Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Duke Anticoagulation Satisfaction Scale

Aim. The aim of this study was to evaluate the internal reliability and validity of the BrazilianPortuguese version of Duke Anticoagulation Satisfaction Scale (DASS) among cardiovascular patients. Background. Oral anticoagulation is widely used to prevent and treat thromboembolic events in several conditions, especially in cardiovascular diseases; however, this therapy can induce dissatisfaction and reduce the quality of life. Design. Methodological and cross-sectional research design. Methods. The cultural adaptation of the DASS included the translation and back-translation, discussions with healthcare professionals and patients to ensure conceptual equivalence, semantic evaluation and instrument pretest. The BrazilianPortuguese version of the DASS was tested among subjects followed in a university hospital anticoagulation outpatient clinic. The psychometric properties were assessed by construct validity (convergent, known groups and dimensionality) and internal consistency/reliability (Cronbachs alpha). Results. A total of 180 subjects under oral anticoagulation formed the baseline validation population. DASS total score and SF-36 domain correlations were moderate for General health (r = -0.47, p < 0.01), Vitality (r = -0.44, p < 0.01) and Mental health (r = -0.42, p < 0.01) (convergent). Age and length on oral anticoagulation therapy (in years) were weakly correlated with total DASS score and most of the subscales, except Limitation (r = -0.375, p < 0.01) (Known groups). The Cronbachs alpha coefficient was 0.79 for the total scale, and it ranged from 0.76 (hassles and burdens)0.46 (psychological impact) among the domains, confirming the internal consistency reliability. Conclusions. The BrazilianPortuguese version of the DASS has shown levels of reliability and validity comparable with the original English version. Relevance to clinical practice. Healthcare practitioners and researchers need internationally validated measurement tools to compare outcomes of interventions in clinical management and research tools in oral anticoagulation therapy.

Adaptation and validation of the Patient Expectations and Satisfaction with Prenatal Care instrument among Brazilian pregnant women

Objective: to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbach’s alpha) for distinct groups and dimensions. Method: 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbach’s alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instrument’s adapted version is valid in the studied group. Results: there is strong evidence for the validity and reliability of the instrument’s adaptation. Conclusion: the instrument needs to be tested in groups of pregnant women with different social characteristics.

Cross-cultural adaptation and psychometric properties of the Brazilian version of the scale of oral health outcomes for 5-year-old children (SOHO-5)

Abstract Background Most of the instruments available to measure the oral health-related quality of life (OHRQoL) in paediatric populations focus on older children, whereas parental reports are used for very young children. The scale of oral health outcomes for 5-year-old children (SOHO-5) assesses the OHRQoL of very young children through self-reports and parental proxy reports. We aimed to cross-culturally adapt the SOHO-5 to the Brazilian Portuguese language and to assess its reliability and validity. Findings We tested the quality of the cross-cultural adaptation in 2 pilot studies with 40 children aged 5–6 years and their parents. The measurement was tested for reliability and validity on 193 children that attended the paediatric dental screening program at the University of São Paulo. The children were also clinically examined for dental caries. The internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.90 for the children’s self-reports and 0.77 for the parental proxy reports. The test-retest reliability results, which were based on repeated administrations on 159 children, were excellent; the intraclass correlation coefficient was 0.98 for parental and 0.92 for child reports. In general, the construct validity was satisfactory and demonstrated consistent and strong associations between the SOHO-5 and different subjective global ratings of oral health, perceived dental treatment need and overall well-being in both the parental and children’s versions (p < 0.001). The SOHO-5 was also able to clearly discriminate between children with and without a history of dental caries (mean scores: 5.8 and 1.1, respectively; p < 0.001). Conclusion The present study demonstrated that the SOHO-5 exhibits satisfactory psychometric properties and is applicable to 5- to 6-year-old children in Brazil.

Prodromal Questionnaire: translation, adaptation to Portuguese and preliminary results in ultra-high risk individuals and first episode psychosis

OBJECTIVE: The Prodromal Questionnaire (PQ) is a 92-item self-report screening tool for individuals at ultra-high risk (UHR) to develop psychosis. This study aims to present the translation to Portuguese and preliminary results in UHR and first episode (FE) psychosis in a Portuguese sample. METHODS: The PQ was translated from English to Portuguese by two bilingual researchers from the research program on early psychosis of the Instituto de Psiquiatria HCFMUSP, São Paulo, Brazil (ASAS - "Evaluation and Follow up of Adolescents and Young Adults in São Paulo") and back translated by two other researchers. The study participants (n = 11-) were evaluated through the Portuguese version of the Prodromal Questionnaire (PQ) and SIPS. RESULTS: The individuals at UHR (n = 7) presented a lower score than first episode patients (n = 4). The UHR mean scores and standard deviation on Portuguese version of the PQ were: 13.0 ± 10.0 points on positive symptoms subscale, and FE patients: 33.0 ± 10.0. CONCLUSION: The UHR and FE patients' of this study presented PQ scores similar to the ones found in the literature; what suggests that it is possible to use the PQ in Brazilian help-seeking individuals as a screening tool.

Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.

Cross-cultural adaptation of the Safety Attitudes Questionnaire - Short Form 2006 for Brazil

The objective of this study was to perform a cross-cultural adaptation of the Safety Attitudes Questionnaire - Short Form 2006 for Brazil. The instrument was applied in six hospitals in three regions of Brazil. Content, face, and construct validity was performed. Analysis of the instrument's reliability was performed by verifying the items' internal consistency through Cronbach's alpha. The sample was composed of 1301 professionals working in clinical and surgical wards of six hospitals. Confirmatory analysis showed that the model including 41 items was satisfactory. The Portuguese version presented an alpha of 0.89. The item-total correlations among the domains were moderate to strong, except for the domain Stress Recognition. We concluded that the instrument's version adapted to Portuguese and applied in our sample is valid and reliable.

Adaptation and Constraint in the Plant Reproductive Phase

Conservatism is a central theme of organismic evolution. Related species share characteristics due to their common ancestry. Some concern have been raised among evolutionary biologists, whether such conservatism is an expression of natural selection or of a constrained ability to adapt. This thesis explores adaptations and constraints within the plant reproductive phase, particularly in relation to the evolution of fleshy fruit types (berries, drupes, etc.) and the seasonal timing of flowering and fruiting. The different studies were arranged along a hierarchy of scale, with general data sets sampled among seed plants at the global scale, through more specific analyses of character evolution within the genus Rhamnus s.l. L. (Rhamnaceae), to descriptive and experimental field studies in a local population of Frangula alnus (Rhamnaceae). Apart from the field study, this thesis is mainly based on comparative methods explicitly incorporating phylogenetic relationships. The comparative study of Rhamnus s.l. species included the reconstruction of phylogenetic hypotheses based on DNA sequences. Among geographically overlapping sister clades, biotic pollination was not correlated with higher species richness when compared to wind pollinated plants. Among woody plants, clades characterized by fleshy fruit types were more species rich than their dry-fruited sister clades, suggesting that the fleshy fruit is a key innovation in woody habitats. Moreover, evolution of fleshy fruits was correlated with a change to more closed (darker) habitats. An independent contrast study within Rhamnus s.l. documented allometric relations between plant and fruit size. As a phylogenetic constraint, allometric effects must be considered weak or non-existent, though, as they did not prevail among different subclades within Rhamnus s.l. Fruit size was correlated with seed size and seed number in F. alnus. This thesis suggests that frugivore selection on fleshy fruit may be important by constraining the upper limits of fruit size, when a plant lineage is colonizing (darker) habitats where larger seed size is adaptive. Phenological correlations with fruit set, dispersal, and seed size in F. alnus, suggested that the evolution of reproductive phenology is constrained by trade-offs and partial interdependences between flowering, fruiting, dispersal, and recruitment phases. Phylogenetic constraints on the evolution of phenology were indicated by a lack of correlation between flowering time and seasonal length within Rhamnus cathartica and F. alnus, respectively. On the other hand, flowering time was correlated with seasonal length among Rhamnus s.l. species. Phenological differences between biotically and wind pollinated angiosperms also suggested adaptive change in reproductive phenology.

Cyanobacteria in biological soil crusts, Earth´s Most Extensive Biofilms: adaptation and sensitivity to global warming

School of Life Sciences, Arizona State University, Tempe AZ, USA

Rich media content adaptation in e-learning systems

The wide use of e-technologies represents a great opportunity for underserved segments of the population, especially with the aim of reintegrating excluded individuals back into society through education. This is particularly true for people with different types of disabilities who may have difficulties while attending traditional on-site learning programs that are typically based on printed learning resources. The creation and provision of accessible e-learning contents may therefore become a key factor in enabling people with different access needs to enjoy quality learning experiences and services. Another e-learning challenge is represented by m-learning (which stands for mobile learning), which is emerging as a consequence of mobile terminals diffusion and provides the opportunity to browse didactical materials everywhere, outside places that are traditionally devoted to education. Both such situations share the need to access materials in limited conditions and collide with the growing use of rich media in didactical contents, which are designed to be enjoyed without any restriction. Nowadays, Web-based teaching makes great use of multimedia technologies, ranging from Flash animations to prerecorded video-lectures. Rich media in e-learning can offer significant potential in enhancing the learning environment, through helping to increase access to education, enhance the learning experience and support multiple learning styles. Moreover, they can often be used to improve the structure of Web-based courses. These highly variegated and structured contents may significantly improve the quality and the effectiveness of educational activities for learners. For example, rich media contents allow us to describe complex concepts and process flows. Audio and video elements may be utilized to add a “human touch” to distance-learning courses. Finally, real lectures may be recorded and distributed to integrate or enrich on line materials. A confirmation of the advantages of these approaches can be seen in the exponential growth of video-lecture availability on the net, due to the ease of recording and delivering activities which take place in a traditional classroom. Furthermore, the wide use of assistive technologies for learners with disabilities injects new life into e-learning systems. E-learning allows distance and flexible educational activities, thus helping disabled learners to access resources which would otherwise present significant barriers for them. For instance, students with visual impairments have difficulties in reading traditional visual materials, deaf learners have trouble in following traditional (spoken) lectures, people with motion disabilities have problems in attending on-site programs. As already mentioned, the use of wireless technologies and pervasive computing may really enhance the educational learner experience by offering mobile e-learning services that can be accessed by handheld devices. This new paradigm of educational content distribution maximizes the benefits for learners since it enables users to overcome constraints imposed by the surrounding environment. While certainly helpful for users without disabilities, we believe that the use of newmobile technologies may also become a fundamental tool for impaired learners, since it frees them from sitting in front of a PC. In this way, educational activities can be enjoyed by all the users, without hindrance, thus increasing the social inclusion of non-typical learners. While the provision of fully accessible and portable video-lectures may be extremely useful for students, it is widely recognized that structuring and managing rich media contents for mobile learning services are complex and expensive tasks. Indeed, major difficulties originate from the basic need to provide a textual equivalent for each media resource composing a rich media Learning Object (LO). Moreover, tests need to be carried out to establish whether a given LO is fully accessible to all kinds of learners. Unfortunately, both these tasks are truly time-consuming processes, depending on the type of contents the teacher is writing and on the authoring tool he/she is using. Due to these difficulties, online LOs are often distributed as partially accessible or totally inaccessible content. Bearing this in mind, this thesis aims to discuss the key issues of a system we have developed to deliver accessible, customized or nomadic learning experiences to learners with different access needs and skills. To reduce the risk of excluding users with particular access capabilities, our system exploits Learning Objects (LOs) which are dynamically adapted and transcoded based on the specific needs of non-typical users and on the barriers that they can encounter in the environment. The basic idea is to dynamically adapt contents, by selecting them from a set of media resources packaged in SCORM-compliant LOs and stored in a self-adapting format. The system schedules and orchestrates a set of transcoding processes based on specific learner needs, so as to produce a customized LO that can be fully enjoyed by any (impaired or mobile) student.

Neuroglobin, Cytoglobin und Myoglobin in der Blindmaus Spalax ehrenbergi: Adaptation an „unterirdische Verhältnisse“

Hypoxie ist ein Zustand des Sauerstoffmangels, hervorgerufen durch fehlende Verfügbarkeit von Sauerstoff in der Umgebung eines Organismus oder durch pathologisch bedingte unzureichende Nutzbarkeit des Sauerstoffs von Geweben. Die Sensitivität gegenüber Hypoxie variiert enorm im Tierreich zwischen verschiedenen Phyla und Spezies. Die meisten Säugetiere sind nur unzureichend an niedrige Sauerstoffkonzentrationen angepasst, wohingegen einige unterirdisch lebende Säuger sehr resistent gegen Hypoxiestress sind. Um die molekulare Basis der Hypoxietoleranz zu bestimmen, wurden in der vorliegenden Arbeit Globine untersucht, die potenziell in der Lage sind, als respiratorische Proteine zur Hypoxietoleranz von Tieren beizutragen. Dazu wurde die Expression der Globine in der hypoxieresistenten, in Israel lebenden Blindmaus Spalax ehrenbergi mit der Genexpression in der hypoxiesensitiven Ratte (Rattus norvegicus) verglichen. In der vorliegenden Arbeit wurden die erst vor wenigen Jahren entdeckten Globine Neuroglobin und Cytoglobin untersucht, deren exakte physiologische Rolle noch unklar ist, und mit Daten des viel detaillierter untersuchten Myoglobins verglichen. Beim Vergleich der Expression von Cytoglobin und Neuroglobin in Spalax versus Ratte fällt auf, dass Neuroglobin und Cytoglobin bereits unter normoxischen Bedingungen auf mRNA- und Proteinebene in der Blindmaus um einen Faktor von mindesten 2 bis 3 verstärkt exprimiert werden. Bei Myoglobin (als dem Kontrollgen mit bekannter Funktion) konnte auf mRNA-Ebene eine noch weitaus stärkere Expression in Spalax vs. Ratte gefunden werden. Das übergreifende Phänomen der verstärkten Genexpression von Globinen in Spalax kann im Sinne einer Präadaptation an das unterirdische, häufig hypoxische Leben der Blindmaus interpretiert werden. Einen weiteren Hinweis auf eine besondere, spezialisierte Funktion von Neuroglobin in Spalax geben immunhistochemische Daten, die zeigen, dass Neuroglobin im Gehirn von Spalax im Gegensatz zur Ratte nicht nur in Neuronen, sondern auch in Gliazellen exprimiert wird. Dies impliziert Änderungen des oxidativen Stoffwechsels im Nervensystem der hypoxietoleranten Spezies. Die zellulären Expressionsmuster von Cytoglobin erscheinen hingegen in beiden Säugerspezies weitgehend identisch. Es wurde der Frage nachgegangen, ob und wie experimentell induzierte Hypoxie die Genexpression der Globine verändert. Dabei zeigten sich für Neuroglobin und Cytoglobin unterschiedliche Expressionsmuster. Neuroglobin wird unter diversen Sauerstoffmangelbedingungen sowohl in der Ratte als auch in Spalax auf mRNA- und Proteinebene herunterreguliert. Ein ähnliches Regulationsverhalten wurde auch für Myoglobin beobachtet. Die verminderte Expression von Neuroglobin (und evtl. auch Myoglobin) unter Hypoxie ist mit einer gezielten Verringerung der Sauerstoff-Speicherkapazität in Abwesenheit von O2 zu erklären. Ein weiterer denkbarer Grund könnte auch die allgemeine Tendenz sein, unter Hypoxie aus Energiespargründen den Metabolismus herunter zu regulieren. Cytoglobin, das bei normalen Sauerstoffbedingungen nur im Gehirn von Spalax (nicht jedoch in Herz und Leber) ebenfalls um Faktor 2 bis 3 stärker exprimiert wird als in der Ratte, ist mit einiger Sicherheit ebenfalls von adaptivem Nutzen für die Anpassung von Spalax an niedrige Sauerstoffbedingungen, wenngleich seine Funktion unklar bleibt. Unter Hypoxie wird die Cytoglobin-mRNA sowohl in Spalax als auch in der Ratte hochreguliert. Es konnte in der vorliegenden Arbeit dargelegt werden, dass die Expression von Cygb höchstwahrscheinlich durch den Transkriptionsfaktor Hif-1 gesteuert wird, der die molekulare Hypoxieantwort vieler Tierarten zentral steuert. In der vorliegenden Arbeit wurde ebenfalls die Expression von Ngb und Cygb im Gehirn des Hausschweins (Sus scrofa) untersucht. Diese Spezies diente in der Arbeit als weiterer hypoxiesensitiver Organismus sowie als biomedizinisch relevantes Modell für eine Operation an Säuglingen mit angeborenen Herzkrankheiten. Die Versuche haben gezeigt, dass die Gabe bestimmter Medikamente wie dem Immunsuppressivum FK506 zu einer erhöhten Ngb-Konzentration auf mRNA-Ebene führen kann, was potenziell im Zusammenhang mit beobachteten protektiven Effekten der Medikamentengabe während und nach der Herzoperation steht.

Effects of Global Warming on Berry Composition of cv. Sangiovese: Biochemical and Molecular Aspects and Agronomical Adaptation Approaches

Wine grape must deal with serious problems due to the unfavorable climatic conditions resulted from global warming. High temperatures result in oxidative damages to grape vines. The excessive elevated temperatures are critical for grapevine productivity and survival and contribute to degradation of grape and wine quality and yield. Elevated temperature can negatively affect anthocyanin accumulation in red grape. Particularly, cv. Sangiovese was identified to be very sensitive to such condition. The quantitative real-time PCR analysis showed that flavonoid biosynthetic genes were slightly repressed by high temperature. Also, the heat stress repressed the expression of the transcription factor “VvMYBA1” that activates the expression of UFGT. Moreover, high temperatures had repressing effects on the activity of the flavonoids biosynthetic enzymes “PAL” and “UFGT”.Anthocyanin accumulation in berry skin is due to the balance between its synthesis and oxidation. In grape cv. Sangiovese, the gene transcription and activity of peroxidases enzyme was elevated by heat stress as a defensive mechanism of ROS-scavenging. Among many isoforms of peroxidases genes, one gene (POD 1) was induced in Sangiovese under thermal stress condition. This gene was isolated and evaluated via the technique of genes transformation from grape to Petunia. Reduction in anthocyanins concentration and higher enzymatic activity of peroxidase was observed in POD 1 transformed Petunia after heat shock compared to untrasformed control. Moreover, in wine producing regions, it is inevitable for the grape growers to adopt some adaptive strategies to alleviate grape damages to abiotic stresses. Therefore, in this thesis, the technique of post veraison trimming was done to improve the coupling of phenolic and sugar ripening in Vitis vinifera L. cultivar Sangiovese. Trimming after veraison showed to be executable to slow down the rate of sugar accumulation in grape (to decrease the alcohol potential in wines) without evolution of the main berry flavonoids compounds.

An Innovation System Perspective on Adaptation Strategies to Climate Variability and Water Management in India

Government policies play a critical role in influencing market conditions, institutions and overall agricultural productivity. The thesis therefore looks into the history of agriculture development in India. Taking a political economy perspective, the historical account looks at significant institutional and technological innovations carried out in pre- independent and post independent India. It further focuses on the Green Revolution in Asia, as forty years after; the agricultural community still faces the task of addressing recurrent issue of food security amidst emerging challenges, such as climate change. It examines the Green Revolution that took place in India during the late 1960s and 70s in a historical perspective, identifying two factors of institutional change and political leadership. Climate change in agriculture development has become a major concern to farmers, researchers and policy makers alike. However, there is little knowledge on the farmers’ perception to climate change and to the extent they coincide with actual climatic data. Using a qualitative approach,it looks into the perceptions of the farmers in four villages in the states of Maharashtra and Andhra Pradesh. While exploring the adaptation strategies, the chapter looks into the dynamics of who can afford a particular technology and who cannot and what leads to a particular adaptation decision thus determining the adaptive capacity in water management. The final section looks into the devolution of authority for natural resource management to local user groups through the Water Users’ Associations as an important approach to overcome the long-standing challenges of centralized state bureaucracies in India. It addresses the knowledge gap of why some local user groups are able to overcome governance challenges such as elite capture, while others-that work under the design principles developed by Elinor Ostrom. It draws conclusions on how local leadership, can be promoted to facilitate participatory irrigation management.

Dynamic Adaptive Streaming over Http: implementazione e analisi sperimentale di algoritmi di rate adaptation su client Android

Il lavoro svolto in questa tesi consiste nell'implementare un'applicazione Android per lo streaming video, conforme allo standard MPEG-DASH. L'obiettivo è quello di fornire un valido strumento al fine di eseguire delle analisi sperimentali su algoritmi particolari, detti di rate adaptation. MPEG-Dynamic Adaptive Streaming over Http è uno standard emergente ed è considerato da molti il futuro dello streaming multimediale. Questa tecnologia consente di auto-regolare la qualità del video in base alle condizioni della rete, la capacità del dispositivo o le preferenze dell'utente. Inoltre, essendo uno standard, permette di rendere interoperabili i server e i device dei vari fornitori di contenuti multimediali. Nei primi capitoli introduttivi verrà presentato lo standard e i lavori correlati, successivamente verrà descritta la mia proposta applicativa: DashPlayer. In conclusione, verrà compiuta una valutazione sperimentali sugli algoritmi sopracitati che costituiscono la parte logico-funzionale dell'applicazione.

Active Translation into English and Italian of Hosseini's adaptation of the Persian epic,"Shahname"

This thesis proposes a translation from Persian into Italian and English of an ancient Persian epic called Shahname, or literally “The Book of Kings,” by Ferdosi, first published in the 11th century CE. The translation proposed, however, is not based on the original book by Ferdosi, which is written all in verse, but rather, an edited, shorter, and simplified version written in prose, by Mohamad Hosseini, first published in 2013. Nonetheless, in his version, Hosseini included some of the verses from the original poems in order to show the value and the beauty of Ferdosi’s writing. Many translations of Ferdosi’s book have been made into English, but only one translation has been made into Italian, by one Italo Pizzi, in 8 volumes, all in verse, in 1886. This thesis analyses and discusses the choices made for the two translations presented into English and Italian. My project is not only to propose translations of Hosseini’s version, but to also introduce the reader to the Persian culture, and to the life of the most famous Iranian epic writer, Ferdosi, and his masterpiece, Shahname.