Portuguese version of the clinical effectiveness and evidence based practice questionnaire

Describe the process of translation and linguistic validation and cultural context for the Portuguese Questionnaire Clinical Effectiveness and Evidence-Based Practice (EBPQ) originally developed by Upton & Upton (2006)

Portuguese version of the evidence-based practice questionnaire

1. Objectives: Evidence-based practice is defined as the process by which nurses make clinical decisions using the best available scientific evidence, according with their clinical experience and patient preferences in the context of available resources. The Evidence-Based Practice Questionnaire (EBPQ) developed by Upton & Upton (2006) was designed to collect information and opinions on the use of evidence-based practices by health professionals and is validating its important so that it can be utilized in a generalized mode. Its application is now currently and several versions are available in most common languages. This study aims to present and describe the exploratory process of linguistic and cultural validation for the Portuguese population of the EBPQ, including the review of its psychometric properties. 2. Methods: We developed a cross-sectional study. For linguistic and cultural adaptation was made a translation and a retroversion according to the usual standards. To determining the psychometric characteristics of EBPQ we used the Principal Component Analysis with orthogonal Varimax rotation method. Internal consistency was assessed by Cronbach’s alpha value. The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 22.0, and data collection occurred between December 2013 and February 2014. 3. Results: 358 subjects participated, nurses to exercise clinical practice at an Academic Hospital Centre, corresponding to a response rate of 36 %. The majority were female (76.5 %) and the predominant age group 30-39 years (47.2 %). The version in this study had 24 items and three subscales: Practices (Cronbach’s alpha = 0.84); Attitudes (Cronbach’s alpha = 0.75); Knowledge / Skills and Competencies (Cronbach’s alpha = 0.95) and has an overall internal consistency of Cronbach’s alpha = 0.839. The principal components analysis suggests five dimensions that explain 65.78% of total variance, however, forcing the three dimensions, in line with the authors proposal at the original questionnaire and rejecting one item for presenting an anomalous behaviour of overlap in components 1 and 2, we obtain a final value of Cronbach’s alpha = 0.74 in this case being explained 55.86% of the total variance. 4. Discussion: The analysis showed empirical evidence that the Portuguese version of the questionnaire is valid and suitable for use in the context studied. This being an exploratory approach, it is expected a further refinement of the analysis in order to obtain and present a definitive final version of EBPQ allowing systematized use and dissemination. This will be important by allowing nurses and other health care team responsible to identify several skills/competences, attitudes and practices to be developed for the implementation of evidence-based nursing

Validação da versão portuguesa do questionário de eficácia clínica e prática baseada em evidências

Introduction: Currently, the importance of a clinical practice based on the best available evidence justifies the development of investigation to construct a situational diagnosis that allows to identify in different contexts of care, barriers, attitudes and practices towards an evidence-based nursing. Objective: In this investigation we aim to identify barriers regarding the adoption of an Evidence Based Practice (EBP) in different care settings and describe the main nurse’s attitudes and practices in relation to PBE. Method: We developed a cross-sectional study in a local health unit in the north of Portugal including nurses working in a hospital and in several primary health care settings. Data collection occurred in two distinct stages: between December 2010 and March 2011 and between March and July 2012 Through a convenience sample we applied the Portuguese version of the "Attitudes Towards Evidence-Based Practice Questionnaire " to 345 participants, the rate of response of 70.7% (n = 244). We proceed to univariate and descriptive statistics and performed the t Student and the chi-square (χ2) tests. Results: Nurses demonstrated a positive belief in supporting practices based on research, believing that this will contribute for a better future professional development. Comparing the studied settings we globally verified a favourable perspective for the adoption of an EBP existing however facilitators whose mean is highest in the hospital context. Conclusion: It has been noted the need for additional support regarding the adoption of EBP. Therefore is essential an integrated policy to streamline clinical research involving the active participation both of the clinical practice nurses and academic institutions

Validação da versão portuguesa do Questionário de Eficácia Clínica e Prática Baseada em Evidências

Objetivos: descrever o processo de tradução e validação linguística e cultural para o contexto português do Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). Método: desenvolveu-se um estudo metodológico e transversal. Foi efetuada tradução e retroversão, de acordo com os padrões usuais. Na determinação das características psicométricas do QECPBE utilizou-se a Análise de Componentes Principais com rotação ortogonal, segundo o método Varimax, seguida de análise fatorial confirmatória. A consistência interna foi determinada pelo valor alfa de Cronbach. A coleta de dados ocorreu entre dezembro de 2013 e fevereiro de 2014. Resultados: participaram 358 enfermeiros que exercem a prática clínica num centro hospitalar do norte de Portugal. O QECPBE apresenta 20 itens e três subescalas: Práticas (α=0,74); Atitudes (α=0,75); Conhecimentos/Habilidades e Competências (α=0,95), apresentando consistência interna global de α=0,74. No modelo testado obteve-se variância explicada de 55,86%. O modelo demonstrou um bom ajuste: χ2(167)=520,009; p=0,0001; χ2df=3,114; CFI=0,908; GFI=0,865; PCFI=0,798; PGFI=0,678; RMSEA=0,077 (IC90%=0,07-0,08). Conclusão: através da análise fatorial confirmatória realizada demonstrou-se que o questionário é válido e adequado para utilização no contexto estudado.info:eu-repo/semantics/publishedVersio

Innovation for resilience

Last decade is characterized by different types of crises and shocs in the socioeconomic systems, creating a turbulent context and calling for a better understanding of what the dynamic perspective of change is. For countries, regions and cities a better understanding of governance urges and calls for action

Independent association of the variant rs1333049 at the 9p21 locus and coronary heart disease

Introdução: Estudos recentes de associação genómica em larga escala (GWAS) identificaram vários polimorfismos de um único nucleótido (SNP), localizados no locus 9p21, associados com doença arterial coronária (DAC). De entre eles o SNP rs1333049 demonstrou uma associação consistente com a DAC tendo sido reproduzida, com sucesso, em várias populações. Objectivo: Investigar se a nova variante rs1333049, no cromossoma 9p21, é um factor de risco independente para DAC, na população Portuguesa. Material e métodos: Estudo caso-controlo, que incluiu 1406 indivíduos, 723 doentes coronários internados consecutivamente (idade média de 53,7±8,9 anos 79,9% do sexo masculino) e 683 controlos sem doença coronária (idade média de 53,3±10,5 anos, 73,9 % do sexo masculino) seleccionados para não serem significativamente diferentes quanto ao sexo e idade. Estudou-se o SNP rs1333049, em todos os indivíduos, com recurso à técnica convencionada de PCR combinada com a técnica TaqMan (Applied Biosystems). Determinou-se a distribuição alélica e genotípica (C/G), odds ratio e respectivo intervalo de confiança para risco de DAC. Foi construído um modelo de regressão logística forward wald ajustado para a idade, sexo, factores de risco convencionais, marcadores bioquímicos e genótipos em estudo, afim de avaliar quais as variáveis associadas de forma significativa e independente com DAC. Resultados: 60% dos doentes coronários e 53% dos controlos apresentaram o alelo C (OR=1,33; p=0,0002), 35,7% dos doentes e 29,3% dos controlos tinham o genótipo homozigoto CC (OR=1,34;p=0,010). O heterozigoto CG estava presente em 48,1% dos doentes e 47% nos controlos, não atingindo significância estatística, para risco vascular (OR=1,05;p=0,670). Após análise multivariada de regressão logística o genótipo CC do cromossoma 9p21 ficou na equação com um OR=1,7, p=0,018 e o genótipo heterozigoto CG com um OR=1,5, p=0,048. Conclusão: Com o presente trabalho replicou-se, numa população portuguesa, o risco coronário ligado à nova variante rs1333049 do cromossoma 9p21. A robustez deste genótipo, tanto em homo como em heterozigotia, tem sido consistente e relevante na estratificação de risco para a DAC, mesmo em contextos populacionais muito diversos. Nestas circunstâncias, a utilização do genótipo CC ou CG poderá vir a revelar-se útil para a previsão do risco de DAC na nossa população.Introduction: Recent genome-wide association studies have identified single-nucleotide polymorphisms (SNPs) at the 9p21 locus as risk factors for coronary artery disease (CAD). Among them, the SNP rs1333049 has demonstrated a consistent association with CAD, which has been successfully replicated in several populations. Aim: To investigate whether the SNP rs1333049 located on the 9p21 chromosome is an independent risk factor for CAD in a Portuguese population. Methods: We performed a case-control study which included 1406 individuals, 723 consecutive coronary patients (mean age 53.7±8.9 years, 79.9% male) and 683 controls without coronary disease (mean age 53.3±10.5 years, 73.9% male). Cases and controls were selected so as not to be significantly different in terms of gender and age. We studied the SNP rs1333049 at the 9p21 locus in all individuals, using standard PCR combined with the TaqMan technique (Applied Biosystems). The allelic and genotype distribution (C/G), odds ratios and corresponding confidence intervals for CAD risk were determined. A forward Wald logistic regression analysis model was constructed, adjusted for age, gender, conventional risk factors, biochemical markers and the genotypes under study, in order to determine which variables were linked significantly and independently with CAD. Results: The C allele was found in 60% of the CAD patients and 53% of the controls, with OR=1.33; p=0.0002. The CC genotype appeared in 35.7% of CAD patients, with OR=1.34, p=0.010. The heterozygous CG genotype was present in 48.1% of the CAD patients and 47% of the controls, and did not present vascular risk (OR=1.05, p=0.670). After logistic regression analysis, the CC genotype remained in the equation with OR=1.7; p=0.018 and CG with OR=1.5, p=0.048. Conclusion: In the present study we replicated the coronary risk linked to the recently discovered variant rs1333049 on the 9p21 chromosome in a Portuguese population. Although the mechanism underlying the risk is still unknown, the robustness of this risk allele in risk stratification for CAD has been consistent, even in very different populations. The presence of the CC or CG genotype may thus prove to be useful for predicting the risk of developing CAD in the Portuguese population.info:eu-repo/semantics/publishedVersio

Validación de la versión portuguesa del Cuestionario de Eficacia Clínica y Práctica Basada en Evidencias

OBJETIVOS: descrever o processo de tradução e validação linguística e cultural para o contexto português do Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). MÉTODO: desenvolveu-se um estudo metodológico e transversal. Foi efetuada tradução e retroversão, de acordo com os padrões usuais. Na determinação das características psicométricas do QECPBE utilizou-se a Análise de Componentes Principais com rotação ortogonal, segundo o método Varimax, seguida de análise fatorial confirmatória. A consistência interna foi determinada pelo valor alfa de Cronbach. A coleta de dados ocorreu entre dezembro de 2013 e fevereiro de 2014. RESULTADOS: participaram 358 enfermeiros que exercem a prática clínica num centro hospitalar do norte de Portugal. O QECPBE apresenta 20 itens e três subescalas: Práticas (α=0,74); Atitudes (α=0,75); Conhecimentos/Habilidades e Competências (α=0,95), apresentando consistência interna global de α=0,74. No modelo testado obteve-se variância explicada de 55,86%. O modelo demonstrou um bom ajuste: χ2(167)=520,009; p=0,0001; χ2df=3,114; CFI=0,908; GFI=0,865; PCFI=0,798; PGFI=0,678; RMSEA=0,077 (IC90%=0,07-0,08). CONCLUSÃO: através da análise fatorial confirmatória realizada demonstrou-se que o questionário é válido e adequado para utilização no contexto estudado.OBJETIVOS: describir el proceso de traducción y validación lingüística y cultural para el contexto portugués del Cuestionario de Eficacia Clínica y Práctica Basada en Evidencias (CECPBE). MÉTODO: se desarrolló un estudio metodológico y transversal. Fue efectuada traducción y retroversión de acuerdo con los estándares usuales. En la determinación de las características psicométricas del CECPBE se utilizó el Análisis de Componentes Principales con rotación ortogonal, según el método Varimax, seguido por análisis factorial confirmatorio. La consistencia interna fue determinada por el valor alfa de Cronbach. La recolección de datos ocurrió entre diciembre de 2013 y febrero de 2014. RESULTADOS: participaron 358 enfermeros que ejercían la práctica clínica en un centro hospitalario en el norte de Portugal. El CECPBE presenta 20 ítems y tres subescalas: Prácticas (α=0,74); Actitudes (α=0,75); Conocimientos/Habilidades y Competencias (α=0,95), presentando consistencia interna global de α=0,74. En el modelo probado se obtuvo variancia explicada de 55,86%. El modelo demostró un buen ajuste: χ2(167)=520,009; p=0,0001; χ2df=3,114; CFI=0,908; GFI=0,865; PCFI=0,798; PGFI = 0,678; RMSEA = 0,077 (IC90%=0,07-0,08). CONCLUSIÓN: a través del análisis factorial confirmatorio se demostró que el cuestionario es válido y adecuado para utilización en el contexto estudiado.OBJECTIVES: to describe the process of translation and linguistic and cultural validation of the Evidence Based Practice Questionnaire for the Portuguese context: Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). METHOD: a methodological and cross-sectional study was developed. The translation and back translation was performed according to traditional standards. Principal Components Analysis with orthogonal rotation according to the Varimax method was used to verify the QECPBE's psychometric characteristics, followed by confirmatory factor analysis. Internal consistency was determined by Cronbach's alpha. Data were collected between December 2013 and February 2014. RESULTS: 358 nurses delivering care in a hospital facility in North of Portugal participated in the study. QECPBE contains 20 items and three subscales: Practice (α=0.74); Attitudes (α=0.75); Knowledge/Skills and Competencies (α=0.95), presenting an overall internal consistency of α=0.74. The tested model explained 55.86% of the variance and presented good fit: χ2(167)=520.009; p = 0.0001; χ2df=3.114; CFI=0.908; GFI=0.865; PCFI=0.798; PGFI=0.678; RMSEA=0.077 (CI90%=0.07-0.08). CONCLUSION: confirmatory factor analysis revealed the questionnaire is valid and appropriate to be used in the studied context

In vitro digestion and stability assessment of b-lactoglobulin/riboflavin nanostructures

B-Lactoglobulin (b-Lg) is the major protein fraction of bovine whey serum and a primary gelling agent. b-Lg has a high nutritional value, is stable at low pH being highly resistant to proteolytic degradation in the stomach, besides, it has the ability of acting as an encapsulating agent. This study aims at assessing the ability of b-Lg nanostructures to associate a nutraceutical - i.e. riboflavin - and release it in a controlled manner throughout an in vitro gastrointestinal (GI) system. For this reason b-Lg nanostructures loaded with riboflavin were critically characterized in terms of their morphology (i.e. size, polydispersity, -potential and shape) by dynamic light scattering (DLS) and transmission electron microscopy (TEM), and efficiency to associate to riboflavin through spectrofluorimetry. Furthermore, these nanocomplexes were evaluated in an in vitro GI model, simulating the physiological conditions. Stable b-Lg nanostructures were obtained at pH 6, of spherical shape, characterized by particle size of 172±1 nm, low polydispersity (i.e. PDI of 0.06±0.02), -potential of -32±3 mV and association efficiency (AE) of 26±1 %. b-Lg nanostructures showed to be stable upon their passage throughout stomach (i.e. particle size, PDI and potential of 248±10 nm, 0.18±0.03 and 18±3 mV, respectively). Concerning their passage throughout the intestine, such nanostructures were mostly degraded in the duodenum. Regarding riboflavin, a release of about 11 % was observed after their passage through stomach, while 35 %, 38 % and 5 % were the released percentages of the total riboflavin associated observed after passage through duodenum, jejunum and ileum, respectively. Hence,b-Lg nanostructures showed to be suitable carriers for riboflavin until the intestine, where their degradation occurs. b-Lg also showed to be structurally stable, under food simulant conditions (yoghurt simulant, composed of 3 % acetic acid), over 14 days, with a protective effect upon riboflavin activity, releasing it in a 7 day period.Oscar L. Ramos, Ricardo N. Pereira and Ana C. Pinheiro gratefully acknowledge their Post-Doctoral grants (SFRH/BPD/80766/2011, SFRH/BPD/81887/2011 and SFRH/BPD/101181/2014, respectively) and Ana I. Bourbon gratefully acknowledge her Doctoral grant (SFRH/BD/73178/2010) to Fundacao para a Ciencia e a Tecnologia (FCT). The authors would like to acknowledge to Francisco Figueiredo from the Institute for Molecular and Cell Biology (IBMC), University of Porto, for assistance in taking the TEM pictures. The authors thank the FCT Strategic Project of UID/BIO/04469/2013 unit, COMPETE 2020 (POCI-01-0145-FEDER-006684), the project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462), and the project "BioInd e Biotechnology and Bioengineering for improved Industrial and Agro-Food processes", REF. NORTE-07-0124-FEDER-000028, co-funded by the Programa Operacional Regional do Norte (ON. 2 - O Novo Norte), QREN, FEDER