Psychometric properties of the DASS-Depression scale among a Brazilian population with chronic pain

Background: Depression is a common contributor to suffering and disability in people with chronic pain. However, the assessment of depression in this population has been hampered by the presence of a number of somatic symptoms that are shared between chronic pain, treatment side-effects and traditional concepts of depression. As a result, the use of depression measures that do not contain somatic items has been encouraged. Objective: This study examined the psychometric properties of the Depression sub-scale of the Depression Anxiety and Stress Scales (DASS) in a Brazilian chronic pain patient population. Method: Data on a number of measures were collected from 348 participants attending pain facilities. Results: Principal components and exploratory factor analyses indicated the presence of only one factor. Item analyses indicated adequate item-scale correlations. The Cronbach alpha was .96, which suggests an excellent internal consistency. Conclusion: The DASS-Depression scale has adequate psychometric properties and its further use with Brazilian chronic pain populations can now be supported. (c) 2008 Elsevier Inc. All rights reserved.

Incidence of Pressure Ulcers in the Institutionalized Elderly

PURPOSE: The aim of this study was to analyze the incidence of pressure ulcers (PUs) in elderly people living in long-term care facilities (LTCFs). DESIGN: We completed a prospective, comparison cohort study. SUBJECTS AND SETTING: Ninety-four persons, 60 years or older, participated in the study. Participants resided in 4 not-for-profit LTCFs in 3 cities in the southern region of the Brazilian state of Minas Gerais. METHODS: Participants underwent complete skin examination and Braden Scale rating every 2 days for 3 months. When a PU was detected, a careful examination was done to assess its stage, location, and size. From this moment on, the patient was included in the incidence rate and was excluded from the study. RESULTS: The incidence rate of PUs was 39.4%; 37 (77.1%) developed a single ulcer. The most common locations were the malleolus (27.1%) and the ischium (25.0%). Stage I PU were most frequent (66.7%). Females (62.8%) and whites (68.19%) prevailed, with an average age of 79.06 +/- 9.6 years. Body mass index was 20.93 +/- 4.9, with a predominance of urinary diseases (58.5%) and use of neuroleptics/psychotropics (52.1%); 28.7% had had a previous ulcer. Gender and the occurrence of a previous ulcer were found to predict the development of PU, based on logistic regression analysis (r(2) = 0.311). CONCLUSIONS: The overall incidence of PU was significant, but the incidence of stage II and higher PUs was less than 12% and no elders had stage III or IV ulcers. Factors associated with PU development include female gender, regular use of neuroleptic or psychotropic medications, and a history of pressure ulceration.

Fatigue in Brazilian cancer patients, caregivers, and nursing students: a psychometric validation study of the Piper Fatigue Scale-Revised

The objective of this study was to validate the Piper Fatigue Scale-Revised (PFS-R) for use in Brazilian culture. Translation of the PFS-R into Portuguese and validity and reliability tests were performed. Convenience samples in Brazil we as follows: 584 cancer patients (mean age 57 +/- 13 years; 51.3% female); 184 caregivers (mean age 50 +/- 12.7 years; 65.8% female); and 189 undergraduate nursing students (mean age 21.6 +/- 2.8 years; 96.2% female); Instruments used were as follows: Brazilian PFS, Beck Depression Inventory (BDI), and Karnofsky Performance Scale (KPS). The 22 items of the Brazilian PFS loaded well (factor loading > 0.35) on three dimensions identified by factor analysis (behavioral, affective, and sensorial-psychological). These dimensions explained 65% of the variance. Internal consistency reliability was very good (Cronbach`s alpha ranged from 0.841 to 0.943 for the total scale and its dimensions). Cancer patients and their caregivers completed the Brazilian PFS twice for test-retest reliability and results showed good stability (Pearson`s r a parts per thousand yenaEuro parts per thousand 0,60, p < 0,001). Correlations among the Brazilian PFS and other scales were significant, in hypothesized directions, and mostly moderate contributing to divergent (Brazilian PFS x KPS) and convergent validity (Brazilian PFS x BDI). Mild, moderate, and severe fatigue in patients were reported by 73 (12.5%), 167 (28.6%), and 83 (14.2%), respectively. Surprisingly, students had the highest mean total fatigue scores; no significant differences were observed between patients and caregivers showing poor discriminant validity. While the Brazilian PFS is a reliable and valid instrument to measure fatigue in Brazilian cancer patients, further work is needed to evaluate the discriminant validity of the scale in Brazil.

Political Systems and the Perspective on Nursing Education during the Spanish Transition (from the Franco Regime to Democracy). A Contribution based on Nursing History

The aim of this study is to describe the changes in nursing education during the process prior to and after the establishment of democracy in Spain. It begins with the hypothesis that differences in social and political organization influenced the way the system of nursing education evolved, keeping it in line with neopositivistic schemes and exclusively technical approaches up until the advent of democracy. The evolution of a specific profile for nursing within the educational system has been shaped by the relationship between the systems of social and political organization in Spain. To examine the insertion of subjects such as the anthropology of healthcare into education programs for Spanish nursing, one must consider the cultural, intercultural and transcultural factors that are key to understanding the changes in nursing education that allowed for the adoption of a holistic approach in the curricula. Until the arrival of democracy in 1977, Spanish nursing education was solely technical in nature and the role of nurses was limited to the tasks and procedures defined by the bureaucratic thinking characteristic of the rational-technological paradigm. Consequently, during the long period prior to democracy, nursing in Spain was under the influence of neopositivistic and technical thinking, which had its effect on educational curricula. The addition of humanities and anthropology to the curricula, which facilitated a holistic approach, occurred once nursing became a field of study at the university level in 1977, a period that coincided with the beginnings of democracy in Spain.

Brazilian registered nurses` perceptions and attitudes towards adverse events in nursing care: a phenomenological study

Aim To describe the perceptions and attitudes of registered nurses (RNs) towards adverse events (AEs) in nursing care. Background The professionals` subjective perspectives should be taken into account for the prevention of AEs in care settings. Method Schutz`s social phenomenology was developed. Interviews were conducted with nine Intensive Care Unit RNs. Results The following five descriptive categories emerged: (1) the occurrence of AEs is inherent to the human condition but provokes a feeling of insecurity, (2) the occurrence of AEs indicates the existence of failures in health care systematization, (3) the professionals` attitudes towards AEs should be permeated by ethical principles; (4) the priority regarding AEs should be the mitigation of harm to patients, and (5) decisions regarding the communication of AEs were determined by the severity of the error. Conclusions The various subjective perspectives related to the occurrence of AEs requires a health care systematization with a focus on prevention. Ethical behaviour is essential for the patients` safety. Implications for nursing management Activities aimed at the prevention of AEs should be integrated jointly with both the professionals and the health care institution. A culture of safety, not punishment, and improvement in the quality of care provided to patients should be priorities.

Pressure Ulcer Knowledge Among Nurses in a Brazilian University Hospital

To facilitate the implementation of evidence-based skin and pressure ulcer (PU) care practices and related staff education programs in a university hospital in Brazil, a cross-sectional study was conducted to evaluate nurses` knowledge about PU prevention, wound assessment, and staging. Of the 141 baccalaureate nurses (BSN) employed by the hospital at the time of the study, 106 consented to participate. Using a Portuguese version of Pieper`s Pressure Ulcer Knowledge Test (PUKT), participants were asked to indicate whether 33 statements about PU prevention and eight about PU assessment and staging were true or false. For the 33 prevention statements, the average number answered correctly was 26.07 (SD 4.93) and for the eight assessment statements the average was 4.59 (SD 1.62). Nurses working on inpatient clinical nursing units had significantly better scores (P = 0.000). Years of nursing experience had a weak and negative correlation with correct PUKT scores (r = -0.21, P = 0.033) as did years of experience working in the university hospital (r = -.179, P <071). Incorrect responses were most common for statements related to patient positioning, massage, PU assessment, and staging definitions. The results of this study confirm that nurses have an overall understanding of PU prevention and assessment principles but important knowledge deficits exist. Focused continuing education efforts are needed to facilitate the implementation of evidence-based care.

Reinterpreting the history of women's judo in Japan

This paper reassesses the role of women in judo in Japan, from its secluded and restricted beginnings in the late nineteenth century to the gradual changes in gender and social paradigms triggered by the influence of Western feminist struggle from the 1960s onwards. Judo has been considered in theory an inclusive martial art because its creator, Jigoro Kano, stressed safety, etiquette and moral teachings irrespective of age, size or gender of its adherents. However, the social and cultural environment in Japan has traditionally discriminated against women both outside and inside the dojo (training place). We treat this issue historically, considering the broader context of the Japanese social, political and cultural developments.

Peak torque and rate of torque development in elderly with and without fall history

Background Falls are one of the greatest concerns among the elderly A number of studies have described peak torque as one of the best fall-related predictor. No studies have comprehensively focused on the rate of torque development of the lower limb muscles among elderly fallers. Then, the aim of this study was to determine the relationship between muscle peak torque and rate of torque development of the lower limb joints in elderly with and without fall history It was also aimed to determine whether these parameters of muscle performance (i e, peak torque and rate of torque development) are related to the number of falls. Methods: Thirty-one women volunteered to participate in the study and were assigned in one of the groups according to the number of falls over the 12 months that preceded the present Then, participants with no fall history (Cl; n = 13; 67.6[7.5] years-old), one fall (GII; n = 8, 66 0[4 91 years-old) and two or more falls (GIII, n = 10; 67.8[8.8] years-old) performed a number of lower limb maximal isometric voluntary contractions from which peak torque and rate of torque development were quantified Findings. Primary outcomes indicated no peak torque differences between experimental groups in any lower limb joint. The rate of torque development of the knee flexor muscles observed in the non-fallers (Cl) was greater than that observed in the fallers (P < 0.05) and had a significant relationship with the number of falls (P < 0 05) Interpretation. The greater knee flexor muscles` rate of torque development found in the non-fallers in comparison to the fallers indicated that the ability of the elderly to rapidly reorganise the arrangement of the lower limb may play a significant role in allowing the elderly to recover balance after a trip. Thus, training stimulus aimed to improve the rate of torque development may be more beneficial to prevent falls among the elderly than other training stimulus, which are not specifically designed to improve the ability to rapidly produce large amounts of torque (C) 2010 Published by Elsevier Ltd

Salivary immunoglobulin a response to a match in top-level Brazilian soccer players

Moreira, A, Arsati, F, Cury, PR, Franciscon, C, Oliveira, PR, and Araujo, VC. Salivary immunoglobulin a response to a match in top-level brazilian soccer players. J Strength Cond Res 23(7): 1968-1973, 2009-It has been suggested that several parameters of mucosal immunity, including salivary immunoglobulin A (s-IgA), are affected by heavy exercise either in field sports or in the laboratory environment. Few observations have been made during a true sporting environment, particularly in professional soccer. We tested the hypothesis that salivary IgA levels will be decreased after a 70-minute regulation in a top-level professional soccer friendly match. Saliva samples from 24 male professional soccer players collected before and after the match were analyzed. Salivary immunoglobulin A concentration was measured by enzyme-linked immunosorbent assay and expressed as the absolute concentration (s-IgAabs), s-IgA relative to total protein concentration (IgA-Pro), and the secretion rate of IgA (s-IgArate). Rate of perceived exertion (RPE) was used to monitor the exercise intensity. The paired t-test showed no significant changes in s-IgAabs and s-IgArate (p > 0.05) from PRE to POST match. However, a significant (p < 0.05) increase in total protein concentration (1.46 +/- 0.4 to 2.00 +/- 07) and a decrease in IgA-Pro were observed. The best and most significant correlation was obtained with the RPE and changes in IgA-Pro (rs = -0.43) and could indicate that this expression may be an interesting marker of intensity in a soccer match. However, further investigation regarding exercise intensity, protein concentration, and immune suppression, particularly in team sports, is warranted. From a practical application, the variability of the responses among the players leads us to suggest that there is a need to individually analyze the results with team sports. Some athletes showed a decrease in s-IgA expressions, suggesting the need for taking protective actions to minimize contact with cold viruses or even reducing the training load.

Physiological, performance, and nutritional profile of the Brazilian olympic wushu (kung-fu) team

Artioli, GG, Gualano, B, Franchini, E, Batista, RN, Polacow, VO, and Lancha, AH Jr. Physiological, performance, and nutritional profile of the Brazilian Olympic Wushu (kung-fu) team. J Strength Cond Res 23(1): 20-25, 2009-The purpose of the present study was to determine physiological, nutritional, and performance profiles of elite Olympic Wushu (kung-fu) athletes. Ten men and four women elite athletes took part in the study. They completed the following tests: body composition, nutritional assessment, upper-body Wingate Test, vertical jump, lumbar isometric strength, and flexibility. Blood lactate was determined at rest and after the Wingate Test. Blood lactate was also determined during a training session (combat and Taolu training). We found low body fat (men: 9.5 +/- 6.3%; women: 18.0 +/- 4.8%), high flexibility (sit-and-reach-men: 45.5 +/- 6.1 cm; women: 44.0 +/- 6.3 cm), high leg power (vertical jump-men: 37.7 +/- 8.4 cm; women: 32.3 +/- 1.1 cm), high lumbar isometric strength (men: 159 6 13 cm; women: 94 6 6 cm), moderate arm mean and peak power (Wingate Test-men: 4.1 +/- 0.4 and 5.8 +/- 0.5 W.kg(-1), respectively; women: 2.5 +/- 0.3 and 3.4 +/- 0.3 W.kg(-1), respectively), and elevated blood lactate after the Wingate Test (men: 10.8 +/- 2.0 mmol.L(-1); women: 10.2 +/- 2.0 mmol.L(-1)) and during training (combat: 12.0 +/- 1.8 mmol.L(-1); Taolu: 7.7 +/- 3.3 mmol.L(-1)). Men athletes consume a high-fat, low-carbohydrate diet, whereas women consume a moderate, high-carbohydrate diet. Energy consumption was markedly variable. In conclusion, Olympic Wushu seems to be a highly anaerobic-dependent combat sport. Low body fat, high flexibility, leg anaerobic power, isometric strength, and moderately high arm anaerobic power seem to be important for successful competitive performance.

Assessing land availability to produce biomass for energy: The case of Brazilian charcoal for steel making

The paper discusses the availability of biomass in Brazil to supply charcoal to the steel industry on the bases of an initial global assessment of land potentially available for plantations and of Brazilian data that allows refining the assessment and specifying the issue of practical availability. Technical potentials are first assessed through a series of simple rules against direct competition with agriculture, forests and protected areas, and of quantitative criteria, whether geo-climatic (rainfall), demographic (population density) or legal (reserves). Institutional, social and economic factors are then identified and discussed so as to account for the practical availability of Brazilian biomass through six criteria. The ranking of nine Brazilian States according to these criteria brings out the necessary trade-offs in the selection of land for plantations that would efficiently supply charcoal to the steel industry. (C) 2008 Elsevier Ltd. All rights reserved.

Ethanol production by a new pentose-fermenting yeast strain, Scheffersomyces stipitis UFMG-IMH 43.2, isolated from the Brazilian forest

The ability of a recently isolated Scheffersomyces stipitis strain (UFMG-IMH 43.2) to produce ethanol from xylose was evaluated. For the assays, a hemicellulosic hydrolysate produced by dilute acid hydrolysis of sugarcane bagasse was used as the fermentation medium. Initially, the necessity of adding nutrients (MgSO(4).7H(2)O, yeast extract and/or urea) to this medium was verified, and the yeast extract supplementation favoured ethanol production by the yeast. Then, in a second stage, assays under different initial xylose and cell concentrations, supplemented or not with yeast extract, were performed. All these three variables showed significant (p < 0.05) influence on ethanol production. The best results (ethanol yield and productivity of 0.19 g/g and 0.13 g/l/h, respectively) were obtained using the hydrolysate containing an initial xylose concentration of 30 g/l, supplemented with 5.0 g/l yeast extract and inoculated with an initial cell concentration of 2.0 g/l. S. stipitis UFMG-IMH 43.2 was demonstrated to be a yeast strain with potential for use in xylose conversion to ethanol. The establishment of the best fermentation conditions was also proved to be of great importance to increasing the product formation by this yeast strain. These findings open up new perspectives for the establishment of a feasible technology for ethanol production from hemicellulosic hydrolysates. Copyright (C) 2011 John Wiley & Sons, Ltd.

Composites from Brazilian natural fibers with polypropylene: mechanical and thermal properties

Brazil has a well established ethanol production program based on sugarcane. Sugarcane bagasse and straw are the main by-products that may be used as reinforcement in natural fiber composites. Current work evaluated the influence of fiber insertion within a polypropylene (PP) matrix by tensile, TGA and DSC measurements. Thus, the mechanical properties, weight loss, degradation, melting and crystallization temperatures, heat of melting and crystallization and percentage of crystallinity were attained. Fiber insertion in the matrix improved the tensile modulus and changed the thermal stability of composites (intermediary between neat fibers and PP). The incorporation of natural fibers in PP promoted also apparent T(c) and Delta H(c) increases. As a Conclusion, the fibers added to polypropylene increased the nucleating ability, accelerating the crystallization process, improving the mechanical properties and consequently the fiber/matrix interaction.

Influence of Granulometry and Organic Treatment of a Brazilian Montmorillonite on the Properties of Poly(styrene-co-n-butyl acrylate)/Layered Silicate Nanocomposites Prepared by Miniemulsion Polymerization

The influence of granulometry and organic treatment of a Brazilian montmorillonite (MMT) clay on the synthesis and properties of poly(styrene-co-n-butyl acrylate)/layered silicate nanocomposites was studied. Hybrid latexes of poly(styrene-co-butyl acrylate)/MMT were synthesized via miniemulsion polymerization using either sodium or organically modified MMT. Five clay granulometries ranging from clay particles smaller than 75 mu m to colloidal size were selected. The size of the clay particles was evaluated by Specific surface area measurements (BET). Cetyl trimethyl ammonium chloride was used as an organic modifier to enhance the clay compatibility with the monomer phase before polymerization and to improve the clav distribution and dispersion within the polymeric matrix after polymerization. The sodium and organically modified natural clays as well as the composites were characterized by X-ray diffraction analysis. The latexes were characterized by dynamic light scattering. The mechanical, thermal, and rheological properties of the composites obtained were characterized by dynamical-mechanical analysis, thermogravimetry, and small amplitude oscillatory, shear tests, respectively. The results showed that smaller the size of the organically modified MMT, the higher the degree of exfoliation of nanoplatelets. Hybrid latexes in presence of Na-MMT resulted in materials with intercalated structures. (C) 2009 Wiley, Periodicals, Inc. J Appl Polym Sci 112: 1949-1958, 2009