Psychometric Properties of the Brazilian Version of the Quality of Dying and Death for Adult Family Members of ICU Patients

Death is a complex, subjective phenomenon that requires an understanding of experiences to be qualified to provide care during the end-of-life process. This study aimed to analyze the psychometric properties of the Portuguese version (Brazil) of the Quality of Dying and Death (QODD) scale on family members of patients who died in adult intensive care units. A methodological study was conducted with 326 family members of patients that died in three ICUs of public hospitals in the state of São Paulo, Brazil. For this study, the QODD 3.2a (25 items and six domains) was administered during the period from December 2020 to March 2022. The analysis was performed using the classic theory of the tests and the goodness of fit of the model was tested using confirmatory factor analysis. We have used Spearman's correlation coefficients between the scores of the overall scale and domains. Cronbach's alpha coefficient and the intraclass correlation coefficient (ICC) were used for the evaluation of internal consistency and temporal stability, respectively. The Horn's parallel analysis indicated two factors that were not confirmed in the exploratory factor analysis. A single factor retained 18 of the initial 25 items and the analysis of the goodness of fit to the unidimensional model resulted in the following: CFI = 0.7545, TLI = 0.690, chi-squared = 767.33, df = 135, RMSEA = 0.121 with 90%CI, and p = 5.04409. The inter-item correlations indicated a predominance of weak correlations among the items of the instrument. The items with the largest number of moderate correlations were questions 13b, 9b, and 10b and a strong correlation was found between questions 15b and 16b. Cronbach's alpha coefficient was 0.8 and the ICC was 0.9. The Quality of Dying and Death-Version 3.2a (intensive therapy) in Brazilian Portuguese has a unidimensional structure and acceptable reliability. However, it did not obtain a good fit to the proposed factorial model

Genetic programs controlling cortical interneuron fate.

The origins of cortical interneurons in rodents have been localized to the embryonic subcortical telencephalon where distinct neuroepithelial precursors generate defined interneuron subsets. A swathe of research activity aimed at identifying molecular determinants of subtype identity has uncovered a number of transcription factors that function at different stages of interneuron development. Pathways that lead to the acquisition of mature interneuron traits are therefore beginning to emerge. As genetic programs are influenced by external factors the search continues not only into genetic determinants but also extrinsic influences and the interplay between the two in cell fate specification

Exploring the physiological role of transthyretin in glucose metabolism in the liver

Transthyretin (TTR), a 55 kDa evolutionarily conserved protein, presents altered levels in several conditions, including malnutrition, inflammation, diabetes, and Alzheimer’s Disease. It has been shown that TTR is involved in several functions, such as insulin release from pancreatic ß-cells, recovery of blood glucose and glucagon levels of the islets of Langerhans, food intake, and body weight. Here, the role of TTR in hepatic glucose metabolism was explored by studying the levels of glucose in mice with different TTR genetic backgrounds, namely with two copies of the TTR gene, TTR+/+; with only one copy, TTR+/-; and without TTR, TTR-/-. Results showed that TTR haploinsufficiency (TTR+/-) leads to higher glucose in both plasma and in primary hepatocyte culture media and lower expression of the influx glucose transporters, GLUT1, GLUT3, and GLUT4. Further, we showed that TTR haploinsufficiency decreases pyruvate kinase M type (PKM) levels in mice livers, by qRT-PCR, but it does not affect the hepatic production of the studied metabolites, as determined by 1H NMR. Finally, we demonstrated that TTR increases mitochondrial density in HepG2 cells and that TTR insufficiency triggers a higher degree of oxidative phosphorylation in the liver. Altogether, these results indicate that TTR contributes to the homeostasis of glucose by regulating the levels of glucose transporters and PKM enzyme and by protecting against mitochondrial oxidative stress.This work was supported by Norte-01-0145-FEDER-000008-Porto Neurosciences and Neurologic Disease Research Initiative at I3S, and Pest-OE/SAU/UI0215/2014 at UMIB, supported by Norte Portugal Regional Operational Programme (NORTE2020), under the PORTUGAL 2020 Partnership Agreement, by COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, through the European Regional Development Fund (FEDER), by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274), and by a grant from Fundação Millennium bcp. Alemi M was a recipient of fellowship by Norte-01-0145-FEDER-000008. Oliveira  was a recipient of fellowship by Norte-01-0145-FEDER-000008. Cardoso I, Oliveira PF, and Alves MG work under the Investigator FCT Program, which is financed by national funds through the Foundation for Science and Technology and co-financed by the European Social Fund (ESF) through the Human Potential Operational Programme (HPOP), type 4.2—Promotion of Scientific Employment

Subjective social status and mortality: the English Longitudinal Study of Ageing

Self-perceptions of own social position are potentially a key aspect of socioeconomic inequalities in health, but their association with mortality remains poorly understood. We examined whether subjective social status (SSS), a measure of the self-perceived element of social position, was associated with mortality and its role in the associations between objective socioeconomic position (SEP) measures and mortality. We used Cox regression to model the associations between SSS, objective SEP measures and mortality in a sample of 9972 people aged ≥ 50 years from the English Longitudinal Study of Ageing over a 10-year follow-up (2002-2013). Our findings indicate that SSS was associated with all-cause, cardiovascular, cancer and other mortality. A unit decrease in the 10-point continuous SSS measure increased by 24 and 8% the mortality risk of people aged 50-64 and ≥ 65 years, respectively, after adjustment for age, sex and marital status. The respective estimates for cardiovascular mortality were 36 and 11%. Adjustment for all covariates fully explained the association between SSS and cancer mortality, and partially the remaining associations. In people aged 50-64 years, SSS mediated to a varying extent the associations between objective SEP measures and all-cause mortality. In people aged ≥ 65 years, SSS mediated to a lesser extent these associations, and to some extent was associated with mortality independent of objective SEP measures. Nevertheless, in both age groups, wealth partially explained the association between SSS and mortality. In conclusion, SSS is a strong predictor of mortality at older ages, but its role in socioeconomic inequalities in mortality appears to be complex

Physical fights involvement in school setting and adolescents’ behaviours : highlights from health behaviour in school-aged children (HBSC/WHO) - fights in school setting and adolescent’s behaviours

Copyright © 2019 Susana Gaspar et al. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and work is properly cited.Aim: To analyse gender differences and associations regarding physical fights and their relationship with other health compromising behaviours. Methods: Participants consisted of 5,423 Portuguese adolescents in the context of the Health Behaviour in School-aged Children/World Health Organization study. Independent Chi-Square, Independent Sample T-tests were used to analyse the relationship between physical fights involvement and health compromising behaviour. Binary logistic regressions were conducted to analyse the associations between physical fights involvement and variables with statistical significance for at least one gender in preliminary bivariate analysis. Regression analyses were stratified by gender adjusted by age. Result: 21.3% of the adolescents reported at least one fighting episode. 61.1% of fights occurred in school. Students from 6th grade had a higher involvement in fights than 10th grade students. For both genders, fighting occurrence is related to consumptions (alcohol, drugs use), violence (being bullied, being a bully, carrying weapons and safety perception at school). Boys from Alentejo region, 6th grade and who practice physical activity, reported more physical fights involvement. For boys, carrying weapons decreases the probability of fights occurrence in school. Conclusion: This study confirms the impact of physical fighting in Portuguese adolescents and emphasizes that specific strategies to address this physical fighting are important. Public policies must take gender and age specificities into consideration while designing and implementing preventive interventions with pupils and families, in the school and in the community, in order to promote a safer environment at school and an adolescents’ positive development. Active social support from peers, parents, teachers and school staff is needed so that weapons are not used as a way to secure schools’ environment. National strategies and interventions in school context must be prioritized with regional focus in order to address regional specificities.info:eu-repo/semantics/publishedVersio

Immunoprofiling of oral squamous cell carcinomas reveals high p63 and survivin expression

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106715/1/odi12136.pd

Sperm, metabolic memory and echoes from Lamarck

There is a widespread misconception that only maternal variables affect in utero development.Epigenetic markers carried by the spermatozoon are transmitted to the zygote.Sperm-born epigenetic factors influence in utero development, for various generations.Acquired traits of metabolic disease can be inherited by the offspring via the male gamete.Health assessment of future fathers is essential to predict the offspring's health.</ul

Human Papillomavirus in Brazilian women with and without cervical lesions

<p>Abstract</p> <p>Background</p> <p>Human Papillomavirus (HPV) high-risk (HR) types are the causal factor for cervical cancer and premalignant dysplasia. Data on frequency of HPV types provide a basis to design and evaluate HPV prevention programs. Taking into account the heterogeneity of HPV types across and within populations this study aims to access the HPV frequency in Brazilian women.</p> <p>Results</p> <p>We identified 24 different types of HPV, including a <it>Betapapillomavirus </it>and a likely new type, previously reported, from 132 women positive for the virus analysed by Hybrid Capture II assay. These women were infected by a single or multiple HPV types and 142 HPV strains were identified. HR types were found in 75% of women and HPV types 16, 18, 45, 58, and 66 had the highest frequency. Significant differences in frequency of HR HPV types were found for presence of cervical lesions, and for different HPV species and women age.</p> <p>Conclusions</p> <p>Compared with previous studies in Brazil, our data indicated differences in frequency and HPV type diversity, a significant association of other HR-types but HPV16 and 18 and cervical lesions, and a trend for distinct distribution of HPV types by age.</p

Research on classroom practice: A monograph for topic study group 24, ICME 11 - The introductory chapter

published_or_final_versionThe 11th International Congress on Mathematical Education (ICME 11), Monterrey, Mexico, 6-13 July 2008. In Quaderni di Ricerca in Didattica, 2009, n. S4, p. 1-

A switch from high-fat to normal diet does not restore sperm quality but prevents metabolic syndrome

In recent decades, the prevalence of metabolic diseases has concomitantly increased with a decline on fertility rates and sperm quality. High-fat diets (HFD) are seldom considered part of the problem, but the molecular mechanisms underlying its effects on male fertility remain poorly understood. Herein we postulated that HFD alter sperm quality. We evaluated the effects of switching from a HFD to a normal diet in early adulthood on metabolic disease onset, testicular metabolism and sperm quality. Thirty-six male C57BL6/J mice were divided in: a control group fed with standard chow; a group fed with HFD for 200 days; and a group fed with HFD for 60 days and then with standard chow (HFDt). Biometric data and whole-body metabolism were assessed. Epididymal sperm was studied for concentration, motility, viability and morphology. 1H-NMR metabolomics approach was performed on testicular extracts to trace the metabolic changes. Diet switch reduced body weight and fat mass, preventing metabolic syndrome onset. However, sperm viability, motility and morphology were deteriorated by HFD consumption and not restored by diet switch. HFD induced irreversible changes in pyruvate and glutamate metabolism, ethanol degradation and ammonia recycling in testis. Furthermore, HFDt changed purine and cysteine metabolism, urea cycle, and glutathione content. Overall, HFD caused irreversible changes in testicular metabolism even after switching to normal diet. HFD feeding until early adulthood decreases sperm quality, which cannot be restored by diet switch or weight loss, even when development of metabolic syndrome is avoided