Measuring Instruments In Cardiology Adapted Into Portuguese Language Of Brazil: A Systematic Review

This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach’s alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology.


Management of basic health units in municipalities of different size: profile and management instruments

Objective To identify the characteristics of managers and their use of management instruments in primary care and to analyze differences in these features among municipalities of different sizes. Method The present cross-sectional descriptive study was conducted at 108 basic health units from 21 municipalities in northern Paraná, Brazil. The data were collected using a semi-structured questionnaire during the second half of 2010. Results Most managers had graduate degrees and were female and nurses. The managers from the small municipalities were younger, their payment was lower, and they had less work experience. The use of management instruments was expressive for both the organization and work management; however, the instruments were used less in the small municipalities. Conclusion The managers were committed to their role; it is recommended that policies and guidance should be formulated at the federal and state levels to support small municipalities.

Use of patients’ classification instruments: analysis of the brazilian production of knowledge

Objective To analyze the production of scientific knowledge about the use of patients’ classification instruments in care and management practice in Brazil. Method Integrative literature review with databases search in: Latin American and Caribbean Literature on Health Sciences (LILACS), Medical Literature Analysis and Retrieval System on-line (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and SCOPUS, between January 2002 through December 2013. Results 1,194 studies were found, 31 met the inclusion criteria. We observed a higher number of studies in the category care plans and workload (n=15), followed by the category evaluation of psychometric properties (n=14). Conclusion Brazilian knowledge production has not yet investigated some purposes of using instruments for classifying patients in professional nursing practice. The identification of unexplored areas can guide future research on the topic.


Research and training in medicinal chemistry in south and central american countries and sub-saharan Africa

With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.

What can and should be legalized in ecological restoration?

After listing the five key elements of ecological restoration, ecology, economics, social values, cultural values, and politics, I celebrate the fact that in Brazil there is legislation on how to perform ecological restoration of degraded tropical forests, as well as an ongoing dialogue among legislators and scientists about this legislation, and also a lively debate among scientists as the best way forward, referring to articles by Brancalion et al. (2010) and Durigan et al. (2010) in this issue of Revista Árvore. Legislators elsewhere, especially megadiversity countries, should take note. I do not take sides in the debate; I think both groups of authors make very good points. Instead I call on the scientists and legislators concerned with restoration to ponder five strategic tools: A. Start with clear concepts. B. Decide where you want to go and why. C. Negotiate who should benefit & how, and who should pay, how, & why. D. Work out how an honest cost-benefit analysis of restoration would look, regardless of the biome in which you are working. Finally, figure out how to make the restoration immediately attractive for private landowners. Otherwise, they will not cooperate as fully as they could or should, and restoration efforts will not achieve its full potential.

Unintentionally retained foreign bodies after surgical procedures. Analysis of 4547 cases

Objective: this study aims to explore the experience of Brazilian surgeons on Unintentionally Retained Foreign Bodies (RFB) after surgical procedures. Methods: A questionnaire was sent to surgeons by electronic mail, between March and July 2012. The questions analyzed their experience with foreign bodies (FB), foreign bodies' types, clinical manifestations, diagnoses, risk factors and legal implications. Results: in the 2872 eligible questionnaires, 43% of the surgeons asserted that they had already left FB and 73% had removed FB in one or more occasions, totalizing 4547. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year and 14% remained asymptomatic. Among doctors with less than five years after graduation, 36% had already left a FB. The most frequently surgical procedures mentioned were the elective (57%) and routine (85%) ones. Emergency (26%), lack of counting (25%) and inadequate conditions of work contributed (12.5%) to the occurrence. In 46% of the cases patients were alerted about the FB, and 26% of them sued the doctors or the institution. Conclusions: challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

Developmental norms for eight instruments used in the neuropsychological assessment of children: studies in Brazil

Norms for a battery of instruments, including Denckla's and Garfield's tests of Motor Persistence, Benton's Right-Left Discrimination, two recall modalities (Immediate and Delayed) of the Bender Test, Wechsler's Digit Span, the Color Span Test and the Human Figure Drawing Test, were developed for the neuropsychological assessment of children in the greater Rio de Janeiro area. Additionally, the behavior of each child was assessed with the Composite Teacher Rating Scale (Brito GNO and Pinto RCA (1991) Journal of Clinical and Experimental Neuropsychology, 13: 417-418). A total of 398 children (199 boys and 199 girls balanced for age) with a mean age of 9.3 years (SD = 2.8), who were attending a public school in Niterói, were the subjects of this study. Gender and age had significant effects on performance which depended on the instrument. Nonachievers performed worse than achievers in most neuropsychological tests. Comparison of our data to the available counterparts in the United States revealed that American children outperformed Brazilian children on the Right-Left Discrimination, Forward Digit Span, Color Span and Human Figure Drawing Tests. Further analysis showed that the neurobehavioral data consist of different factorial dimensions, including Human Body Representation, Motor Persistence of the Legs, Orbito-Orobuccal Motor Persistence, Attention-Memory, Visuospatial Memory, Neuropsychomotor Speed, Hyperactivity-Inattention, and Anxiety-Negative Socialization. We conclude that gender and age should be taken into account when using the normative data for most of the instruments studied in the present report. Furthermore, we stress the need for major changes in the Brazilian public school system in order to foster the development of secondary cognitive abilities in our children

The Lebanese mutation as an important cause of familial hypercholesterolemia in Brazil

Familial hypercholesterolemia (FH) is a common autosomal disorder that affects about one in 500 individuals in most Western populations and is caused by a defect in the low-density-lipoprotein receptor (LDLr) gene. In this report we determined the molecular basis of FH in 59 patients from 31 unrelated Brazilian families. All patients were screened for the Lebanese mutation, gross abnormalities of the LDLr gene, and the point mutation in the codon 3500 of the apolipoprotein B-100 gene. None of the 59 patients presented the apoB-3500 mutation, suggesting that familial defective ApoB-100 (FDB) is not a major cause of inherited hypercholesterolemia in Brazil. A novel 4-kb deletion in the LDLr gene, spanning from intron 12 to intron 14, was characterized in one family. Both 5' and 3' breakpoint regions were located within Alu repetitive sequences, which are probably involved in the crossing over that generated this rearrangement. The Lebanese mutation was detected in 9 of the 31 families, always associated with Arab ancestry. Two different LDLr gene haplotypes were demonstrated in association with the Lebanese mutation. Our results suggest the importance of the Lebanese mutation as a cause of FH in Brazil and by analogy the same feature may be expected in other countries with a large Arab population, such as North American and Western European countries.

Examining life-course influences on chronic disease: the importance of birth cohort studies from low- and middle- income countries. An overview

The objectives of this overview are to describe the past and potential contributions of birth cohorts to understanding chronic disease aetiology; advance a justification for the maintenance of birth cohorts from low- and middle-income countries (LMIC); provide an audit of birth cohorts from LMIC; and, finally, offer possible future directions for this sphere of research. While the contribution of birth cohorts from affluent societies to understanding disease aetiology has been considerable, we describe several reasons to anticipate why the results from such studies might not be directly applied to LMIC. More than any other developing country, Brazil has a tradition of establishing, maintaining and exploiting birth cohort studies. The clear need for a broader geographical representation may be precipitated by a greater collaboration worldwide in the sharing of ideas, fieldwork experience, and cross-country cohort data comparisons in order to carry out the best science in the most efficient manner. This requires the involvement of a central overseeing body - such as the World Health Organization - that has the respect of all countries and the capacity to develop strategic plans for `global' life-course epidemiology while addressing such issues as data-sharing. For rapid progress to be made, however, there must be minimal bureaucratic entanglements.

Culture of human intestinal epithelial cell using the dissociating enzyme thermolysin and endothelin-3

Epithelium, a highly dynamic system, plays a key role in the homeostasis of the intestine. However, thus far a human intestinal epithelial cell line has not been established in many countries. Fetal tissue was selected to generate viable cell cultures for its sterile condition, effective generation, and differentiated character. The purpose of the present study was to culture human intestinal epithelial cells by a relatively simple method. Thermolysin was added to improve the yield of epithelial cells, while endothelin-3 was added to stimulate their growth. By adding endothelin-3, the achievement ratio (viable cell cultures/total cultures) was enhanced to 60% of a total of 10 cultures (initiated from 8 distinct fetal small intestines), allowing the generation of viable epithelial cell cultures. Western blot, real-time PCR and immunofluorescent staining showed that cytokeratins 8, 18 and mouse intestinal mucosa-1/39 had high expression levels in human intestinal epithelial cells. Differentiated markers such as sucrase-isomaltase, aminopeptidase N and dipeptidylpeptidase IV also showed high expression levels in human intestinal epithelial cells. Differentiated human intestinal epithelial cells, with the expression of surface markers (cytokeratins 8, 18 and mouse intestinal mucosa-1/39) and secretion of cytokines (sucrase-isomaltase, aminopeptidase N and dipeptidylpeptidase IV), may be cultured by the thermolysin and endothelin-3 method and maintained for at least 20 passages. This is relatively simple, requiring no sophisticated techniques or instruments, and may have a number of varied applications.

Manipulating Greek musical modes and tempo affects perceived musical emotion in musicians and nonmusicians

The combined influence of tempo and mode on emotional responses to music was studied by crossing 7 changes in mode with 3 changes in tempo. Twenty-four musicians aged 19 to 25 years (12 males and 12 females) and 24 nonmusicians aged 17 to 25 years (12 males and 12 females) were required to perform two tasks: 1) listening to different musical excerpts, and 2) associating an emotion to them such as happiness, serenity, fear, anger, or sadness. ANOVA showed that increasing the tempo strongly affected the arousal (F(2,116) = 268.62, mean square error (MSE) = 0.6676, P < 0.001) and, to a lesser extent, the valence of emotional responses (F(6,348) = 8.71, MSE = 0.6196, P < 0.001). Changes in modes modulated the affective valence of the perceived emotions (F(6,348) = 4.24, MSE = 0.6764, P < 0.001). Some interactive effects were found between tempo and mode (F (1,58) = 115.6, MSE = 0.6428, P < 0.001), but, in most cases, the two parameters had additive effects. This finding demonstrates that small changes in the pitch structures of modes modulate the emotions associated with the pieces, confirming the cognitive foundation of emotional responses to music.

Failure Mode and Effect Analysis (FMEA) for confectionery manufacturing in developing countries: Turkish delight production as a case study

The Failure Mode and Effect Analysis (FMEA) was applied for risk assessment of confectionary manufacturing, in whichthe traditional methods and equipment were intensively used in the production. Potential failure modes and effects as well as their possible causes were identified in the process flow. Processing stages that involve intensive handling of food by workers had the highest risk priority numbers (RPN = 216 and 189), followed by chemical contamination risks in different stages of the process. The application of corrective actions substantially reduced the RPN (risk priority number) values. Therefore, the implementation of FMEA (The Failure Mode and Effect Analysis) model in confectionary manufacturing improved the safety and quality of the final products.