assess user satisfaction using the CARDIOSATIS scale. Methods: This was a pilot study developed by a partnership between the Institute of Cardiology and the Telehealth Center of Rio Grande do Sul. The study was carried out at Eri Flores-Vila Vargas health center in the city of Porto Alegre, from May to October 2019, and included 21 patients attending the health center. The descriptive analysis of data was performed using the SPSS program (Statistical Package for the Sciences) version 23. Data normality was checked using the Kolmogorov-Smirnov test. Statistical significance was set at 10%. Results: Mean age of participants was 43.8 ± 16.1 years. The most common risk factors in the sample were physical inactivity (81%) and smoking (43%). Most patients had normal electrocardiogram (ECG) readings. The time elapsed from the performance of the ECG test, transmission of the ECG traces to Telehealth, and return of the final ECG report to the health center was 0-7 days. The CARDIOSATIS scale revealed a high prevalence of "very satisfied" users for the general satisfaction domain, and only 14.3% of patients were dissatisfied with their health. Conclusions: Telecardiology reduced the distance between patient and the specialized professional, with a high level of patient and health professional satisfaction. Our study can serve as a basis for the implementation of a telecardiology network in the city of Porto Alegre in the future.

Clinical significance of frusemide stress test in predicting the severity of acute kidney injury / Significância clínica do teste de estresse com furosemida na predição da gravidade da lesão renal aguda

Abstract Introduction: The outcomes of Acute Kidney Injury (AKI) remain dismal even today, owing in part due to the lack of an ideal biomarker for detecting renal damage early enough. We conducted this pilot study to determine the clinical significance of Frusemide Stress Test (FST) to predict the severity of AKI. Methods: A total of 80 patients with AKI-KDIGO (Kidney Disease: Improving Global Outcomes) stage 1 or stage 2 underwent FST by administering a bolus dose of frusemide (1mg/kg for frusemide naïve and 1.5mg/kg for prior frusemide exposure in the past week), and urine output was then measured for the next two hours with volume replacement as desirable. The progression to AKI-KDIGO stage 3 within 14 days of FST was studied as the primary outcome. The composite end point of achieving AKI-KDIGO stage 3 or death within 14 days of FST was studied as the secondary outcome. Results: Out of 80 patients, 28(35%) patients met the primary outcome, and 34(42.5%) patients met the secondary composite outcome. Except for baseline Chronic Kidney Disease (CKD) status (p=0.018), other demographic characteristics were comparable between progressors and non-progressors group. Using receiver operating characteristics (ROC) curve analysis, a cumulative 2-hour post-FST urine output of ≤300 mL predicted progression to stage 3 AKI with 82.14% sensitivity, 82.69% specificity, and AUC of 0.89±0.03 (p<0.0001). Conclusion: The FST showed promising results as a novel tubular biomarker to identify progression to severe AKI with good predictive ability.

Resumo Introdução: Os desfechos da Lesão Renal Aguda (LRA) permanecem desanimadores ainda hoje, em parte pela falta de um biomarcador ideal para detectar danos renais com a devida antecedência. Realizamos este estudo piloto para determinar a importância clínica do Teste de Estresse com Furosemida (TEF) em prever a gravidade da LRA. Métodos: Um total de 80 pacientes com LRA-KDIGO estágio 1 ou 2 foram submetidos ao TEF pela administração de uma dose em bolus de furosemida (1mg/kg para pacientes virgens de furosemida e 1,5mg/kg para exposição prévia à furosemida na semana anterior). O débito urinário foi então medido durante as duas horas seguintes com reposição de volume conforme desejável. A progressão para LRA-KDIGO estágio 3 dentro de 14 dias de TEF foi estudada como principal desfecho. O desfecho composto de atingir a LRA-KDIGO estágio 3 ou óbito em 14 dias após TEF foi estudado como desfecho secundário. Resultados: Dos 80 pacientes, 28 (35%) atingiram desfecho primário, e 34 (42,5%) pacientes atingiram o desfecho composto secundário. Exceto pelo estado basal da Doença Renal Crônica (DRC) (p=0,018), outras características demográficas foram comparáveis entre o grupo progressores e não progressores. Usando a análise da Curva Característica de Operação do Receptor (ROC), um débito urinário cumulativo de 2 horas pós-TEF de ≤300 mL previu a progressão para estágio 3 da LRA com 82,14% de sensibilidade, 82,69% de especificidade, e AUC de 0,89±0,03 (p<0,0001). Conclusão: O TEF mostrou resultados promissores como novo biomarcador tubular para identificar progressão para LRA grave com boa capacidade preditiva.

Prevalence of and risk factors for depression among female Syrian refugees and Jordanians with chronic disease: a pilot study

Background: Chronic disease and depression are primary contributors to morbidity among displaced and local populations. Aims: This study aims to address the prevalence for and risk factors of comorbid depression among Jordanian and Syrian women with known chronic disease. Methods: To provide evidence for mental health intervention planning, we conducted a cross-sectional survey to investigate determinants of depression among female Syrian refugees and Jordanians with chronic disease living in Amman. A total of 272 female Syrian refugees and Jordanians with chronic disease were recruited from 4 clinics across Amman from June to August 2017. We compared demographic and health characteristics and depression level and identified predictors of depression via multivariable ordinal regression. Results: Moderate to high levels of depression were reported in 55.9% of the participants, with a prevalence of 41.1% among Jordanians and 70.6% among Syrians. Syrians with chronic disease had 2.73 times greater odds of higher levels of depression than their Jordanian peers. After adjusting for age, income, spouse employment status, gastrointestinal or genitourinary disorder status, and perceived self-efficacy, Syrians were not at significantly greater odds of reporting higher levels of depression. Risk factors for higher depression levels included having an unemployed spouse, diagnosis of gastrointestinal or genitourinary disorder and low perceived self-efficacy. Conclusion: Depression is frequently comorbid with chronic physical conditions and has a deleterious impact on health status. Mental health interventions and chronic disease management tailored to differences among local and displaced communities may reduce disease burden and disability.

Salud en personas mayores afrodescendientes Chilenas / Health in older people of african-descendant in Chile

Chile recientemente ha reconocido al pueblo tribal afrodescendiente, se trata de un colectivo poco estudiado y con severas desventajas sociales y sanitarias. Este estudio tiene como objetivo describir el perfil de salud y el acceso a servicios sanitarios, junto con analizar la asociación entre las variables sociodemográficas, de salud y los síntomas depresivos en personas mayores afrodescendientes. Estudio piloto que contó con la participación de 60 personas mayores afrodescendientes, se aplicaron diversas escalas de valoración geriátrica. Los antecedentes de salud indicarían que el 78% es hipertenso, 57% tiene síntomas depresivos, el 30% es independiente en actividades de la vida diaria (AVD), y un 61% tiene riesgo leve de caídas. Respecto al acceso a salud: 84% está inscrito en un centro de salud, el 68% es beneficiario del programa de salud cardiovascular y un 71% está al día con la vacuna preventiva de la influenza. Las variables predictivas de depresión son ser beneficiario del programa de alimentación complementaria y la dependencia en AVD. Este estudio ratifica la relevancia de la inclusión de patologías específicas concorde al perfil epidemiológico de los grupos étnicos-raciales y seguir avanzando en estudios sanitarios específicos en minorías étnicas.

Chile has recently recognized the Afrodescendant tribal people, a little studied group with severe social and health disadvantages. This study aims to describe the health profile and access to health services, and to analyze the association between sociodemographic and health variables and depressive symptoms in older people of African descent. Pilot study with the participation of 60 elderly people of African descent, with the application of several geriatric assessment scales. Health history indicated that 78% are hypertensive, 57% have depressive symptoms, 59% are independent in activities of daily living (ADL), and 61% have a slight risk of falling. Regarding access to health care: 84% are enrolled in a health center, 68% are beneficiaries of the cardiovascular health program and 71% are up to date with the preventive influenza vaccine. The variables predictive of depression are being a beneficiary of the complementary feeding program and dependence in ADLs. Conclusion: This study ratifies the relevance of including specific pathologies according to the epidemiological profile of ethnic-racial groups and to continue advancing in specific health studies in ethnic minorities.

Importância do destreinamento físico sobre a capacidade funcional em indivíduos com doença arterial obstrutiva crônica periférica: estudo transversal piloto / Importance of physical detraining in functional capacity of individuals with chronic peripheral arterial occlusive disease: a cross-sectional pilot study

Resumo Contexto O treinamento físico é uma estratégia bem estabelecida para a reabilitação da capacidade funcional de indivíduos com doença arterial obstrutiva crônica periférica (DAOP). No entanto, após um programa de treinamento físico, alguns indivíduos podem descontinuá-lo, causando destreinamento. A literatura é escassa sobre os efeitos do destreinamento físico em indivíduos com DAOP; portanto, torna-se importante investigar os efeitos nessa temática. Objetivos Avaliar os efeitos do destreinamento físico sobre a capacidade funcional em indivíduos com DAOP. Métodos Estudo transversal com 22 indivíduos. Os participantes foram divididos em dois grupos: grupo destreinamento (GD), grupo controle (GC). Foram avaliadas a distância percorrida no teste de caminhada de 6 minutos (DTC6M) e a distância livre de dor claudicante (DLDC), a qual é referida pela distância percorrida até o início da claudicação, ou seja, sem dor. Resultados A média da idade foi de 66±8 para o GD e de 67±7 para o GC. Tanto a DTC6M como a DLDC não apresentaram diferenças entre os grupos (p = 0,428 e p = 0,537, respectivamente). Conclusões O presente estudo piloto permite concluir que indivíduos com DAOP que participaram de um programa de treinamento físico e posterior destreinamento não tiveram efeitos superiores na sua capacidade funcional em relação a indivíduos que não participaram de programa de treinamento físico. O resultado do presente estudo serve para incentivar a manutenção da prática de exercício físico, visto que o treinamento físico deixa de ser efetivo se ocorrer destreinamento.

Abstract Background Physical training is a well-established strategy for rehabilitation of the functional capacity of individuals with chronic peripheral arterial occlusive disease (PAOD). However, some individuals quit training after participating in a physical training program, undergoing detraining. There is scant literature on the effects of physical detraining in individuals with PAOD and it is therefore important to investigate the effects of this phenomenon. Objectives The objective of this article was to evaluate the effects of physical detraining on functional capacity in individuals with PAOD. Methods Cross-sectional study with 22 individuals. Participants were divided into two groups: a detraining group (DG) and a control group (CG). The distance covered in the 6-minute walk test (6MWTD) and the pain-free walking distance (PFWD) were evaluated. The PFWD is the distance covered until claudication begins, i.e., the distance covered without pain. Results Mean age was 66 ± 8 in the DG and 67 ± 7 in the CG. There were no differences between the groups in either the 6MWTD or the PFWD (p = 0.428; p = 0.537, respectively). Conclusions The present pilot study allows us to conclude that the functional capacity of individuals with PAOD who participated in a physical training program and subsequently underwent detraining was not superior in relation to individuals who did not participate in a physical training program. The results of the present study serve to encourage maintenance of physical exercise, since physical training is no longer effective if detraining occurs.

Importância do destreinamento físico sobre a capacidade funcional em indivíduos com doença arterial obstrutiva crônica periférica: estudo transversal piloto / Importance of physical detraining in functional capacity of individuals with chronic peripheral arterial occlusive disease: a cross-sectional pilot study

Resumo Contexto O treinamento físico é uma estratégia bem estabelecida para a reabilitação da capacidade funcional de indivíduos com doença arterial obstrutiva crônica periférica (DAOP). No entanto, após um programa de treinamento físico, alguns indivíduos podem descontinuá-lo, causando destreinamento. A literatura é escassa sobre os efeitos do destreinamento físico em indivíduos com DAOP; portanto, torna-se importante investigar os efeitos nessa temática. Objetivos Avaliar os efeitos do destreinamento físico sobre a capacidade funcional em indivíduos com DAOP. Métodos Estudo transversal com 22 indivíduos. Os participantes foram divididos em dois grupos: grupo destreinamento (GD), grupo controle (GC). Foram avaliadas a distância percorrida no teste de caminhada de 6 minutos (DTC6M) e a distância livre de dor claudicante (DLDC), a qual é referida pela distância percorrida até o início da claudicação, ou seja, sem dor. Resultados A média da idade foi de 66±8 para o GD e de 67±7 para o GC. Tanto a DTC6M como a DLDC não apresentaram diferenças entre os grupos (p = 0,428 e p = 0,537, respectivamente). Conclusões O presente estudo piloto permite concluir que indivíduos com DAOP que participaram de um programa de treinamento físico e posterior destreinamento não tiveram efeitos superiores na sua capacidade funcional em relação a indivíduos que não participaram de programa de treinamento físico. O resultado do presente estudo serve para incentivar a manutenção da prática de exercício físico, visto que o treinamento físico deixa de ser efetivo se ocorrer destreinamento.

Abstract Background Physical training is a well-established strategy for rehabilitation of the functional capacity of individuals with chronic peripheral arterial occlusive disease (PAOD). However, some individuals quit training after participating in a physical training program, undergoing detraining. There is scant literature on the effects of physical detraining in individuals with PAOD and it is therefore important to investigate the effects of this phenomenon. Objectives The objective of this article was to evaluate the effects of physical detraining on functional capacity in individuals with PAOD. Methods Cross-sectional study with 22 individuals. Participants were divided into two groups: a detraining group (DG) and a control group (CG). The distance covered in the 6-minute walk test (6MWTD) and the pain-free walking distance (PFWD) were evaluated. The PFWD is the distance covered until claudication begins, i.e., the distance covered without pain. Results Mean age was 66 ± 8 in the DG and 67 ± 7 in the CG. There were no differences between the groups in either the 6MWTD or the PFWD (p = 0.428; p = 0.537, respectively). Conclusions The present pilot study allows us to conclude that the functional capacity of individuals with PAOD who participated in a physical training program and subsequently underwent detraining was not superior in relation to individuals who did not participate in a physical training program. The results of the present study serve to encourage maintenance of physical exercise, since physical training is no longer effective if detraining occurs.

Validación de los instrumentos cuantitativo y cualitativo para determinar los factores sociodemográficos que inciden en la accesibilidad al servicio de inmunizaciones en niños menores de 24 meses / Validation of the quantitative and qualitative instruments to determine the sociodemographic factors that affect the accessibility to the immunization service in children under 24 months

La inmunización es una de las intervenciones de salud más exitosas y costo-efectivas, por medio de la cual se pueden prevenir entre dos y tres millones de muertes cada año en el mundo, sigue siendo considerada como una intervención eficaz que salva vidas y evita el sufrimiento; beneficia a los niños porque mejora la salud y la esperanza de vida, también por su impacto social y económico a escala mundial. Objetivo: Validar los instrumentos cuantitativo y cualitativo para determinar los factores sociodemográficos que inciden en la accesibilidad al servicio de inmunizaciones en niños menores de 24 meses. Metodología: El presente estudio es de enfoque mixto (cuanti ­ cualitativo) de corte transversal, exploratorio de tipo descriptivo y de campo, con un enfoque cualitativo fenomenológico diseñado por 3 categorías y codificado de acuerdo al número de participantes. La población como muestra de la investigación es de 100 personas, de las cuales se hizo un estudio piloto de 15 personas para la encuesta y 1 persona para la entrevista a profundidad. Resultados: Al aplicar el criterio de los juicios de expertos, se obtuvieron los siguientes resultados: en el instrumento cuantitativo se obtuvo un promedio de 96 y en el instrumento cualitativo logrando un promedio de 95, ambos resultados equivalentes a muy confiable. Conclusión: El plan piloto da a entender que los instrumentos tienen propiedades buenas para determinar los factores sociodemográficos que incidan a la accesibilidad del servicio de inmunizaciones(AU)

Immunization is one of the most successful and cost-effective health interventions; because of it, two and three million deaths can be prevented each year in the world. It continues to be considered an effective intervention that saves lives and avoid suffering; it benefits children because it improves health and life expectancy because of its social and economic impact on a global scale. Objective: To validate the quantitative and qualitative instruments in order to determine the sociodemographic factors that affect accessibility to the immunization service in children under 24 months. Methodology: The present study is a cross-sectional (quantitative - qualitative) mixed approach, exploratory, descriptive and field, with a phenomenological qualitative approach designed by three categories and coded according to the number of participants. The population as a sample of the research is 100 people, of which a pilot study of 15 people was carried out for the survey and one person for the in-depth interview. Results: When applying the criterion of expert judgments, getting the following results: in the quantitative instrument obtained an average of 96 and in the qualitative instrument achieving an average of 95, both results equivalent to very reliable. Conclusion: The pilot plan suggests that the instruments have good properties to determine the sociodemographic factors that affect the accessibility of the immunization service(AU)

Evaluación de conocimientos y autonomía para la transición de adolescentes hacia la atención de adultos / Assessment of knowledge and autonomy for the transition from adolescent toward adult care

INTRODUCCIÓN: Cada vez más niños con enfermedades complejas logran sobrevivir requiriendo el paso de una atención pediátrica a una de adultos. Es fundamental contar con herramientas que permitan conocer el grado de preparación del paciente para este traslado. OBJETIVO: Crear un cuestionario local para medir el estado de preparación para la transición de adolescentes con enfermedad crónica y someterlo a pruebas de validación. PACIENTES Y MÉTODO: Basado en cuestionarios internacionales se diseñó un instrumento de auto-reporte que se sometió a validez de contenido por expertos, y luego a pruebas de comprensión y factibilidad en grupo piloto. Posteriormente se realizó validación de constructo y fiabilidad utilizando análisis factorial tras ser aplicado en adolescentes con enfermedad crónica. RESULTADOS: Tras el análisis por 11 expertos y piloto de 8 pacientes se obtuvo un instrumento que fue respondido en forma completa por 168 adolescentes. Edad promedio 14,4 años. Tras la validación de constructo se genera un instrumento de 24 ítems de alta relevancia clínica, con 9 ítems con resultados psicométricos aceptables, los que se destacan en el cuestionario final. CONCLUSIÓN: Se presenta un cuestionario de auto-reporte para medir el estado de preparación de los adolescentes para la transición a servicios de adultos. Las propiedades psicométricas del instrumento resultaron insuficientes para su validación, ya que sólo se comprueba la validez de constructo y confiabilidad para 9 de los 24 ítems.

INTRODUCTION: In the last decades more and more children survive with complex health conditions, requiring a transition from pediatric to adult care. It is essential to have instruments that provide information on the level of preparation of patients for this process. OBJECTIVE: To create and validate a questionnaire to measure the readiness status of adolescent patients with chronic diseases in the transition process. PATIENTS AND METHOD: Based on international questionnaires, a self-report instrument was designed which was subjected to content validity by experts, and then to comprehension and feasibility tests in a pilot group. Subsequently, construct and reliability validation were performed through a factorial analysis after applied it to adolescents living with a chronic illness. RESULTS: After the analysis made by 11 experts and the pilot group with 8 patients, we obtained an instrument that was fully answered by 168 teenagers (Average age 14.4 years). After construct validation, a 24-items instrument of high clinical relevance was developed, with 9 items with acceptable psychometric properties, which were highlighted in the final questionnaire. CONCLUSION: a self-report instrument aimed to measure the readiness of adolescents during the transition process to adult care is presented. The reported psycho metric properties of the instrument were insufficient to consider it validated since the construct vali dity and reliability were only checked for 9 of the 24 items.

Infusion of convalescent plasma is associated with clinical improvement in critically ill patients with Covid-19: a pilot study

ABSTRACT Background: The ideal treatment of coronavirus disease (COVID)-19 has yet to be defined, but convalescent plasma (CoPla) has been successfully employed. Objective: The objective of the study was to study the safety and outcomes of the administration of CoPla to individuals with severe COVID-19 in an academic medical center. Methods: Ten patients were prospectively treated with plasma from COVID-19 convalescent donors. Results: Over 8 days, the sequential organ failure assessment score dropped significantly in all patients, from 3 to 1.5 (p = 0.014); the Kirby index (PaO2/FiO2) score increased from 124 to 255, (p < 0.0001), body temperature decreased significantly from 38.1 to 36.9°C (p = 0.0058), and ferritin levels also dropped significantly from 1736.6 to 1061.8 ng/ml (p = 0.0001). Chest X-rays improved in 7/10 cases and in 6/10, computerized tomography scans also revealed improvement of the lung injury. Decreases in C-reactive protein and D-dimer levels were also observed. Three of five patients on mechanical ventilation support could be extubated, nine were transferred to conventional hospital floors, and six were sent home; two patients died. The administration of CoPla had no side effects and the 24-day overall survival was 77%. Conclusions: Although other treatments were also administered to the patients and as a result data are difficult to interpret, it seems that the addition of CoPla improved pulmonary function.

Irisin and troponin I expression in dialysis patients submitted to remote ischemic preconditioning: a pilot study / Expressão de irisina e troponina I em pacientes em diálise submetidos a pré-condicionamento isquêmico remoto: um estudo piloto

ABSTRACT Background: Renal replacement therapy continues to be related to high hospitalization rates and poor quality of life. All-cause morbidity and mortality in renal replacement therapy in greater than 20% per year, being 44 times greater when diabetes is present, and over 10 times that of the general population. Regardless of treatment, the 5-year survival is 40%, surpassing many types of cancers. Irisin is a hormone that converts white adipose tissue into beige adipose tissue, aggregating positive effects like fat mass control, glucose tolerance, insulin resistance, prevention of muscle loss, and reduction in systemic inflammation. Objectives: To determine the serum levels of troponin I in hemodialysis patients submitted to remote ischemic preconditioning (RIPC) associated with irisin expression. Methods: This was a prospective, randomized, double-blind clinical trial with patients with chronic kidney disease submitted to hemodialysis for a 6-month period. Troponin I, IL-6, urea, TNF-α, and creatinine levels were determined from blood samples. The expressions of irisin, thioredoxin, Nf-kb, GPX4, selenoprotein and GADPH were also evaluated by RT-PCR. Results: Samples from 14 hypertensive patients were analyzed, 9 (64.3%) of whom were type 2 diabetics, aged 44-64 years, and 50% of each sex. The difference between pre- and post-intervention levels of troponin I was not significant. No differences were verified between the RIPC and control groups, except for IL-6, although a significant correlation was observed between irisin and troponin I. Conclusion: Remote ischemic preconditioning did not modify irisin or troponin I expression, independent of the time of collection.

RESUMO Introdução: A terapia de substituição renal continua associada a altas taxas de hospitalização e baixa qualidade de vida. A morbimortalidade por todas as causas na terapia de substituição renal é superior a 20% ao ano, sendo 44 vezes maior quando a diabetes está presente e mais de 10 vezes a da população em geral. Independentemente do tratamento, a sobrevida em 5 anos é de 40%, superando muitos tipos de câncer. A irisina é um hormônio que converte tecido adiposo branco em tecido adiposo bege, agregando efeitos positivos como o controle de massa gorda, tolerância à glicose, resistência à insulina, prevenção de perda muscular e redução da inflamação sistêmica. Objetivos: Determinar os níveis séricos de troponina I em pacientes em hemodiálise submetidos ao pré-condicionamento isquêmico remoto (PCIR) associado à expressão da irisina. Métodos: Estudo clínico prospectivo, randomizado, duplo-cego, com pacientes com doença renal crônica submetidos à hemodiálise por um período de 6 meses. Os níveis de troponina I, IL-6, uréia, TNF-α e creatinina foram determinados a partir de amostras de sangue. As expressões de irisina, tioredoxina, Nf-kb, GPX4, selenoproteína e GADPH foram também avaliadas por RT-PCR. Resultados: Foram analisadas amostras de 14 pacientes hipertensos, 9 (64,3%) dos quais eram diabéticos tipo 2, com idades entre 44 e 64 anos e 50% de cada gênero. A diferença entre os níveis pré e pós-intervenção de troponina I não foi significativa. Não houve diferenças entre os grupos PCIR e controle, exceto pela IL-6, embora tenha sido observada correlação significativa entre irisina e troponina I. Conclusão: O pré-condicionamento isquêmico remoto não modificou a expressão de irisina ou troponina I, independentemente do tempo de coleta.

Relationships among oncostatin M, insulin resistance, and chronic inflammation: a pilot study

ABSTRACT Objective Activated macrophages (M1-type macrophages) in adipose tissue secrete many proinflammatory cytokines that induce insulin resistance (IR). Oncostatin M (OSM), a member of the interleukin-6 (IL-6) family of Gp130 cytokines, plays an important role in a variety of biological functions, including the regulation of inflammatory responses. Proinflammatory cytokines released in patients with IR trigger a chronic, low-grade inflammatory reaction in blood vessel walls. This inflammator response leads to endothelial damage, which is the main mechanism for atherosclerosis and many cardiovascular diseases. Animal studies have reported a relationship between OSM and IR. To the best of our knowledge, however, few clinical studies have examined this topic. Therefore, we studied the relationship between serum levels of OSM and IR. Subjects and methods This prospective cross-sectional case-control study enrolled 50 people with IR (according to the HOMA-IR and QUICKI indices) and 34 healthy controls. The fasting blood concentrations of insulin, glucose, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, total cholesterol, C-reactive protein (CRP), and OSM were determined. Results There were no significant differences between the two groups in age, sex, and HbA1c levels. Univariate analyses showed that waist circumference (WC) and levels of fasting glucose, insulin, CRP, HDL-C, OSM, HOMA-IR, and QUICKI differed between the two study groups. In multivariate analyses, both IR indices (QUICKI and HOMA) and OSM differed between the two groups. Conclusion OSM was correlated with the IR indices (QUICKI and HOMA). For simplicity, it might replace the other IR indices in the future. Further detailed studies are needed to confirm this.

Human pilot study of bare-metal stent: INC-01

ABSTRACT Background: The cost of performing a percutaneous coronary intervention is considerably high for the patient as well as for health systems, which have promoted the development of local technology to help meet the need for these devices. Methods: The INC-01 bare-metal stent was developed at the National Institute of Cardiology in Mexico City and was first implanted on porcine models with technical success in 100% of the evaluated parameters. Presentation of Cases: We present the first three cases of patients with ischemic heart disease, to whom the INC-01 bare-metal stent was implanted. Intracoronary ultrasonography was performed post-stent implantation, showing all the characteristics of implant success during evaluation and clinical follow-up. Conclusions: Angiography and intracoronary ultrasound were carried out demonstrating that the INC-01 bare-metal stent has physical, biological, and histological characteristics similar to those found in commercial metallic stents.

Socioeconomic status and family functioning influence oral health literacy among adolescents

ABSTRACT OBJECTIVE Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87-0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS The following variables remained associated with better OHL: high mother's schooling level (RR = 1.07; 95%CI: 1.03-1.12), high income (RR = 1.04; 95%CI: 1.01-1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01-1.10), married parents (RR = 1.04; 95%CI: 1.01-1.09), "enmeshed" family cohesion (RR = 1.21; 95%CI: 1.12-1.30), "structured" (RR = 1.06; 95%CI: 1.01-1.12) or "rigid" (RR = 1.11; 95%CI: 1.04-1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01-1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03-1.13). CONCLUSION Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

The Global Action Plan in Tajikistan: coming together for healthy lives and well-being

The Republic of Tajikistan has been selected as one of the global pilot countries for the national implementation of the Global Action Plan for Healthy Lives and Well-being for All (GAP), with a focus on strengthening health financing as an accelerator towards achieving Sustainable Development Goal (SDG) 3 on health and well-being for all. This process is supported by United Nations agency partners of the GAP and other development partners. It is a timely and opportune moment as the country is in the process of drafting National Programme 2021–2030, the new programme for health care and social protection, which is embedded in the National Programme of Development of the Republic of Tajikistan up to the year 2030.

A Health Behaviour in School-aged Children (HBSC) study and Schools for Health in Europe network (SHE) collaborative project for data-led health action planning in schools: findings and reflections from three European pilot case studies

This pilot project represents a collaboration between members of the Schools for Health in Europe (SHE) network and members of the Health Behaviour in School-aged Children (HBSC) study national teams in four countries/regions: Croatia, North Macedonia, United Kingdom (Scotland) and United Kingdom (Wales). It was coordinated by the WHO Regional Office for Europe. The overall aim of the project was to test the usefulness of SHE resources and HBSC national data for engaging the school community in health action planning in three case study countries/region (Croatia, North Macedonia and Scotland) by: bringing together the work being carried out by HBSC and in the SHE network; providing two schools in each country/region with a toolkit of SHE resources and HBSC national data to understand and evaluate health and well-being in their schools; and gathering feedback from schools (teachers and students) on using the resources. This report reflects feedback from the pilot countries/region and provides some recommendations for promoting data-driven health action planning in schools in Europe.

Bullying among adolescents: are the victims also perpetrators?

Objective: To analyze factors associated with the prevalence of maltreatment and bullying and to identify types of involvement (verbal, physical, social, sexual, cyberbullying) among high school students aged 15 to 19 years. Methods: A cross-sectional, school-based epidemiological survey was performed. The sample included 2,293 adolescents from public and private schools in the Greater Vitoria area (state of Espírito Santo, Brazil). A modified version of the Brazilian Portuguese Olweus Bully/Victim Questionnaire was used. Results: Among maltreatment behaviors, 43.3% of adolescents reported having been victims vs. 40.4% reporting to be aggressors. Among bullying behaviors, 41% reported victimization and 29.1% aggression. The most frequent types of bullying were verbal (victim = 33.8%, bully = 23.1%), social (victim = 21.8%, bully = 16.9%), and physical bullying (victim = 15.1%, bully = 8.7%). Of those reporting to be victims, 37.5% stated that they did not react as frequently as they were attacked. Almost half of the students (50.9%) identified themselves as victims, without practicing any type of aggression against another schoolmate. School network (public or private) and gender were significantly associated with victimization and aggression behaviors. Conclusion: The adolescents identified as victims did not generally attack other students, i.e., did not identify themselves as perpetrators. The high prevalence of maltreatment and bullying detected in this study, especially the verbal, social, and physical types, underscores the need for interventions addressing bullying in schools.