Knowledge of the Portuguese population on Basic Life Support and availability to attend training

OBJECTIVETo evaluate the level of knowledge and the availability of the Portuguese population to attend training in Basic Life Support (BLS) and identify factors related to their level of knowledge about BLS.METHODObservational study including 1,700 people who responded to a questionnaire containing data on demography, profession, training, interest in training and knowledge about BLS.RESULTSAmong 754 men and 943 women, only 17.8% (303) attended a course on BLS, but 95.6% expressed willingness to carry out the training. On average, they did not show good levels of knowledge on basic life support (correct answers in 25.9 ± 11.5 of the 64 indicators). Male, older respondents who had the training and those who performed BLS gave more correct answers, on average (p<0.01).CONCLUSIONThe skill levels of the Portuguese population are low, but people are available for training, hence it is important to develop training courses and practice to improve their knowledge.

Morphological studies on castes of Protopolybia chartergoides (Hymenoptera, Vespidae, Epiponini) observed in colonies during male production stage

Social wasps are important for the study of social behavior evolution because their colonies present different degrees of caste differentiation, from morphologically similar to highly conspicuous, associated with the occasional presence of intermediate females, which bears developed ovaries but no insemination. In the Polistinae, depending on the taxon, such differentiation can be discreet or conspicuous. This work intended to study morphological and physiological differences between castes in Protopolybia chartergoides by using morphometric analyses associated with multivariate statistical analyses and physiological evaluations from females' ovarian development. Results evidence low morphological and physiological differences among the castes in P. chartergoides, indicating three groups of females: queens, workers and intermediates. In this way, it was possible to suggest that Protopolybia chartergoides presents post-imaginal caste differentiation (or a very subtle form of pre-imaginal determination).

More than one inseminated female in colonies of the independent-founding wasp Mischocyttarus cassununga von Ihering (Hymenoptera, Vespidae)

In the primitively eusocial wasps, especially Polistini and Mischocyttarini tribes, the physiological condition of each individual is strongly associated with its dominance status in the colonial hierarchy. As a rule, in independent-founding wasps, female wasps are all morphologically alike, and their role is apparently quite flexible even as adults. However, some studies have shown that differences in body size can exist between reproductive and non-reproductive females. Thus, the present study aimed at detecting differences between reproductive (inseminated) and non-reproductive (uninseminated) individuals based on morphological and physiological parameters. We tape-recorded the daily behavioural repertory of six colonies of Mischocyttarus cassununga for determining the hierarchical dominance in the field, and then collected these colonies (in different cycle stages) for measuring 13 set characters, and assessing the physiological condition of each individual by inspecting their fat bodies and ovaries. Our results revealed that inseminated and uninseminated females are not significantly different in relation to body size, in spite of first group shows higher average than second in almost all measured parts. The physiological evaluation of each individual demonstrated more than one inseminated female per colony during all stages of the colony cycle, suggesting a strategic condition of this species against difficulties (predation and parasitism of the colony) in nature.

Seasonal flight and resource collection patterns of colonies of the stingless bee Melipona bicolor schencki Gribodo (Apidae, Meliponini) in an Araucaria forest area in southern Brazil

Melipona bicolor schencki occurs in southern Brazil and at high elevations in southeastern Brazil. It has potential for use in meliponiculture but this stingless bee species is vulnerable to extinction and we have little knowledge about its ecology. In order to gather essential information for species conservation and management, we made a study of seasonal flight activities in its natural environment. We sampled bees entering the nests with pollen, nectar/water and resin/mud, in five colonies during each season. In parallel, we analyzed the influence of hour of the day and meteorological factors on flight activity. Flights were most intense during spring and summer, with daily mean estimates of 2,100 and 2,333 flights respectively, while in fall and winter the daily flight estimate was reduced to 612 and 1,104 flights, respectively. Nectar and water were the most frequently-collected resources, followed by pollen and building materials. This preference occurred in all seasons, but with variations in intensity. During spring, daily flight activity lasted over 14 hours; this period was reduced in the other seasons, reaching eight hours in winter. Meteorological factors were associated with 40.2% of the variation in flight and resource collection activity. Apparently, other factors that we did not measure, such as colony needs and availability of floral resources, also strongly influence the intensity of resource collection.

Internal ambience of bee colonies submitted to strengthening management by adding broods

This study aimed to investigate the ideal brood area to be introduced for strengthening Apis mellifera colonies, considering variations in the hive's internal ambience. Therefore, eight colonies were equipped with data loggers for recording variations in temperature and humidity inside the hives. Then, these colonies were split in four treatments involving the swapping of four, three, two and one brood comb between strong and weak colonies. Growth in the amount of brood and food stores to the four colony strengthening treatments was assessed counting the comb cells to record changes in the brood and food area. The colonies tended to restore their normal thermoregulation within four hours after they had been manipulated and the hive cover had been closed, which quickly increased brood area in the receiving colonies. Results showed that adding up to three brood combs constitute an important alternative for strengthening Apis mellifera colonies because it did not interfere with nest thermoregulation, speeded up population growth in weak colonies and did not affect the development of strong colonies.

Translation and Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema into Portuguese Language

Objective The objective of the study is to describe the process of translation and cross-cultural adaptation of the Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) into (Brazilian) Portuguese. Methods The process was comprised of five steps - translation, back translation, revision by an expert panel, pretest, and final translation. The first translation was performed by two professionals of the healthcare area, and the back translation was performed by two translators. An expert panel assessed the questions for semantics and idiomatic, cultural, and conceptual equivalence. The pretest was conducted on 10 patients with lymphedema. Results Small differences were identified between the translated and back-translated versions, which were revised by the expert panel. The patients included in the pretest found 10 questions difficult to understand; these questions were reassessed by the same expert panel. Conclusion The results of the translation and cross-cultural adaptation of the Lymph- ICF-LL resulted in a Brazilian Portuguese version, which still requires validation with various samples of the local population.

Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory

The psychometric properties of the Portuguese version of the trait form of the State-Trait Anxiety Inventory (STAI-T) and its relation to the Beck Depression Inventory (BDI) were evaluated in a large Brazilian college student sample containing 845 women and 235 men. STAI-T scores tended to be higher for women, singles, those who work, and subjects under 30 years. Factor analysis of the STAI-T for total sample and by gender yielded two factors: the first representing a mood dimension and the second being related to worrying or cognitive aspects of anxiety. In order to study the relation between anxiety and depression measures, factor analysis of the combination of the 21 BDI items and the 20 STAI-T items was also carried out. The analysis resulted in two factors that were analyzed according to the tripartite model of anxiety and depression. Most of the BDI items (measuring positive affectivity and nonspecific symptoms of depression) were loaded on the first factor and four STAI-T items that measure positive affectivity. The remaining STAI-T items, all of them measuring negative affect, remained in the second factor. Thus, factor 1 represents a depression dimension and factor 2 measures a mood-worrying dimension. The findings of this study suggest that, although widely used as an anxiety scale, the STAI-T in fact measures mainly a general negative affect.

A Portuguese version of the Christo Inventory for Substance-Misuse Services: a simple outcome evaluation tool

The Christo Inventory for Substance-Misuse Services (CISS) is a single page outcome evaluation tool completed by drug alcohol service workers either on the basis of direct client interviews or of personal experience of their client supplemented by existing assessment notes. It was developed to assist substance misuse services to empirically demonstrate the effectiveness of their treatments to their respective funding bodies. Its 0 to 20 unidimensional scale consists of 10 items reflecting clients' problems with social functioning, general health, sexual/injecting risk behavior, psychological functioning, occupation, criminal involvement, drug/alcohol use, ongoing support, compliance, and working relationships. Good reliability and validity has already been demonstrated for the CISS [Christo et al., Drug and Alcohol Dependence 2000; 59: 189-197] but the original was written in English and a Portuguese version is presented here. The present review explores its applicability to a Brazilian setting, summarizes its characteristics and uses, and describes the process of translation to Portuguese. A pilot study conducted in a substance misuse service for adolescents indicated it is likely to be suitable for use among a Brazilian population. The simplicity, flexibility and brevity of the CISS make it a useful tool allowing comparison of clients within and between many different service settings.

Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS) for tardive dyskinesia in Brazilian patients

The objective of the present study was to evaluate the reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS). Videotaped interviews with 16 psychiatric inpatients treated with antipsychotic drugs for at least 5 years were evaluated. Reliability was assessed by the intraclass correlation coefficient (ICC) between three raters, two with and one without clinical training in psychopathology. Clinical utility was assessed by the difference between the scores of patients with (N = 11) and without (N = 5) tardive dyskinesia (TD). Patients with TD exhibited a higher severity of global evaluation by the AIMS (sum of scores: 4.2 ± 0.9 vs 0.4 ± 0.2; score on item 8: 2.3 ± 0.3 vs 0.4 ± 0.2, TD vs controls). The ICC for the global evaluation was fair between the two skilled raters (0.58-0.62) and poor between these raters and the rater without clinical experience (0.05-0.29). Thus, we concluded that the Portuguese version of the AIMS shows an acceptable inter-rater reliability, but only between clinically skilled raters, and that it is clinically useful.

Validation of the Brazilian Children's Test of Pseudoword Repetition in Portuguese speakers aged 4 to 10 years

The phonological loop is a component of the working memory system specifically involved in the processing and manipulation of limited amounts of information of a sound-based phonological nature. Phonological memory can be assessed by the Children's Test of Nonword Repetition (CNRep) in English speakers but not in Portuguese speakers due to phonotactic differences between the two languages. The objectives of the present study were: 1) to develop the Brazilian Children's Test of Pseudoword Repetition (BCPR), a Portuguese version of the CNRep, and 2) to validate the BCPR by correlation with the Auditory Digit Span Test from the Stanford-Binet Intelligence Scale. The BCPR and Digit Span were assessed in 182 children aged 4-10 years, 84 from Minas Gerais State (42 from a rural region) and 98 from the city of São Paulo. There are subject age and word length effects causing repetition accuracy to decline as a function of the number of syllables of the pseudowords. Correlations between BCPR and Digit Span forward (r = 0.50; P <= 0.01) and backward (r = 0.43; P <= 0.01) were found, and partial correlation indicated that higher BCPR scores were associated with higher Digit Span scores. BCPR appears to depend more on schooling, while Digit Span was more related to development. The results demonstrate that the BCPR is a reliable measure of phonological working memory, similar to the CNRep.

Category fluency test: effects of age, gender and education on total scores, clustering and switching in Brazilian Portuguese-speaking subjects

Verbal fluency tests are used as a measure of executive functions and language, and can also be used to evaluate semantic memory. We analyzed the influence of education, gender and age on scores in a verbal fluency test using the animal category, and on number of categories, clustering and switching. We examined 257 healthy participants (152 females and 105 males) with a mean age of 49.42 years (SD = 15.75) and having a mean educational level of 5.58 (SD = 4.25) years. We asked them to name as many animals as they could. Analysis of variance was performed to determine the effect of demographic variables. No significant effect of gender was observed for any of the measures. However, age seemed to influence the number of category changes, as expected for a sensitive frontal measure, after being controlled for the effect of education. Educational level had a statistically significant effect on all measures, except for clustering. Subject performance (mean number of animals named) according to schooling was: illiterates, 12.1; 1 to 4 years, 12.3; 5 to 8 years, 14.0; 9 to 11 years, 16.7, and more than 11 years, 17.8. We observed a decrease in performance in these five educational groups over time (more items recalled during the first 15 s, followed by a progressive reduction until the fourth interval). We conclude that education had the greatest effect on the category fluency test in this Brazilian sample. Therefore, we must take care in evaluating performance in lower educational subjects.

A study of the abilities in oral language comprehension of the Boston Diagnostic Aphasia Examination - Portuguese version: a reference guide for the Brazilian population

We analyzed the performance of 162 normal subjects, subdivided into groups according to age and schooling, in the oral comprehension tasks of the Boston Diagnostic Aphasia Examination translated and adapted to Brazilian Portuguese to obtain a profile of performance for the Brazilian population, as well as cut-off scores for each task, and to determine the best combination of tasks that distinguish normal from aphasic subjects, as a guide for clinicians. The normal subjects were compared to 69 aphasics. Age alone influenced the performance in the designation of actions (subjects above 70 years showing the worst performance); schooling alone influenced the comprehension of forms, colors and numbers (subjects with less than four years of education showing a poorer performance). Both age and schooling influenced the performance in Body Part Identification (BPI) and Complex Ideational Material (CIM) with mean values of 70.5 ± 3.3 (Word Discrimination, WD), 18.9 ± 1.4 (BPI), 14.7 ± 0.9 (Commands), and 10.3 ± 1.7 (CIM) for the whole sample; the cut-off scores obtained were 65 (WD), 17.5 (BPI), 14 (Commands), and 9.5 (CIM) for the whole sample. Logistic regression showed that the combination of BPI + Commands + CIM was the most efficient in differentiating normal subjects from aphasics, with 72.5% sensitivity and 97.6% specificity. However, for low-education subjects, BPI and Commands were sufficient for this differentiation (75.7% sensitivity and 84.7% specificity). The main contribution of this study was to provide reference values that are far more representative of our population to be used by health professionals in Brazil, taking into account cultural differences.

Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire

The objective of the present study was to translate, adapt and validate a Brazilian Portuguese version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. The study was carried out in two steps. The first was to translate the DASH into Portuguese and to perform cultural adaptation and the second involved the determination of the reliability and validity of the DASH for the Brazilian population. For this purpose, 65 rheumatoid arthritis patients of either sex (according to the classification criteria of the American College of Rheumatology), ranging in age from 18 to 60 years and presenting no other diseases involving the upper limbs, were interviewed. The patients were selected consecutively at the rheumatology outpatient clinic of UNIFESP. The following results were obtained: in the first step (translation and cultural adaptation), all patients answered the questions. In the second step, Spearman's correlation coefficients for interobserver evaluation ranged from 0.762 to 0.995, values considered to be highly reliable. In addition, intraclass correlation coefficients ranged from 0.97 to 0.99, also highly reliable values. Spearman's correlation coefficients and the intraclass correlation coefficients obtained during intra-observer evaluation ranged from 0.731 to 0.937 and from 0.90 to 0.96, respectively, being highly reliable values. The Ritchie Index showed a weak correlation with Brazilian DASH scores, while the visual analog scale of pain showed a good correlation with DASH score. We conclude that the Portuguese version of the DASH is a reliable instrument.

Validation of the Beck Depression Inventory for a Portuguese-speaking Chinese community in Brazil

The objective of the present study was to investigate the psychometric properties and cross-cultural validity of the Beck Depression Inventory (BDI) among ethnic Chinese living in the city of São Paulo, Brazil. The study was conducted on 208 community individuals. Reliability and discriminant analysis were used to test the psychometric properties and validity of the BDI. Principal component analysis was performed to assess the BDI's factor structure for the total sample and by gender. The mean BDI score was lower (6.74, SD = 5.98) than observed in Western counterparts and showed no gender difference, good internal consistency (Cronbach's alpha 0.82), and high discrimination of depressive symptoms (75-100%). Factor analysis extracted two factors for the total sample and each gender: cognitive-affective dimension and somatic dimension. We conclude that depressive symptoms can be reliably assessed by the BDI in the Brazilian Chinese population, with a validity comparable to that for international studies. Indeed, cultural and measurement biases might have influenced the response of Chinese subjects.

Reliability and validity of a Portuguese version of the Young Mania Rating Scale

The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001) for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001). For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.