Portuguese validation of the Symptom Inventory of the M.D. Anderson Cancer Center

Objective To analyze the reliability and validity of the psychometric properties of the Brazilian version of the instrument for symptom assessment, titled MD Anderson Symptom Inventory - core. Method A cross-sectional study with 268 cancer patients in outpatient treatment, in the municipality of Ijuí, state of Rio Grande do Sul, Brazil. Results The Cronbach’s alpha for the MDASI general, symptoms and interferences was respectively (0.857), (0.784) and (0.794). The factor analysis showed adequacy of the data (0.792). In total, were identified four factors of the principal components related to the symptoms. Factor I: sleep problems, distress (upset), difficulties in remembering things and sadness. Factor II: dizziness, nausea, lack of appetite and vomiting. Factor III: drowsiness, dry mouth, numbness and tingling. Factor IV: pain, fatigue and shortness of breath. A single factor was revealed in the component of interferences with life (0.780), with prevalence of activity in general (59.7%), work (54.9%) and walking (49.3%). Conclusion The Brazilian version of the MD Anderson Symptom Inventory - core showed adequate psychometric properties in the studied population.

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.

Validation of the Social Phobia and Anxiety Inventory for Children (SPAI-C) in a sample of Brazilian children

The purpose of the present study was to examine the factor structure and psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C), an instrument developed in the United States and applied to a sample of Brazilian schoolchildren. The process included the translation of the original material from English into Portuguese by two bilingual psychiatrists and a back translation by a bilingual physician. Both the front and back translations were revised by a bilingual child psychiatrist. The study was performed using a cross-sectional design and the Portuguese version of the SPAI-C was applied to a sample of 1954 children enrolled in 3rd to 8th grade attending 2 private and 11 public schools. Eighty-one subjects were excluded due to an incomplete questionnaire and 2 children refused to participate. The final sample consisted of 1871 children, 938 girls (50.1%) and 933 boys (49.8%), ranging in age from 9 to 14 years. The majority of the students were Caucasian (89.0%) and the remainder were African-Brazilian (11.0%). The Pearson product-moment correlation showed that the two-week test-retest reliability coefficient was r = 0.780 and Cronbach's alpha was 0.946. The factor structure was almost similar to that reported in previous studies. The results regarding the internal consistency, the test-retest reliability and the factor structure were similar to the findings obtained in studies performed on English speaking children. The present study showed that the Portuguese language version of SPAI-C is a reliable and valid measure of social anxiety for Brazilian children.

Adaptação para língua portuguesa do questionário Tinnitus Handicap Inventory: validade e reprodutibilidade

O zumbido traz grande repercussões a qualidade de vida dos pacientes, e temos dificuldade em quantificá-los. OBJETIVO: Determinar a reprodutibilidade e validade da tradução para língua portuguesa do Tinnitus Handicap Inventory (THI), um questionário auto-aplicável que avalia a repercussão do zumbido na qualidade de vida dos pacientes. MATERIAL E MÉTODOS: Neste estudo do tipo transversal prospectivo foi traduzido e adaptado culturalmente o questionário THI para a população brasileira de acordo com metodologia internacionalmente aceita e, então, respondido por 180 pacientes com zumbido. A avaliação de reprodutibilidade foi feita através do cálculo do alfa de Cronbach, enquanto que a validade foi testada através da comparação do THI com escala de depressão de Beck, calculando o coeficiente de correlação de Pearson. RESULTADOS: A tradução do THI apresenta boa validade interna, comparável com a demonstrada na versão original. Correlação alta foi observada entre o THI e a escala de Beck. CONCLUSÃO: A versão para a língua portuguesa é um instrumento válido e reprodutível para ser utilizado para quantificar o impacto do zumbido na qualidade de vida dos pacientes brasileiros que nos procuram com esse sintoma.

Análise da correlação entre a escala visual-análoga e o Tinnitus Handicap Inventory na avaliação de pacientes com zumbido

Um dos tópicos mais questionado nos estudos clínicos sobre zumbido é o método de mensuração do mesmo. As Escalas Visual-Análogas (EVAs) e o Tinnitus Handicap Inventory (THI) são freqüentemente utilizados para este fim. OBJETIVO: Verificar a correlação entre os escores da EVA e do THI em pacientes com zumbido neurossensorial através de um estudo prospectivo. MATERIAL E MÉTODO: 43 pacientes com zumbido neurossensorial quantificaram o zumbido pelos dois métodos, sendo os escores comparados através do Coeficiente de Relação de Spearman. RESULTADOS: Foi observada correlação entre os escores da EVA e do THI. CONCLUSÃO: Em pacientes com zumbido neurossensorial existe correlação entre os escores da EVA e do THI.

Brazil's strategic partnerships: an assessment of the Lula era (2003-2010)

This article examines the priority bilateral relations of Brazil, named "strategic partnerships", both because of their tradition and historical relevance and due to the existence of political and economic cooperation projects. An assessment of these relationships, especially under Lula's administration, is made in this work, bearing in mind the concept of "strategic partnerships" and its development in Brazilian foreign policy. There will be considered partnerships with the US; Argentina; Japan; China; India; South Africa and the European Union. In the article, the meaning of the increase in these relationships is interpreted on the grounds of its significance to the international insertion strategy of Brazil

Multi-level governance and social cohesion in the European Union: the assessment of local agents, a study case inside Galicia

Implementing multi-level governance has been a key priority in EU cohesion policy. This study assesses the perceived achievements and shortcomings in implementing European Social Fund by analyzing the deficits and weaknesses as well as the poor participation of local agents who are in direct contact with the beneficiaries in order to design and implement this fund, which is the main financial instrument of EU social policy.

Neoinstitutionalism and the appropriation of bourdieu's work: a critical assessment

Despite the still present hegemony of the structural-functionalist orthodoxy, the mid 1980's witnesses the insurgence of new philosophical approaches. This body of work had become a vital intellectual and ideological resource for those who wanted to confront the functionalist dominance in organization studies, such as structuration theory, labour process theory and neoinstitutionalist theory. The purpose of this paper is to review the incorporation of Bourdieu's work into neoinstitutionalism. I argue that this appropriation has resulted in a significant loss of theoretical strength. By giving place to the cognitivist metaphors of mental models, "scripts" and "schemas", instead of adopting the notion of habitus, neoinstitutionalism reinforces some of the ever-present dichotomies in social sciences, especially those of agency/structure and individual/society. While neoinstitutionalism was refining the cognitive approach in the 1990's, Bourdieu was moving towards psychoanalysis. Some indications for future research are provided in the concluding notes.

Access to information: assessment of the use of automated interaction technologies in call centers

With the purpose of at lowering costs and reendering the demanded information available to users with no access to the internet, service companies have adopted automated interaction technologies in their call centers, which may or may not meet the expectations of users. Based on different areas of knowledge (man-machine interaction, consumer behavior and use of IT) 13 propositions are raised and a research is carried out in three parts: focus group, field study with users and interviews with experts. Eleven automated service characteristics which support the explanation for user satisfaction are listed, a preferences model is proposed and evidence in favor or against each of the 13 propositions is brought in. With balance scorecard concepts, a managerial assessment model is proposed for the use of automated call center technology. In future works, the propositions may become verifiable hypotheses through conclusive empirical research.

Sustainable Tourism and Eradication of Poverty (Step): impact assessment of a tourism development program in Brazil

This paper aims to evaluate the social impacts of the Tourism Development Program (Prodetur) in the northeastern town of Porto Seguro, Bahia, Brazil. The method used is based on the difference in difference technique applied to the 1991 and 2000 Census microdata. The results suggest social advances following from poverty relief based on income - where the benefits are distributed, generally, in a relatively equal manner between the native and migrant population. There is a relative deterioration in the sanitary situation, which consists of a very serious problem in the mid- and long-term, whose costs are mostly borne by the native population. Therefore, maintaining the natural capital is the main aspect that distances Porto Seguro’s tourism supply from the concept of sustainability. The article also relies on difference in difference estimators to assess the impacts of local public policies related to the sector.

A gestão do conhecimento na administração pública municipal em Curitiba com a aplicação do método OKA - Organizational Knowledge Assessment

O presente artigo objetiva analisar como a gestão do conhecimento se manifesta na administração pública da Prefeitura Municipal de Curitiba; para tanto, buscou-se a aplicação do método Organizational Knowledge Assessment (OKA), criado pelo Banco Mundial e organizado pela Escola Nacional de Administração Pública (Enap). No que tange aos procedimentos metodológicos, utilizou-se o estudo de caso como instrumento de pesquisa e coleta dos dados. Como resultado, identificaram-se o processo de avaliação organizacional, indicando as similaridades e distinções do desenvolvimento do método de cada área-fim, e a importância de implantar sistematicamente um processo de avaliação aliado ao planejamento da organização pública com estratégias para disseminar, compartilhar e aplicar o conhecimento produzido.

Assessment and prediction of asthma and its severity in the pediatric community

Seventy four asthmatic children aged 7 to 11 years were examined along with controls matched by age and sex. Clinical and laboratory investigations preceded a 28-day follow-up where data about morning and evening peak expiratory flow rate (PEF), symptoms and treatment were recorded. The coefficient of variation of PEF was found to be an objective measurement of asthma severity that has statistically significant correlation with both symptoms (r s= .36) and treatment (r s= .60). Moreover, it separates mild and severe asthmatics, as confirmed by statistically significant differences (p= .008 or less) in symptoms, treatment, skin allergy and airways response to exercise. Skin allergy and airways responsiveness to exercise were found to be predictors of both disease and severity. By means of logistic regression analysis it was possible to establish the probabilities for both asthma and severe asthma when children presenting and not presenting these characteristics are compared. One single positive skin test represent a probability of 88% for the development of asthma and a probability of 70% for severe disease. A PEF reduction of 10% after an exercise test implies a probability of 73% for disease and a probability of 64% for severe disease. Increases in these variables imply geometrically increased risks and their presence together have a multiplicative effect in the final risk.

Assessment of a strategy for the control of respiratory diseases in children

A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.