Psychometric properties of the Child Health Assessment Questionnaire (CHAQ) applied to children and adolescents with cerebral palsy

<p>Abstract</p> <p>Background</p> <p>Cerebral palsy (CP) patients have motor limitations that can affect functionality and abilities for activities of daily living (ADL). Health related quality of life and health status instruments validated to be applied to these patients do not directly approach the concepts of functionality or ADL. The Child Health Assessment Questionnaire (CHAQ) seems to be a good instrument to approach this dimension, but it was never used for CP patients. The purpose of the study was to verify the psychometric properties of CHAQ applied to children and adolescents with CP.</p> <p>Methods</p> <p>Parents or guardians of children and adolescents with CP, aged 5 to 18 years, answered the CHAQ. A healthy group of 314 children and adolescents was recruited during the validation of the CHAQ Brazilian-version. Data quality, reliability and validity were studied. The motor function was evaluated by the Gross Motor Function Measure (GMFM).</p> <p>Results</p> <p>Ninety-six parents/guardians answered the questionnaire. The age of the patients ranged from 5 to 17.9 years (average: 9.3). The rate of missing data was low (<9.3%). The floor effect was observed in two domains, being higher only in the visual analogue scales (≤ 35.5%). The ceiling effect was significant in all domains and particularly high in patients with quadriplegia (81.8 to 90.9%) and extrapyramidal (45.4 to 91.0%). The Cronbach alpha coefficient ranged from 0.85 to 0.95. The validity was appropriate: for the discriminant validity the correlation of the <it>disability index </it>with the visual analogue scales was not significant; for the convergent validity CHAQ <it>disability index </it>had a strong correlation with the GMFM (0.77); for the divergent validity there was no correlation between GMFM and the pain and overall evaluation scales; for the criterion validity GMFM as well as CHAQ detected differences in the scores among the clinical type of CP (p < 0.01); for the construct validity, the patients' <it>disability index </it>score (mean:2.16; SD:0.72) was higher than the healthy group (mean:0.12; SD:0.23)(p < 0.01).</p> <p>Conclusion</p> <p>CHAQ reliability and validity were adequate to this population. However, further studies are necessary to verify the influence of the ceiling effect on the responsiveness of the instrument.</p

PERFIL DOS CURSOS DE ESPECIALIZAÇÃO EM ENFERMAGEM NO MUNICÍPIO DE SALVADOR, BAHIA, BRASIL

Objetivos: Caracterizar os cursos de Especialização em Enfermagem na cidade de Salvador, Bahia, Brasil. Método: Trata-se de um estudo exploratório-documental de cunho descritivo, com abordagem quantitativa, cuja coleta de dados ocorreu em sites de busca e páginas on-line das organizações que oferecem os cursos, no período de janeiro a março de 2014. Foi utilizado como instrumento para a coleta de dados um questionário pré-codificado com questões fechadas. Resultados: Foram identificados 72 cursos de especialização oferecidos para enfermeiros. A maioria dos cursos é na modalidade presencial, com carga horário acima de 360 horas, e com a área de conhecimento enfermagem do trabalho. Conclusão: Há um número expressivo de cursos de especialização para enfermeiros, em diversas modalidades e áreas de conhecimento.Descritores: Educação em Enfermagem; Especialização; Enfermagem

Secretory carcinoma of the canine mammary gland with nodal and bone metastases: Case report

Background: Secretory carcinoma is a rare histological type of breast neoplasm in humans and dogs that is characterized by the presence of intracellular and extracellular eosinophilic secretions.Case Description: In this case report, we describe the cytological, histological, and immunohistochemical characteristics of secretory mammary carcinoma in a 10-year-old mixed-breed female dog with nodal and bone metastases. The bitch had a history of claudication and a mass in the left humeral scapular region, which revealed osteolysis of the proximal humerus on radiography. Fine-needle aspiration cytology revealed numerous neoplastic cells arranged mostly in cohesive groups but sometimes isolated, that contained cytoplasmic vacuoles and had a moderate-to-high nucleus: cytoplasm ratio with frequent karyomegaly and evident nucleoli. Histologically, the neoplasm was organized in solid, tubular structures with luminal spaces filled with eosinophilic secretions and was composed of cells with clear cytoplasm and prominent vacuoles that pushed the nuclei to the periphery, resembling signet ring cells. The extracellular and intracytoplasmic material of the epithelial cells was positive for periodic acid-Schiff staining and immunoreactive for alpha-lactalbumin. Two chemotherapy sessions were performed, but 1 month after surgery, the clinical condition worsened, and euthanasia was elected, accounting for 133 days of survival after surgical removal of the tumor.Conclusion: The bitch presented with secretory mammary carcinoma with nodal and bone metastases, and histological and immunohistochemical characteristics were important for diagnosis. The morphological and immunohistochemical characteristics of this carcinoma were similar to those observed in humans. Mammary gland secretory carcinoma with bone metastasis must be included as a differential diagnosis among canine mammary gland carcinomas showing cellular morphological characteristics of intracytoplasmic vacuolization and eosinophilic secretion

Green and roasted arabica coffees differentiated by ripeness, process and cup quality via electrospray ionization mass spectrometry fingerprinting

Direct infusion electrospray ionization mass spectrometry in both the negative ESI(-)-MS and positive ESI(+)-MS ion modes are investigated to differentiate green and roasted Arabica coffees with different stages of ripeness (green, ripe and overripe), post-harvesting process (dry, wet and semi-wet) and coffees with different cup qualities. In the ESI(-)-MS of green coffees, ions from deprotonated fatty acids and chlorogenic acids are the most important for ripeness discrimination. In the ESI(+)-MS, maturity is differentiated by ions from protonated caffeine, chlorogenic acids and K+ adducts of fatty acids. To differentiate between post-harvesting process in both ionization modes, ions from fatty acids, chlorogenic acids, sugars and carboxylic acids generated in the fermentation process are the most representative. Roasted Arabica coffees are also well discriminated: in the ESI(-)-MS, ions from chlorogenic acids and short-chain organic acids derived from sugars are important. In the ESI(+)-MS, discrimination are mainly performed by low m/z ions such as protonated pyridine and alkylpiridines formed via trigonelline degradation. Both ESI(+)-MS and ESI(-)-MS are able to differentiate cup quality for Arabica roasted coffees and the ions used to perform discrimination are the same ones described in ripeness and post-harvesting processes.A habilidade da técnica de espectrometria de massas com infusão direta e ionização por eletronebulização (IES-EM), nos modos de íons positivos e negativos, foi avaliada na diferenciação de cafés Arábica verdes e torrados e com diferentes estágios de amadurecimento (verde, maduro e passado), processo pós-colheita (seco, úmido e semi-úmido) e cafés classificados por prova de xícara. No modo negativo, a análise dos cafés verdes mostrou que os íons correspondentes aos ácidos graxos e ácidos clorogênicos desprotonados são os mais importantes para a discriminação da maturidade. No modo positivo, a maturidade é diferenciada através de íons correspondentes a cafeína, ácidos clorogênicos protonados e adutos de K+ de ácidos graxos. Na diferenciação da pós-colheita, em ambos os modos de ionização, são mais importantes os íons correspondentes aos ácidos graxos, ácidos clorogênicos, açúcares e ácidos carboxílicos formados da fermentação. Cafés Arábica torrados também são discriminados com eficiência. No modo negativo, são importantes os íons correspondentes aos ácidos clorogênicos e ácidos orgânicos de cadeia curta, derivados de açúcares. No modo positivo, a discriminação é realizada por íons de baixa m/z tais como piridina e alquil piridinas protonadas, formadas através da degradação da trigonelina. Ambos os IES(+)-EM e IES(-)-EM são capazes de discriminar diferentes cafés Arábica torrados classificados por prova de xícara e os íons que permitem esta diferenciação são os mesmos descritos para a maturidade e processos pós-colheita.313321Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

A relação entre a apneia do sono e doenças cardiovasculares / The relation between sleep apnea and cardiovascular diseases

INTRODUÇÃO: A apneia do sono ocorre devido ao colabamento das vias aéreas superiores e possui importante associação a doenças cardiovasculares. METODOLOGIA: Trata-se de uma revisão literária realizada por meio de pesquisa na base de dados PubMed, tendo como descritores "sleep apnea syndromes" e "cardiovascular diseases" e publicações nos idiomas inglês e português com disponibilização do texto completo. RESULTADOS: Os estudos ocorreram entre os anos de 2016 e 2020, sendo 2019 o ano de maior índice. Todos os trabalhos são estudos de revisão e dentre os 24 artigos selecionados, 7 foram fundamentais para execução desta pesquisa e destacaram-se como principais referenciais teóricos. DISCUSSÃO: A apneia do sono é uma condição que provoca alterações na fisiologia respiratória, e isso pode acarretar em consequências cardiovasculares. Indivíduos com apneia do sono estão predispostos a diversas afecções cardiovasculares como: hipertensão arterial sistêmica, fibrilação atrial, morte súbita, doença coronariana e consequentemente insuficiência cardíaca, e isso pode ser explicado por diversos mecanismos. CONCLUSÃO: Os estudos mostraram que existe uma intensa correlação entre a apneia do sono e patologias cardiovasculares, que é explicada por alguns eventos que ocorrem no nosso corpo e geram um processo de remodelação da atividade elétrica do coração e também uma remodelação estrutural

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Caracterização espectral de estágios sucessionais de vegetação secundária arbórea em Altamira (PA), através de dados orbitais Spectral characterization of successional stages of vegetation in Altamira (PA), Brazil using orbital radiometric data

Imagens TM/Landsat 5 (bandas TM1-TM5 e TM7) de Altamira, PA, de 07.02.1991 foram transformadas em reflectância de superfície usando o modelo 6S de correção atmosférica com o objetivo de caracterizar espectralmente formações florestais secundárias. Dados biofísicos (DAP, G e H) foram coletados de 16 parcelas em campo, os quais foram utilizados no cálculo da área basal total (GT) e da rugosidade do dossel (Rug) e no estabelecimento de correlações entre os valores de reflectância de superfície dessas mesmas parcelas. Os coeficientes de correlação mais elevados foram verificados nas relações com a banda TM7. Regressões lineares foram estabelecidas tendo como variável dependente os parâmetros biofísicos e como variável independente, os valores de reflectância de superfície da banda TM7, a partir das quais foram elaborados mapas temáticos representativos da distribuição espacial dos parâmetros biofísicos. A reflectância de superfície não foi sensível a valores pequenos de dados biofísicos. Apesar disso, a metodologia aqui empregada mostrou-se eficaz para estimativas remotas de dados dendrométricos.Landsat 5 TM images (TM1 to TM5 and TM7 spectral bands) from Altamira PA (Brazil) for 02.07.1991, were transformed into surface reflectance images by the 6S atmospheric correction code in order to characterize spectrally secondary succession stages of vegetation. Biophysical data (ADBH, ABA, TBA, THS and THSTD) collected in the field from 16 sampled vegetation plots were utilized in a correlation study between them and the surface reflectance values extracted from the orbital images. The highest correlation coefficients were found for the TM7 spectral band. Linear regression models were determined for each biophysical parameter considered and thematic images representing the spatial distribution of these parameters were made. The spectral data were not sensitive for detecting lower biophysical parameter values. Nevertheless, the results show that there was a good match between that spatial distribution and the study area landscape, indicating that these thematic images could be utilized in preliminary evaluations of the vegetation's biophysical characteristics