77 resultados para Disabled Persons Scale


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Base-level maps (or ""isobase maps"", as originally defined by Filosofov, 1960), express a relationship between valley order and topography. The base-level map can be seen as a ""simplified"" version of the original topographic surface, from which the ""noise"" of the low-order stream erosion was removed. This method is able to identify areas with possible tectonic influence even within lithologically uniform domains. Base-level maps have been recently applied in semi-detail scale (e.g., 1:50 000 or larger) morphotectonic analysis. In this paper, we present an evaluation of the method's applicability in regional-scale analysis (e.g., 1:250 000 or smaller). A test area was selected in northern Brazil, at the lower course of the Araguaia and Tocantins rivers. The drainage network extracted from SRTM30_PLUS DEMs with spatial resolution of approximately 900 m was visually compared with available topographic maps and considered to be compatible with a 1:1,000 000 scale. Regarding the interpretation of regional-scale morphostructures, the map constructed with 2nd and 3rd-order valleys was considered to present the best results. Some of the interpreted base-level anomalies correspond to important shear zones and geological contacts present in the 1:5 000 000 Geological Map of South America. Others have no correspondence with mapped Precambrian structures and are considered to represent younger, probably neotectonic, features. A strong E-W orientation of the base-level lines over the inflexion of the Araguaia and Tocantins rivers, suggest a major drainage capture. A N-S topographic swath profile over the Tocantins and Araguaia rivers reveals a topographic pattern which, allied with seismic data showing a roughly N-S direction of extension in the area, lead us to interpret this lineament as an E-W, southward-dipping normal fault. There is also a good visual correspondence between the base-level lineaments and geophysical anomalies. A NW-SE lineament in the southeast of the study area partially corresponds to the northern border of the Mosquito lava field, of Jurassic age, and a NW-SE lineament traced in the northeastern sector of the study area can be interpreted as the Picos-Santa Ines lineament, identifiable in geophysical maps but with little expression in hypsometric or topographic maps.

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Based on solvation studies of polymers, the sum (1: 1) of the electron acceptor (AN) and electron donor (DN) values of solvents has been proposed as an alternative polarity scale. To test this, the electron paramagnetic resonance isotropic hyperfine splitting constant, a parameter known to be dependent on the polarity/proticity of the medium, was correlated with the (AN+DN) term using three paramagnetic probes. The linear regression coefficient calculated for 15 different solvents was approximately 0.9, quite similar to those of other well-known polarity parameters, attesting to the validity of the (AN+DN) term as a novel ""two-parameter"" solvent polarity scale.

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Large scale enzymatic resolution of racemic sulcatol 2 has been useful for stereoselective biocatalysis. This reaction was fast and selective, using vinyl acetate as donor of acyl group and lipase from Candida antarctica (CALB) as catalyst. The large scale reaction (5.0 g, 39 mmol) afforded high optical purities for S-(+)-sulcatol 2 and R-(+)-sulcatyl acetate 3, i.e., ee > 99 per cent and good yields (45 per cent) within a short time (40 min). Thermodynamic parameters for the chemoesterification of sulcatol 2 by vinyl acetate were evaluated. The enthalpy and Gibbs free energy values of this reaction were negative, indicating that this process is exothermic and spontaneous which is in agreement with the reaction obtained enzymatically.

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The Brazilian Atlantic Forest is one of the richest biodiversity hotspots of the world. Paleoclimatic models have predicted two large stability regions in its northern and central parts, whereas southern regions might have suffered strong instability during Pleistocene glaciations. Molecular phylogeographic and endemism studies show, nevertheless, contradictory results: although some results validate these predictions, other data suggest that paleoclimatic models fail to predict stable rainforest areas in the south. Most studies, however, have surveyed species with relatively high dispersal rates whereas taxa with lower dispersion capabilities should be better predictors of habitat stability. Here, we have used two land planarian species as model organisms to analyse the patterns and levels of nucleotide diversity on a locality within the Southern Atlantic Forest. We find that both species harbour high levels of genetic variability without exhibiting the molecular footprint of recent colonization or population expansions, suggesting a long-term stability scenario. The results reflect, therefore, that paleoclimatic models may fail to detect refugia in the Southern Atlantic Forest, and that model organisms with low dispersal capability can improve the resolution of these models.

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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.

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Background: Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in Sao Paulo, Brazil; and discuss the implications for public policies. Methods: The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in Sao Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives twice the percentage for men with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion: Among older adults in Sao Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs. Copyright (C) 2011 by the Jacobs Institute of Women`s Health. Published by Elsevier. Inc.

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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.

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The aim of this study was to evaluate the predictive validity of the Braden Scale for Predicting Pressure Sore Risk in elderly residents of long-term care facilities (LTCFs) in Brazil. The determination of the cutoff score for the Brazilian population is important for the comparison between Brazilian and international studies and establishment of guidelines for prevention of pressure ulcers in our health care facilities. This is the first study of its kind in Brazil. This was a secondary analysis of a prospective cohort study conducted with 233 LTCF residents aged 60 and over who underwent complete skin examination and Braden Scale rating every 2 days for 3 months. Two groups of patients were considered: the total group (N = 233) and risk group (n = 94, total scores <= 18). Data from the first and last assessments were analyzed for sensitivity, specificity, and likelihood ratios. The best results were obtained for the total group, with cutoff scores of 18 and 17, sensitivity of 75.9% and 74.1%, specificity of 70.3% and 75.4%, and area under the receiver operating characteristic curve (AUC-ROC) of 0.79 and 0.81 at the first and last assessments, respectively. For the risk group, the cutoff scores of 16 (first assessment) and 13 (last assessment) were associated with a smaller AUC-ROC and, therefore, lower predictive accuracy. The Braden Scale showed good predictive validity in elderly LTCF residents. (Geriatr Nurs 2010;31:95-104)

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AIM: We sought to evaluate the predictive validity of the Waterlow Scale in hospitalized patients. SUBJECTS AND SETTING: The study was conducted at a general private hospital with 220 beds and a mean time of hospitalization of 7.4 days and a mean occupation rate of approximately 80%. Adult patients with a Braden Scale score of 18 or less and a Waterlow Scale score of 16 or more were studied. The sample consisted of 98 patients with a mean age of 71.1 +/- 15.5 years. METHODS: Skin assessment and scoring by using the Waterlow and Braden scales were completed on alternate days. Patients were examined at least 3 times to be considered for analysis. The data were submitted to sensitivity and specificity analysis by using receiver operating characteristic (ROC) curves and positive (+LR) and negative (-LR) likelihood ratios. RESULTS: The cutoff scores were 17, 20, and 20 in the first, second, and third assessment, respectively. Sensitivity was 71.4%, 85.7%, and 85.7% and specificity was 67.0%, 40.7%, and 32.9%, respectively. Analysis of the area under the ROC curve revealed good accuracy (0.64, 95% confidence interval [CI]: 0.35-0.93) only for the cutoff score 17 in the first assessment. The results also showed probabilities of 14%, 10%, and 9% for the development of pressure ulcer when the test results were positive (+LR) and of 3% (-LR) when the test results were negative for the cutoff scores in the first, second, and third assessment, respectively. CONCLUSION: The Waterlow Scale achieved good predictive validity in predicting pressure ulcer in hospitalized patients when a cutoff score of 17 was used in the first assessment.

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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.

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Prolonged standing has been associated with the onset of low back pain symptoms in working populations. So far, it is unknown how individuals with chronic low back pain (CLBP) behave during prolonged unconstrained standing (PS). The aim of the present study was to analyze the control of posture by subjects with CLBP during PS in comparison to matched healthy adults. The center of pressure (COP) position of 12 CLBP subjects and 12 matched healthy controls was recorded in prolonged standing (30 min) and quiet stance tasks (60 s) on a force plate. The number and amplitude of COP patterns, the root mean square (RMS), speed, and frequency of COP sway were analyzed. Statistical analyses showed that CLBP subjects produced less Postural changes in the antero-posterior direction with decreased postural sway during the prolonged standing task in comparison to the healthy group. Only CLBP subjects were influenced by the prolonged standing task, as demonstrated by their increased COP RMS, COP speed and COP frequency in the quiet standing trial after the prolonged standing task in comparison to the pre-PS trial. The present study provides additional evidence that individuals with CLBP might have altered sensory-motor function. Their inability to generate responses similar to those of healthy subjects during prolonged standing may contribute to CLBP persistence or an increase risk of recurrent back pain episodes. Moreover, quantification of postural changes during prolonged standing could be useful to identify CLBP subjects prone to postural control deficits. (C) 2008 Elsevier B.V. All rights reserved.

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This study tested the concurrent and construct validity of a newly developed OMNI-Kayak Scale, testing 8 male kayakers who performed a flatwater load-incremented ""shuttle"" test over a 500-m course and 3 estimation-production trials over a 1,000-m course. Velocity, blood lactate concentration, heart rate, and rating of perceived exertion (RPE), using the OMNI-Kayak RPE Scale and the Borg 6-20 Scale were recorded. OMNI-Kayak Scale RPE was highly correlated with velocity, the Borg 6-20 Scale RPE, blood lactate, and heart rate for both load-incremented test (rs=.87-.96), and estimation trials (rs=.75-.90). There were no significant differences among velocities, heart rate and blood lactate concentration between estimation and production trials. The OMNI-Kayak RPE Scale showed concurrent and construct validity in assessing perception of effort in flatwater kayaking and is a valid tool for self-regulation of exercise intensity.

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Nb(3)Sn is one of the most used superconducting materials for applications in high magnetic fields. The improvement of the critical current densities (J(c)) is important, and must be analyzed together with the optimization of the flux pinning acting in the material. For Nb(3)Sn, it is known that the grain boundaries are the most effective pinning centers. However, the introduction of artificial pinning centers (APCs) with different superconducting properties has been proved to be beneficial for J(c). As these APCs are normally in the nanometric-scale, the conventional heat treatment profiles used for Nb(3)Sn wires cannot be directly applied, leading to excessive grain growth and/or increase of the APCs cross sections. In this work, the heat treatment profiles for Nb(3)Sn superconductor wires with Cu(Sn) artificial pinning centers in nanometric-scale were analyzed in an attempt to improve J(c) . It is described a methodology to optimize the heat treatment profiles in respect to diffusion, reaction and formation of the superconducting phases. Microstructural, transport and magnetic characterization were performed in an attempt to find the pinning mechanisms acting in the samples. It was concluded that the maximum current densities were found when normal phases (due to the introduction of the APCs) are acting as main pinning centers in the global behavior of the Nb(3)Sn superconducting wire.

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Since the discovery of Nb(3)Sn superconductors many efforts have been expended to improve the transport properties in these materials. In this work, the heat treatment profiles for Nb(3)Sn superconductor wires with Cu(Sn) artificial pinning centers (APCs) with nanometric-scale sizes were analyzed in an attempt to improve the critical current densities and upper critical magnetic field. The methodology to optimize the heat treatment profiles in respect to the diffusion, reaction and formation of the superconducting phases is described. Microstructural characterization, transport and magnetic measurements were performed in an attempt to relate the microstructure to the pinning mechanisms acting in the samples. It was concluded that the maximum current densities occur due to normal phases (APCs) that act as the main pinning centers in the global behavior of the Nb(3)Sn superconducting wire. The APC technique was shown to be very powerful because it permitted mixing of the pinning mechanism. This achievement was not possible in other studies in Nb(3)Sn wires reported up to now.

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Sugarcane bagasse was pretreated with diluted sulfuric acid to obtain sugarcane bagasse hemicellulosic hydrolysate (SBHH). Experiments were conducted in laboratory and semi-pilot reactors to optimize the xylose recovery and to reduce the generation of sugar degradation products, as furfural and 5-hydroxy-methylfurfural (HMF). The hydrolysis scale-up procedure was based on the H-Factor, that combines temperature and residence time and employs the Arrhenius equation to model the sulfuric acid concentration (100 mg(acid)/g(dm)) and activation energy (109 kJ/mol). This procedure allowed the mathematical estimation of the results through simulation of the conditions prevailing in the reactors with different designs. The SBHH obtained from different reactors but under the same H-Factor of 5.45 +/- 0.15 reached similar xylose yield (approximately 74%) and low concentration of sugar degradation products, as furfural (0.082 g/L) and HMF (0.0071 g/L). Also, the highest lignin degradation products (phenolic compounds) were rho-coumarilic acid (0.15 g/L) followed by ferulic acid (0.12 g/L) and gallic acid (0.035 g/L). The highest concentration of ions referred to S (3433.6 mg/L), Fe (554.4 mg/L), K (103.9 mg/L), The H-Factor could be used without dramatically altering the xylose and HMF/furfural levels. Therefore, we could assume that H-Factor was directly useful in the scale-up of the hemicellulosic hydrolysate production. (C) 2009 Published by Elsevier Ltd.