Evidências de validade da versão brasileira do questionário das cinco facetas de mindfulness (FFMQ-BR)

In order to assess the psychometric properties of the Brazilian version of the FFMQ, 395 participants divided into smokers, people from the general population, college students, and meditators answered the FFMQ and the Psychological Well-Being Scale (PWBS). An Exploratory Factor Analysis (EFA) was conducted and the reliability was assessed. The FFMQ-BR consists of seven factors and all of them showed good internal consistency. Evidence of the construct and criterion validity was obtained by a significant correlation between the FFMQ-BR scores and well-being and by a significant difference between the scores of the meditators and the other participants on the FFMQ-BR. This study may help in providing subsidies to the progress of research in the topic by examining the empirical relationships between Mindfulness and mental health.Com o objetivo de avaliar as propriedades psicométricas da versão brasileira do FFMQ, 395 participantes divididos entre tabagistas, comunidade geral, universitários e meditadores responderam ao FFMQ e à Escala de Bem-Estar Subjetivo (EBES). Foi realizada uma Análise Fatorial Exploratória (AFE) e a avaliação da fidedignidade. O FFMQ-BR foi composto por sete facetas e todas obtiveram valores adequados de consistência interna. Comprovou-se a validade de construto e de critério através da correlação entre os escores do FFMQ-BR e a EBES e da diferença entre os escores dos meditadores e dos demais participantes no FFMQ-BR, respectivamente. Estes resultados podem fornecer subsídios para o avanço das pesquisas nessa área através da avaliação enpírica de relações entre mindfulness e saúde mental.Universidade Federal de Juiz de ForaHospital Israelita Albert EinsteinUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Prevenção do uso de álcool na atenção primária em municípios do estado de Minas Gerais

OBJECTIVE: To evaluate the effectiveness of implementing screening strategies associated with brief interventions for prevention of alcohol abuse, within primary healthcare. METHODS: This evaluation study was conducted among 113 primary healthcare professionals and managers in three municipalities in the Zona da Mata of Minas Gerais, Southeastern Brazil, in 2007. The health professionals participated in a training to perform screening associated with brief interventions for alcohol use prevention. Six months after this training, a follow-up evaluation was carried out. The qualitative assessment involved participant observation, interviews with managers before the training and during the follow-up, and focus groups with healthcare professionals during the follow-up. The content analysis technique was applied. The following instruments were used for the quantitative assessment: Objective Knowledge Questionnaire, Moralization Scale for Alcohol Use, Perception Model for Alcohol Use Questionnaire and Preventive Practices for Alcohol Use Questionnaire. The municipalities were compared before the training and during the follow-up, and longitudinal evaluations were performed in each municipality, using descriptive and inferential statistics. RESULTS: Participation by the managers and integration among the health professionals regarding the practices of screening and brief intervention were associated with greater effectiveness of implementation. This occurred in one of the municipalities, in which there was a signifi cant decrease in the degree to which alcohol use was moralized by the healthcare professionals, in comparison with the other municipalities. In the other municipalities, the effects of the implementation process for the project indicated that the frequency of performing preventive practices against alcohol use increased, along with the health professionals’ knowledge, although not enough to indicate effective implementation. CONCLUSIONS: Effectiveness in implementing alcohol prevention strategies in primary healthcare services is associated with managers’ engagement in the implementation process for these strategies.OBJETIVO: Avaliar a efetividade da implementação de estratégias de triagem associadas às intervenções breves para prevenção do uso abusivo de álcool na atenção primária à saúde. MÉTODOS: Estudo avaliativo com 113 profissionais e gestores da atenção primária em três municípios da Zona da Mata de Minas Gerais em 2007. Os profissionais de saúde participaram de uma capacitação para a prática de triagem associada às intervenções breves para prevenção do uso de álcool. Seis meses após esta capacitação procedeu-se a avaliação de seguimento. A avaliação qualitativa envolveu observação participante, entrevistas com gestores na pré-capacitação e no seguimento, e grupos focais com profissionais de saúde no seguimento. Foi aplicada a técnica de análise de conteúdo. Para avaliação quantitativa foram utilizados os instrumentos: Questionário de Conhecimento Objetivo, Escala de Moralização do Uso de Álcool, Questionário de Modelo de Percepção do Uso de Álcool e Questionário de Práticas de Prevenção do Uso de Álcool. Foi realizada uma comparação entre municípios na pré-capacitação e no seguimento e uma avaliação longitudinal em cada município, por meio de estatísticas descritivas e inferenciais. RESULTADOS: A participação dos gestores e a integração entre os profissionais de saúde para a prática da triagem e intervenção breve estiveram associadas à maior efetividade da implementação. Tais fatores ocorreram em um dos municípios, no qual houve diminuição significativa do grau de moralização do uso de álcool pelos profissionais de saúde em comparação aos outros municípios. Nos outros municípios, os efeitos do processo de implementação do projeto indicaram aumento na freqüência da realização das práticas de prevenção ao uso de álcool e no conhecimento dos profissionais de saúde em relação a tais práticas, embora não o suficiente para indicar uma implementação efetiva. CONCLUSÕES: A efetividade da implementação das estratégias de prevenção ao uso de álcool em serviços de atenção primária à saúde está associada ao engajamento dos gestores no processo de implementação de tais estratégias

Prevenção do uso de álcool na atenção primária em municípios do estado de Minas Gerais

OBJETIVO: Evaluar la efectividad de la implementación de estrategias de tamizage asociadas a las intervenciones breves para prevención del uso abusivo de alcohol en la atención primaria a la salud. MÉTODOS: Estudio evaluativo con 113 profesionales y gestores de la atención primaria en tres municipios de la Zona da Mata de Minas Gerais (Sureste de Brasil) en 2007. Los profesionales de salud participaron de una capacitación para la práctica de tamizage asociada a las intervenciones breves para prevención del uso de alcohol. Seis meses posteriores a esta capacitación se procedió a evaluación de seguimiento. La evaluación cualitativa envolvió observación participante, entrevistas con gestores en la pre-capacitación y en el seguimiento, y grupos focales con profesionales de salud en el seguimiento. Fue aplicada la técnica de análisis de contenido. Para evaluación cuantitativa fueron utilizados los instrumentos: Cuestionario de Conocimiento Objetivo, Escala de Moralización del Uso de Alcohol, Cuestionario de Modelo de Percepción del Uso de Alcohol e Cuestionario de Prácticas de Prevención del Uso de Alcohol. Fue realizada una comparación entre municipios previo a la capacitación y en el seguimiento y una evaluación longitudinal en cada municipio, por medio de estadísticas descriptivas e inferenciales. RESULTADOS: La participación de los gestores y la integración entre los profesionales de salud para la práctica de la tamizage e intervención breve estuvieron asociadas a la mayor efectividad de la implementación. Tales factores ocurrieron en uno de los municipios, donde hube reducción no significativa del grado de moralización del uso de alcohol por los profesionales de salud en comparación con los otros municipios. En los otros municipios, los efectos del proceso de implementación del proyecto indicaron aumento en la frecuencia de la realización de las prácticas de prevención al uso de alcohol y en el conocimiento de los profesionales de salud en relación a tales prácticas, a pesar de no ser suficiente para indicar una implementación efectiva. CONCLUSIONES: La efectividad de la implementación de estrategias de prevención al uso de alcohol en servicios de atención primaria a la salud está asociada al compromiso de los gestores en el proceso de implementación de tales estrategias.OBJETIVO: Avaliar a efetividade da implementação de estratégias de triagem associadas às intervenções breves para prevenção do uso abusivo de álcool na atenção primária à saúde. MÉTODOS: Estudo avaliativo com 113 profissionais e gestores da atenção primária em três municípios da Zona da Mata de Minas Gerais em 2007. Os profissionais de saúde participaram de uma capacitação para a prática de triagem associada às intervenções breves para prevenção do uso de álcool. Seis meses após esta capacitação procedeu-se a avaliação de seguimento. A avaliação qualitativa envolveu observação participante, entrevistas com gestores na pré-capacitação e no seguimento, e grupos focais com profissionais de saúde no seguimento. Foi aplicada a técnica de análise de conteúdo. Para avaliação quantitativa foram utilizados os instrumentos: Questionário de Conhecimento Objetivo, Escala de Moralização do Uso de Álcool, Questionário de Modelo de Percepção do Uso de Álcool e Questionário de Práticas de Prevenção do Uso de Álcool. Foi realizada uma comparação entre municípios na pré-capacitação e no seguimento e uma avaliação longitudinal em cada município, por meio de estatísticas descritivas e inferenciais. RESULTADOS: A participação dos gestores e a integração entre os profissionais de saúde para a prática da triagem e intervenção breve estiveram associadas à maior efetividade da implementação. Tais fatores ocorreram em um dos municípios, no qual houve diminuição significativa do grau de moralização do uso de álcool pelos profissionais de saúde em comparação aos outros municípios. Nos outros municípios, os efeitos do processo de implementação do projeto indicaram aumento na freqüência da realização das práticas de prevenção ao uso de álcool e no conhecimento dos profissionais de saúde em relação a tais práticas, embora não o suficiente para indicar uma implementação efetiva. CONCLUSÕES: A efetividade da implementação das estratégias de prevenção ao uso de álcool em serviços de atenção primária à saúde está associada ao engajamento dos gestores no processo de implementação de tais estratégias.OBJECTIVE: To evaluate the effectiveness of implementing screening strategies associated with brief interventions for prevention of alcohol abuse, within primary healthcare. METHODS: This evaluation study was conducted among 113 primary healthcare professionals and managers in three municipalities in the Zona da Mata of Minas Gerais, Southeastern Brazil, in 2007. The health professionals participated in a training to perform screening associated with brief interventions for alcohol use prevention. Six months after this training, a follow-up evaluation was carried out. The qualitative assessment involved participant observation, interviews with managers before the training and during the follow-up, and focus groups with healthcare professionals during the follow-up. The content analysis technique was applied. The following instruments were used for the quantitative assessment: Objective Knowledge Questionnaire, Moralization Scale for Alcohol Use, Perception Model for Alcohol Use Questionnaire and Preventive Practices for Alcohol Use Questionnaire. The municipalities were compared before the training and during the follow-up, and longitudinal evaluations were performed in each municipality, using descriptive and inferential statistics. RESULTS: Participation by the managers and integration among the health professionals regarding the practices of screening and brief intervention were associated with greater effectiveness of implementation. This occurred in one of the municipalities, in which there was a significant decrease in the degree to which alcohol use was moralized by the healthcare professionals, in comparison with the other municipalities. In the other municipalities, the effects of the implementation process for the project indicated that the frequency of performing preventive practices against alcohol use increased, along with the health professionals' knowledge, although not enough to indicate effective implementation. CONCLUSIONS: Effectiveness in implementing alcohol prevention strategies in primary healthcare services is associated with managers' engagement in the implementation process for these strategies

Suporte online para parar de fumar

OBJECTIVES: Estimate the frequency of online searches on the topic of smoking and analyze the quality of online resources available to smokers interested in giving up smoking.METHODS: Search engines were used to revise searches and online resources related to stopping smoking in Brazil in 2010. The number of searches was determined using analytical tools available on Google Ads; the number and type of sites were determined by replicating the search patterns of internet users. The sites were classified according to content (advertising, library of articles and other). The quality of the sites was analyzed using the Smoking Treatment Scale-Content (STS-C) and the Smoking Treatment Scale - Rating (STS-R).RESULTS: A total of 642,446 searches was carried out. Around a third of the 113 sites encountered were of the 'library' type, i.e. they only contained articles, followed by sites containing clinical advertising (18.6) and professional education (10.6). Thirteen of the sites offered advice on quitting directed at smokers. The majority of the sites did not contain evidence-based information, were not interactive and did not have the possibility of communicating with users after the first contact. Other limitations we came across were a lack of financial disclosure as well as no guarantee of privacy concerning information obtained and no distinction made between editorial content and advertisements.CONCLUSIONS: There is a disparity between the high demand for online support in giving up smoking and the scarcity of quality online resources for smokers. It is necessary to develop interactive, customized online resources based on evidence and random clinical testing in order to improve the support available to Brazilian smokers.Univ Washington, ADAI, Seattle, WA 98105 USAUniv Fed Juiz de Fora, Dept Psicol, Juiz De Fora, MG, BrazilUniv Fed Juiz de Fora, Inst Ciencias Humanas, Ctr Pesquisa Intervencao & Avaliacao Alcool & Out, Juiz De Fora, MG, BrazilUniv Fed Sao Paulo, Programa Posgrad Psicobiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Programa Posgrad Psicobiol, Sao Paulo, BrazilWeb of Scienc

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly