Assessing cardiorespiratory capacity in older adults with major depression and Alzheimer disease

ABSTRACT Objective To assess cardiorespiratory capacity through subjective and objective tests in older adults diagnosed with major depression (MDD), Alzheimer disease (AD) and healthy older adults. Methods Fifty seven subjects (72 ± 7.9 years) were divided into three groups: MDD (n = 20), AD (n = 17) and Healthy (n = 20). The subjects answered Hamilton Scale (HAM-D), Mini-Mental State Examination (MMSE), Veterans Specific Activity Questionnaire (VSAQ) and 2-minute Step test. Results MDD and AD showed lower scores than healthy group for Nomogram VSAQ (p < 0.001) and 2-minute Step (p = 0.009; p = 0.008, respectively). Adjusted for age and educational level, no differences among groups were observed for Step (MDD, p = 0.097; AD, p = 0.102). AD group did not present differences to healthy group for Step, when adjusting for MMSE (p = 0.261). Conclusions Despite the lower cardiorespiratory fitness of elderly patients with DM and DA have been found in both evaluations, the results should be viewed with caution, since the tests showed low correlation and different risk classifications of functional loss. In addition, age, level educational and cognitive performance are variables that can influence the performance objective evaluation.

Late-life depression, heart failure and frontal white matter hyperintensity: a structural magnetic resonance imaging study

The relevance of the relationship between cardiac disease and depressive symptoms is well established. White matter hyperintensity, a bright signal area in the brain on T2-weighted magnetic resonance imaging scans, has been separately associated with cardiovascular risk factors, cardiac disease and late-life depression. However, no study has directly investigated the association between heart failure, major depressive symptoms and the presence of hyperintensities. Using a visual assessment scale, we have investigated the frequency and severity of white matter hyperintensities identified by magnetic resonance imaging in eight patients with late-life depression and heart failure, ten patients with heart failure without depression, and fourteen healthy elderly volunteers. Since the frontal lobe has been the proposed site for the preferential location of white matter hyperintensities in patients with late-life depression, we focused our investigation specifically on this brain region. Although there were no significant group differences in white matter hyperintensities in the frontal region, a significant direct correlation emerged between the severity of frontal periventricular white matter hyperintensity and scores on the Hamilton scale for depression in the group with heart failure and depression (P = 0.016, controlled for the confounding influence of age). There were no significant findings in any other areas of the brain. This pattern of results adds support to a relationship between cardiovascular risk factors and depressive symptoms, and provides preliminary evidence that the presence of white matter hyperintensities specifically in frontal regions may contribute to the severity of depressive symptoms in cardiac disease.

Multilevel and multidimensional scale for online trust

This paper examines the nature of the construct of consumers' trust toward the electronic channel of their financial institution. Through a study of a total of 372 individual users of Internet banking in Spain, we have managed to develop a third-order measuring instrument that integrates a total of seven dimensions. The exploratory and confirmatory factor analyses were used to test the validation and reliability of the proposed scale. Findings provide useful information to professionals who seek to identify how customer's trust is formed in the online channel and in the financial sector.

The development of a scale to measure concepts of schizophrenia: experience among Brazilian psychiatrists

INTRODUCTION: Among psychiatric disorders schizophrenia is often said to be the condition with the most disputed definition.The Bleulerian and Schneiderian approaches have given rise to diagnostic formulations that have varied with time and place. Controversies over the concept of schizophrenia were examined within European/North American settings in the early 1970s but little has since been reported on the views of psychiatrists in developing countries. In Brazil both concepts are referred to in the literature. A scale was developed to measure adherence to Bleulerian and Schneiderian concepts among psychiatrists working in S. Paulo. METHODOLOGY: A self-reported questionnaire comprising seventeen visual analogue-scale statements related to Bleulerian and Schneiderian definitions of Shizophrenia, plus sociodemographic and training characteristics, was distributed to a non-randomised sample of 150 psychiatrists. The two sub-scales were assessed by psychometric methods for internal consistency, sub-scale structure and test-retest reliability. Items selected according to internal consistency were examined by a two-factor model exploratory factor analysis. Intraclass correlation coefficients described the stability of the scale. RESULTS: Replies were received from 117 psychiatrists (mean age 36 (SD 7.9)), 74% of whom were made and 26% female. The Schneiderian scale showed better overall internal consistency than the Bleulerian scale. Intra-class correlation coefficients for test-retest comparisons were between 0.5 and 0.7 for Schneiderian items and 0.2 and 0.7 for Bleulerian items. There was no negative association between Bleulerian and Schneiderian scale scores, suggesting that respondents may hold both concepts. Place of training was significantly associated with the respondent's opinion; disagreement with a Bleulerian standpoint predominated for those trained at the University of S. Paulo. CONCLUSIONS: The less satisfactory reliability for the Bleulerian sub-scale limits confidence in the whole scale but on the other hand this questionnaire contributes to the understanding of the controversy over Bleulerian and Schneiderian models for conceptualisation of schizophrenia, the former requiring more inference and therefore being prone to unreliability.

Versão resumida da "job stress scale": adaptação para o português

OBJETIVO: Descrever o processo de adaptação, para o português, da versão resumida da "job stress scale", originalmente elaborada em inglês. MÉTODOS: Foram avaliados seis aspectos de equivalência entre a escala original e a versão para o português: as equivalências conceitual, semântica, operacional, de itens, de medidas e funcional. Tomou-se por base um estudo de confiabilidade teste-reteste com 94 indivíduos selecionados. RESULTADOS: O estudo de confiabilidade teste-reteste entre 94 indivíduos permitiu estimativas de reprodutibilidade (coeficientes de correlação intraclasse) para as dimensões de "demanda", "controle" e "apoio social" da escala de 0,88, 0,87 e 0,85, respectivamente. Para as mesmas dimensões, as estimativas de consistência interna (alpha de Cronbach) foram, respectivamente, 0,79, 0,67 e 0,85. CONCLUSÕES: Os resultados sugerem que o processo de adaptação da escala foi bem sucedido, indicando que seu uso no contexto sociocultural da população de estudo (Estudo Pró-Saúde) é apropriado.

Versão em português da Family Environment Scale: aplicação e validação

OBJETIVO: Traduzir a Escala do Ambiente Familiar (Family Environment Scale) para a língua portuguesa e aplicar o instrumento para sua validação. MÉTODOS: A tradução foi aplicada a membros de famílias brasileiras, visando avaliação da consistência interna e a concordância entre membros da mesma família. Foram selecionados 154 voluntários não sujeitos a qualquer intervenção para lidar com problemas familiares, residentes na cidade de São Paulo, em 2003. As pontuações médias nas dez subescalas do instrumento foram comparadas entre homens e mulheres e entre membros da mesma família. Avaliou-se a consistência interna pelo alfa de Cronbach. RESULTADOS: A pontuação máxima possível era nove em cada subescala (bom funcionamento familiar), exceto em relação a conflito e controle. Na maioria das subescalas, a pontuação média da amostra estudada esteve entre 5,1 e 7,6 (homens) e entre 5,4 e 7,7 (mulheres). Nas subescalas conflito e controle as médias variaram entre 1,8 e 4,6 (homens) e entre 1,6 e 4,6 (mulheres), sendo semelhantes às relatadas em estudos internacionais, exceto maior pontuação nas subescalas coesão e organização, e menor na subescala conflito. Não houve diferença estatisticamente significativa entre as pontuações atingidas por homens e mulheres. A confiabilidade da escala avaliada pelo alfa de Cronbach variou entre 0,61 e 0,78 para as dez subescalas. CONCLUSÕES: Fatores culturais podem ter influenciado os resultados obtidos em algumas subescalas. A versão em português da Escala do Ambiente Familiar apresentou razoável consistência interna que permite sua utilização para avaliar alterações no ambiente ou funcionamento familiar, e após intervenções terapêuticas.

Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale

OBJECTIVE: To translate the Need for Recovery Scale (NFR) into Brazilian Portuguese and culturally adapt it and assess the stability, internal consistency and convergent validity of the Brazilian scale among industrial workers. METHODS: The translation process followed the guidelines for cultural adaptation of questionnaires including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The Brazilian Portuguese NFR, final version (Br-NFR) was assessed for stability (n=52) and internal consistency (n=192) and for convergent validity through simultaneous assessment with other instruments: the Borg Scale (n=59); the Chalder Fatigue Questionnaire (n=57) and 3 subscales of the SF-36 (n=56). RESULTS: Stability and internal consistency met the criterion for a reliable measure (ICC=0.80 and Cronbach's alpha =0.87, respectively). The convergent validity between Br-NFR and other instruments also showed good results: Borg Scale (r= 0.64); Chalder Questionnaire (r= 0.67); SF-36 subscales: vitality (r= -0.84), physical functioning (r= -0.54), and role-physical (r= -0.47). CONCLUSIONS: The Br-NFR proved to be a reliable instrument to evaluate work-related fatigue symptoms in industrial workers. Furthermore, it showed significant and good correlations with well-established instruments such as the Borg Scale, the Chalder Questionnaire and SF-36 vitality subscale, supporting the validity of the Br-NFR.

Capital social no ELSA-Brasil: confiabilidade teste-reteste do Resource Generator scale

OBJETIVO: Estimar a confiabilidade teste-reteste dos itens do Resource Generator scale para avaliação de capital social no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil).MÉTODOS: A escala de capital social foi aplicada em subamostra de 281 participantes dos seis Centros de Investigação do ELSA, em duas oportunidades, com intervalo de sete a 14 dias. O instrumento é constituído por 31 itens que representam situações concretas para avaliar o acesso a diferentes tipos de recursos, além de avaliar a fonte dos recursos disponíveis (familiares, amigos ou conhecidos). A análise estatística foi realizada por meio de estatísticas kappa (k) e kappa ajustado pela prevalência (ka).RESULTADOS: Os recursos sociais investigados foram encontrados com grande frequência (acima de 50%). Em relação à presença ou ausência dos recursos, as estimativas de confiabilidade ajustadas pela prevalência (ka) variaram de 0,54 a 0,97. No que se refere à fonte de recurso, essas estimativas variaram de ka = 0,45 (alguém que tenha bons contatos com a mídia) a ka = 0,86 (alguém que se formou no Ensino Médio).CONCLUSÕES: A escala apresentou níveis adequados de confiabilidade, que variaram de acordo com o tipo de recurso.

Brazilian version of the Quality of Care Scale: the perspective of people with disabilities

OBJECTIVE To analyze evidence of the validity and reliability of a Brazilian Portuguese version of the Quality of Care Scale from the perspective of people with physical and intellectual disabilities.METHODS There were 162 people with physical disabilities and 156 with intellectual disabilities from Porto Alegre and metropolitan region, who participated in the study in 2008. Classical psychometrics was used to independently analyze the two samples. Hypotheses for evidence of criterion validity (concurrent type) were tested with the Mann-Whitney test for non-normal distributions. Principal components analysis was used to explore factorial models. Evidence of reliability was calculated with Cronbach alpha for the scales and subscales. Test-retest reliability was analyzed for individuals with intellectual disabilities through intra-class correlation coefficient and the Willcoxon test.RESULTS The principal components in the group with physical disabilities replicated the original model presented as a solution to the international project data. Evidence of discriminant validity and test-retest reliability was found.CONCLUSIONS The transcultural factor model found within the international sample project seems appropriate for the samples investigated in this study, especially the physical disabilities group. Depression, pain, satisfaction with life and disability may play a mediating role in the evaluation of quality of care. Additional research is needed to add to evidence of the validity of the instruments.

Proposal of a short-form version of the Brazilian Food Insecurity Scale

OBJECTIVE To propose a short version of the Brazilian Food Insecurity Scale. METHODS Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of 230 low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15,575 women, whose data were obtained from the 2006 National Survey on Demography and Health. Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. RESULTS Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points. In the sensitivity analysis, the short version of seven questions obtained 97.8% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively, while specificity was 100% in both studies. The five-question model showed similar results (sensitivity of 95.7% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively). In the Pelotas sample, the kappa test of the seven-question version totaled 97.0% and that of the five-question version, 95.0%. In the National Survey on Demography and Health sample, the two models presented a 99.0% kappa. CONCLUSIONS We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions. This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters.

Breeding of Biomphalaria tenagophila in mass scale

An efficient method for breeding Biomphalaria tenagophila (Taim lineage/RS) was developed over a 5-year-period (2005-2010). Special facilities were provided which consisted of four cement tanks (9.4 x 0.6 x 0.22 m), with their bottom covered with a layer of sterilized red earth and calcium carbonate. Standard measures were adopted, as follows: each tank should contain an average of 3000 specimens, and would be provided with a daily ration of 35,000 mg complemented with lettuce. A green-house effect heating system was developed which constituted of movable dark canvas covers, which allowed the temperature to be controlled between 20 - 24 ºC. This system was essential, especially during the coldest months of the year. Approximately 27,000 specimens with a diameter of 12 mm or more were produced during a 14-month-period. The mortality rates of the newly-hatched and adult snails were 77% and 37%, respectively. The follow-up of the development system related to 310 specimens of B. tenagophila demonstrated that 70-day-old snails reached an average of 17.0 ± 0.9 mm diameter. The mortality rates and the development performance of B. tenagophila snails can be considered as highly satisfactory, when compared with other results in literature related to works carried out with different species of the genus Biomphalaria, under controlled laboratory conditions.

Comparison between the spastic paraplegia rating scale, Kurtzke scale, and Osame scale in the tropical spastic paraparesis/myelopathy associated with HTLV

INTRODUCTION:The objective of this study was to compare Osame's scale of motor incapacity and the expanded scale of the state of incapacity of Kurtzke with the spastic paraplegia rating scale for the clinical evaluation of patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). METHODS: Patients with the diagnosis of infection by HTLV-I/HTLV-II and with the clinical suspicion of HAM/TSP were included in the study. RESULTS: There were 45 patients who were evaluated. When analyzing the results of the scales, the researchers found the following averages of 21.08 points for the spastic paraplegia rating scale, 4.35 points for Osame's scale, and 4.77 points for Kurtzke's scale. The relation between the scale of paraplegia with Osame's was very significant with p < 0.0001, and regarding Kurtzke's scale, there was a similar result of p < 0.0001. When comparing Osame's, Kurtze's, and the spastic paraplegia rating scale with the time of disease, the researchers found a significant result of p = 0.0004 for the scale of spastic paraplegia, p = 0.0018 for Osame's scale, and p < 0.0001 for Kurtzke's scale. CONCLUSION: The spastic paraplegia rating scale has a good relation with Osame's and Kurtzke's scales showing a p index that is very significant that indicates that, although the scale was not initially made to be applied to patients with HAM/TSP because of the infection by HLTV, it showed to be as efficient as Osame's and Kurtzke's scales in evaluating the patients' neurological conditions.

Sexual dysfunction and dissatisfaction in chronic hepatitis C patients

IntroductionThe prevalence of sexual dysfunction (SD) and dissatisfaction with sexual life (DSL) in patients with chronic hepatitis C virus infection (CHC) was jointly investigated via a thorough psychopathological analysis, which included dimensions such as fatigue, impulsiveness, psychiatric comorbidity, health-related quality of life (HRQL) and sociodemographic and clinical characteristics.MethodsMale and female CHC patients from an outpatient referral center were assessed using the Brief Fatigue Inventory, the Barrat Impulsiveness Scale, the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale (HAM-A), and the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF). Structured psychiatric interviews were performed according to the Mini-International Neuropsychiatric Interview. SD was assessed based on specific items in the BDI (item 21) and the HAM-A (item 12). DSL was assessed based on a specific question in the WHOQOL-BREF (item 21). Multivariate analysis was performed according to an ordinal linear regression model in which SD and DSL were considered as outcome variables.ResultsSD was reported by 60 (57.1%) of the patients according to the results of the BDI and by 54 (51.4%) of the patients according to the results of the HAM-A. SD was associated with older age, female gender, viral genotype 2 or 3, interferon-α use, impulsiveness, depressive symptoms, antidepressant and benzodiazepine use, and lower HRQL. DSL was reported by 34 (32.4%) of the patients and was associated with depressive symptoms, anxiety symptoms, antidepressant use, and lower HRQL.ConclusionsThe prevalence of SD and DSL in CHC patients was high and was associated with factors, such as depressive symptoms and antidepressant use. Screening and managing these conditions represent significant steps toward improving medical assistance and the HRQL of CHC patients.

The use of saliva as a practical and feasible alternative to urine in large-scale screening for congenital cytomegalovirus infection increasesinclusion and detection rates

INTRODUCTION: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV) infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples. METHODS: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA) was detected by polymerase chain reaction (PCR). RESULTS: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection. CONCLUSIONS: Saliva samples can be used in large-scale neonatal screening for CMV infection.