Adaptação e validação do Cardiac Patients Learnings Needs Inventory para pacientes brasileiros

OBJETIVOS: Adaptar culturalmente o Cardiac Patients'Leaning Needs Inventory para uso no Brasil e testar sua confiabilidade (consistência interna e estabilidade) em pacientes brasileiros com doença arterial coronariana. MÉTODOS: Participaram do estudo 65 pacientes com infarto agudo do miocárdio, internados em um hospital público do interior do Estado de São Paulo. Para a coleta dos dados, foram utilizados um instrumento para caracterização sociodemográfica e a versão em português do Cardiac Patients Leaning Needs Inventory. A consistência interna foi estimada com base no alfa de Cronbach. A estabilidade foi medida apoiada no teste-reteste e calculada pelo teste t de Student. O nível de significância adotado foi 0,05. RESULTADOS: Identificou-se consistência interna alta (0,96 na primeira medida e 0,78 na segunda). O domínio que apresentou melhor consistência interna foi Fatores de Risco (α= 0,91). CONCLUSÃO: A versão adaptada manteve as equivalências conceituais, semânticas e idiomáticas da versão original e apresentou confiabilidade e estabilidade adequadas.

Validação de constructo de tecnologia educativa para pacientes mediante aplicação da técnica Delphi

OBJETIVO: Descrever o processo de validação de uma tecnologia educativa para pacientes submetidos à cirurgia ortognática, mediante a aplicação da técnica Delphi. MÉTODOS: Participaram do estudo, dez juízes (quatro cirurgiões bucomaxilofaciais, duas enfermeiras, duas nutricionistas e duas fonoaudiólogas) que indicaram os assuntos a serem abordados no material destinado à primeira fase da técnica Delphi. Após a construção do material e a obtenção dos resultados da primeira fase, iniciou-se as segunda e terceira fases dessa técnica com validação da pertinência das informações contidas nessa tecnologia educativa. RESULTADOS: Na segunda rodada, obteve-se, pelo menos, 90,0% de concordância em todas as categorias. Na terceira, houve um aumento de 12% para o item conteúdo, melhora de 6,7% em linguagem, de 12,5% em ilustrações, de 3,3% no layout, de 10% em cultura, mantendo-se constante o item motivação. CONCLUSÃO: A técnica Delphi, pode ser uma importante ferramenta na construção e validação de tecnologias educativas.

Evaluation of quality of life in a palliative care context: an integrative literature review

The use of scales that have been validated and standardized for different cultures is very useful for identifying demands in the field of Palliative Care and implementing the most appropriate care. This integrative literature review focuses on instruments assessing the Quality of Life of patients under Palliative Care through a journal search in electronic databases. The study consisted of 49 papers identified in Medline/PubMed, of which 18 met the inclusion criteria previously defined. Information concerning the selected studies is presented and later categorized, with a greater emphasis on the analysis of the psychometric properties of validations of the Palliative Outcome Scale, conducted in three countries. This review enabled the identification of instruments already developed and validated for different cultures, increasing the possibility of knowledge in the field.

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.

Assessment of depression in medical patients: a systematic review of the utility of the beck depression inventory-II

To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depression Inventory-II for measuring depression in medical settings to provide guidelines for practicing clinicians. Considering the inclusion and exclusion criteria seventy articles were retained. Validation studies of the Beck Depression Inventory-II, in both primary care and hospital settings, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The Beck Depression Inventory-II showed high reliability and good correlation with measures of depression and anxiety. Its threshold for detecting depression varied according to the type of patients, suggesting the need for adjusted cut-off points. The somatic and cognitive-affective dimension described the latent structure of the instrument. The Beck Depression Inventory-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in patients with medical conditions, the clinician should seek evidence for how to interpret the score before using the Beck Depression Inventory-II to make clinical decisions

Genetic evidence supporting the association of protease and protease inhibitor genes with inflammatory bowel disease: a systematic review

As part of the European research consortium IBDase, we addressed the role of proteases and protease inhibitors (P/PIs) in inflammatory bowel disease (IBD), characterized by chronic mucosal inflammation of the gastrointestinal tract, which affects 2.2 million people in Europe and 1.4 million people in North America. We systematically reviewed all published genetic studies on populations of European ancestry (67 studies on Crohn's disease [CD] and 37 studies on ulcerative colitis [UC]) to identify critical genomic regions associated with IBD. We developed a computer algorithm to map the 807 P/PI genes with exact genomic locations listed in the MEROPS database of peptidases onto these critical regions and to rank P/PI genes according to the accumulated evidence for their association with CD and UC. 82 P/PI genes (75 coding for proteases and 7 coding for protease inhibitors) were retained for CD based on the accumulated evidence. The cylindromatosis/turban tumor syndrome gene (CYLD) on chromosome 16 ranked highest, followed by acylaminoacyl-peptidase (APEH), dystroglycan (DAG1), macrophage-stimulating protein (MST1) and ubiquitin-specific peptidase 4 (USP4), all located on chromosome 3. For UC, 18 P/PI genes were retained (14 proteases and 4 protease inhibitors), with a considerably lower amount of accumulated evidence. The ranking of P/PI genes as established in this systematic review is currently used to guide validation studies of candidate P/PI genes, and their functional characterization in interdisciplinary mechanistic studies in vitro and in vivo as part of IBDase. The approach used here overcomes some of the problems encountered when subjectively selecting genes for further evaluation and could be applied to any complex disease and gene family.

Exposure modeling of high-frequency electromagnetic fields

We developed a geospatial model that calculates ambient high-frequency electromagnetic field (HF-EMF) strengths of stationary transmission installations such as mobile phone base stations and broadcast transmitters with high spatial resolution in the order of 1 m. The model considers the location and transmission patterns of the transmitters, the three-dimensional topography, and shielding effects by buildings. The aim of the present study was to assess the suitability of the model for exposure monitoring and for epidemiological research. We modeled time-averaged HF-EMF strengths for an urban area in the city of Basel as well as for a rural area (Bubendorf). To compare modeling with measurements, we selected 20 outdoor measurement sites in Basel and 18 sites in Bubendorf. We calculated Pearson's correlation coefficients between modeling and measurements. Chance-corrected agreement was evaluated by weighted Cohen's kappa statistics for three exposure categories. Correlation between measurements and modeling of the total HF-EMF strength was 0.67 (95% confidence interval (CI): 0.33-0.86) in the city of Basel and 0.77 (95% CI: 0.46-0.91) in the rural area. In both regions, kappa coefficients between measurements and modeling were 0.63 and 0.77 for the total HF-EMF strengths and for all mobile phone frequency bands. First evaluation of our geospatial model yielded substantial agreement between modeling and measurements. However, before the model can be applied for future epidemiologic research, additional validation studies focusing on indoor values are needed to improve model validity.Journal of Exposure Science and Environmental Epidemiology (2008) 18, 183-191; doi:10.1038/sj.jes.7500575; published online 4 April 2007.

Finite element analysis for prediction of bone strength

Article preview View full access options BoneKEy Reports | Review Print Email Share/bookmark Finite element analysis for prediction of bone strength Philippe K Zysset, Enrico Dall'Ara, Peter Varga & Dieter H Pahr Affiliations Corresponding author BoneKEy Reports (2013) 2, Article number: 386 (2013) doi:10.1038/bonekey.2013.120 Received 03 January 2013 Accepted 25 June 2013 Published online 07 August 2013 Article tools Citation Reprints Rights & permissions Abstract Abstract• References• Author information Finite element (FE) analysis has been applied for the past 40 years to simulate the mechanical behavior of bone. Although several validation studies have been performed on specific anatomical sites and load cases, this study aims to review the predictability of human bone strength at the three major osteoporotic fracture sites quantified in recently completed in vitro studies at our former institute. Specifically, the performance of FE analysis based on clinical computer tomography (QCT) is compared with the ones of the current densitometric standards, bone mineral content, bone mineral density (BMD) and areal BMD (aBMD). Clinical fractures were produced in monotonic axial compression of the distal radii, vertebral sections and in side loading of the proximal femora. QCT-based FE models of the three bones were developed to simulate as closely as possible the boundary conditions of each experiment. For all sites, the FE methodology exhibited the lowest errors and the highest correlations in predicting the experimental bone strength. Likely due to the improved CT image resolution, the quality of the FE prediction in the peripheral skeleton using high-resolution peripheral CT was superior to that in the axial skeleton with whole-body QCT. Because of its projective and scalar nature, the performance of aBMD in predicting bone strength depended on loading mode and was significantly inferior to FE in axial compression of radial or vertebral sections but not significantly inferior to FE in side loading of the femur. Considering the cumulated evidence from the published validation studies, it is concluded that FE models provide the most reliable surrogates of bone strength at any of the three fracture sites.

Measuring Intensity of End of Life Care: A Systematic Review.

BACKGROUND Many studies have measured the intensity of end of life care. However, no summary of the measures used in the field is currently available. OBJECTIVES To summarise features, characteristics of use and reported validity of measures used for evaluating intensity of end of life care. METHODS This was a systematic review according to PRISMA guidelines. We performed a comprehensive literature search in Ovid Medline, Embase, The Cochrane Library of Systematic Reviews and reference lists published between 1990-2014. Two reviewers independently screened titles, abstracts, full texts and extracted data. Studies were eligible if they used a measure of end of life care intensity, defined as all quantifiable measures describing the type and intensity of medical care administered during the last year of life. RESULTS A total of 58 of 1590 potentially eligible studies met our inclusion criteria and were included. The most commonly reported measures were hospitalizations (n = 44), intensive care unit admissions (n = 39) and chemotherapy use (n = 27). Studies measured intensity of care in different timeframes ranging from 48 hours to 12 months. The majority of studies were conducted in cancer patients (n = 31). Only 4 studies included information on validation of the measures used. None evaluated construct validity, while 3 studies considered criterion and 1 study reported both content and criterion validity. CONCLUSIONS This review provides a synthesis to aid in choosing intensity of end of life care measures based on their previous use but simultaneously highlights the crucial need for more validation studies and consensus in the field.

How to measure Narcissism – an ongoing discussion

Over the last decades, research on narcissism was dominated with a focus on grandiose narcissism as measured by the NPI (Raskin & Terry, 1988), however, recent discussions emphasize the broad range of manifestations of narcissism, in particular more vulnerable aspects. As a result, new questionnaires were developed to cover the full range of these aspects. One example is the Pathological Narcissism Scale (PNI, Pincus et al. 2009), a 52 item questionnaire with seven subscales covering both grandiose and vulnerable aspects. Validation studies show that narcissism as measured with the PNI differs substantially from narcissism as measured with the NPI. Moreover, a discussion concerning the composition of grandiose and vulnerable narcissism has evolved from these data. In our study we demonstrate how scores on narcissism and narcissism subtypes are associated with a broad variety of personality and clinical measures. In a sample of 1837 participants (1240 female, 597 male; mean age 26.8 years) we investigated the correlation patterns of both PNI and NPI subscales with constructs like FFM, aggression, emotions, clinical symptoms, and well-being. Results show that the assignment of subscales to grandiose and vulnerable subtypes are not unambiguous. We therefore conclude that the decision of how to measure narcissism needs further investigation.

AMELIE: Authoring Multimedia-Enhanced Learning Interactive Environment for e-Health Contents

This paper presents the AMELIE Authoring Tool for e-health applications. AMELIE provides the means for creating video-based contents with a focus on e-learning and telerehabilitation processes. The main core of AMELIE lies in the efficient exploitation of raw multimedia resources, which may be already available at clinical centers or recorded ad hoc for learning purposes by health professionals. Three real use cases scenarios involving different target users are presented: (1) cognitive skills? training of surgeons in minimally invasive surgery (medical professionals), (2) training of informal carers for elderly home assistance and (3) cognitive rehabilitation of patients with acquired brain injury. Preliminary validation in the field of surgery hints at the potential of AMELIE; and its versatility in different medical applications is patent from the use cases described. Regardless, new validation studies are planned in the three main application areas identified in this work.

Optimización multiobjetivo inteligente del dimensionamiento energético en sistemas ferroviarios señalizados y en plataformas software de tiempo real

La capacidad de transporte es uno de los baremos fundamentales para evaluar la progresión que puede llegar a tener un área económica y social. Es un sector de elevada importancia para la sociedad actual. Englobado en los distintos tipos de transporte, uno de los medios de transporte que se encuentra más en alza en la actualidad, es el ferroviario. Tanto para movilidad de pasajeros como para mercancías, el tren se ha convertido en un medio de transporte muy útil. Se encuentra dentro de las ciudades, entre ciudades con un radio pequeño entre ellas e incluso cada vez más, gracias a la alta velocidad, entre ciudades con gran distancia entre ellas. Esta Tesis pretende ayudar en el diseño de una de las etapas más importantes de los Proyectos de instalación de un sistema ferroviario: el sistema eléctrico de tracción. La fase de diseño de un sistema eléctrico de tracción ferroviaria se enfrenta a muchas dudas que deben ser resueltas con precisión. Del éxito de esta fase dependerá la capacidad de afrontar las demandas de energía de la explotación ferroviaria. También se debe atender a los costes de instalación y de operación, tanto costes directos como indirectos. Con la Metodología que se presenta en esta Tesis se ofrecerá al diseñador la opción de manejar un sistema experto que como soluciones le plantee un conjunto de escenarios de sistemas eléctricos correctos, comprobados por resolución de modelos de ecuaciones. Correctos desde el punto de vista de validez de distintos parámetros eléctrico, como de costes presupuestarios e impacto de costes indirectos. Por tanto, el diseñador al haber hecho uso de esta Metodología, tendría en un espacio de tiempo relativamente corto, un conjunto de soluciones factibles con las que poder elegir cuál convendría más según sus intereses finales. Esta Tesis se ha desarrollado en una vía de investigación integrada dentro del Centro de Investigaciones Ferroviarias CITEF-UPM. Entre otros proyectos y vías de investigación, en CITEF se ha venido trabajando en estudios de validación y dimensionamiento de sistemas eléctricos ferroviarios con diversos y variados clientes y sistemas ferroviarios. A lo largo de los proyectos realizados, el interés siempre ha girado mayoritariamente sobre los siguientes parámetros del sistema eléctrico: - Calcular número y posición de subestaciones de tracción. Potencia de cada subestación. - Tipo de catenaria a lo largo del recorrido. Conductores que componen la catenaria. Características. - Calcular número y posición de autotransformadores para sistemas funcionando en alterna bitensión o 2x25kV. - Posición Zonas Neutras. - Validación según normativa de: o Caídas de tensión en la línea o Tensiones máximas en el retorno de la línea o Sobrecalentamiento de conductores o Sobrecalentamiento de los transformadores de las subestaciones de tracción La idea es que las soluciones aportadas por la Metodología sugieran escenarios donde de estos parámetros estén dentro de los límites que marca la normativa. Tener la posibilidad de tener un repositorio de posibles escenarios donde los parámetros y elementos eléctricos estén calculados como correctos, aporta un avance en tiempos y en pruebas, que mejoraría ostensiblemente el proceso habitual de diseño para los sistemas eléctricos ferroviarios. Los costes directos referidos a elementos como subestaciones de tracción, autotransformadores, zonas neutras, ocupan un gran volumen dentro del presupuesto de un sistema ferroviario. En esta Tesis se ha querido profundizar también en el efecto de los costes indirectos provocados en la instalación y operación de sistemas eléctricos. Aquellos derivados del impacto medioambiental, los costes que se generan al mantener los equipos eléctricos y la instalación de la catenaria, los costes que implican la conexión entre las subestaciones de tracción con la red general o de distribución y por último, los costes de instalación propios de cada elemento compondrían los costes indirectos que, según experiencia, se han pensado relevantes para ejercer un cierto control sobre ellos. La Metodología cubrirá la posibilidad de que los diseños eléctricos propuestos tengan en cuenta variaciones de coste inasumibles o directamente, proponer en igualdad de condiciones de parámetros eléctricos, los más baratos en función de los costes comentados. Analizando los costes directos e indirectos, se ha pensado dividir su impacto entre los que se computan en la instalación y los que suceden posteriormente, durante la operación de la línea ferroviaria. Estos costes normalmente suelen ser contrapuestos, cuánto mejor es uno peor suele ser el otro y viceversa, por lo que hace falta un sistema que trate ambos objetivos por separado. Para conseguir los objetivos comentados, se ha construido la Metodología sobre tres pilares básicos: - Simulador ferroviario Hamlet: Este simulador integra módulos para construir esquemas de vías ferroviarios completos; módulo de simulación mecánica y de la tracción de material rodante; módulo de señalización ferroviaria; módulo de sistema eléctrico. Software realizado en C++ y Matlab. - Análisis y estudio de cómo focalizar los distintos posibles escenarios eléctricos, para que puedan ser examinados rápidamente. Pico de demanda máxima de potencia por el tráfico ferroviario. - Algoritmos de optimización: A partir de un estudio de los posibles algoritmos adaptables a un sistema tan complejo como el que se plantea, se decidió que los algoritmos genéticos serían los elegidos. Se han escogido 3 algoritmos genéticos, permitiendo recabar información acerca del comportamiento y resultados de cada uno de ellos. Los elegidos por motivos de tiempos de respuesta, multiobjetividad, facilidad de adaptación y buena y amplia aplicación en proyectos de ingeniería fueron: NSGA-II, AMGA-II y ɛ-MOEA. - Diseño de funciones y modelo preparado para trabajar con los costes directos e indirectos y las restricciones básicas que los escenarios eléctricos no deberían violar. Estas restricciones vigilan el comportamiento eléctrico y la estabilidad presupuestaria. Las pruebas realizadas utilizando el sistema han tratado o bien de copiar situaciones que se puedan dar en la realidad o directamente sistemas y problemas reales. Esto ha proporcionado además de la posibilidad de validar la Metodología, también se ha posibilitado la comparación entre los algoritmos genéticos, comparar sistemas eléctricos escogidos con los reales y llegar a conclusiones muy satisfactorias. La Metodología sugiere una vía de trabajo muy interesante, tanto por los resultados ya obtenidos como por las oportunidades que puede llegar a crear con la evolución de la misma. Esta Tesis se ha desarrollado con esta idea, por lo que se espera pueda servir como otro factor para trabajar con la validación y diseño de sistemas eléctricos ferroviarios. ABSTRACT Transport capacity is one of the critical points to evaluate the progress than a specific social and economical area is able to reach. This is a sector of high significance for the actual society. Included inside the most common types of transport, one of the means of transport which is elevating its use nowadays is the railway. Such as for passenger transport of weight movements, the train is being consolidated like a very useful mean of transport. Railways are installed in many geography areas. Everyone know train in cities, or connecting cities inside a surrounding area or even more often, taking into account the high-speed, there are railways infrastructure between cities separated with a long distance. This Ph.D work aims to help in the process to design one of the most essential steps in Installation Projects belonging to a railway system: Power Supply System. Design step of the railway power supply, usually confronts to several doubts and uncertainties, which must be solved with high accuracy. Capacity to supply power to the railway traffic depends on the success of this step. On the other hand is very important to manage the direct and indirect costs derived from Installation and Operation. With the Methodology is presented in this Thesis, it will be offered to the designer the possibility to handle an expert system that finally will fill a set of possible solutions. These solutions must be ready to work properly in the railway system, and they were tested using complex equation models. This Thesis has been developed through a research way, integrated inside Citef (Railway Research Centre of Technical University of Madrid). Among other projects and research ways, in Citef has been working in several validation studies and dimensioning of railway power supplies. It is been working by a large range of clients and railways systems. Along the accomplished Projects, the main goal has been rounded mostly about the next list of parameters of the electrical system: - Calculating number and location of traction substations. Power of each substation. - Type of Overhead contact line or catenary through the railway line. The wires which set up the catenary. Main Characteristics. - Calculating number and position of autotransformers for systems working in alternating current bi-voltage of called 2x25 kV. - Location of Neutral Zones. - Validating upon regulation of: o Drop voltages along the line o Maximum return voltages in the line o Overheating/overcurrent of the wires of the catenary o Avoiding overheating in the transformers of the traction substations. Main objective is that the solutions given by the Methodology, could be suggest scenarios where all of these parameters from above, would be between the limits established in the regulation. Having the choice to achieve a repository of possible good scenarios, where the parameters and electrical elements will be assigned like ready to work, that gives a great advance in terms of times and avoiding several tests. All of this would improve evidently the regular railway electrical systems process design. Direct costs referred to elements like traction substations, autotransformers, neutral zones, usually take up a great volume inside the general budget in railway systems. In this Thesis has been thought to bear in mind another kind of costs related to railway systems, also called indirect costs. These could be enveloped by those enmarked during installation and operation of electrical systems. Those derived from environmental impact; costs generated during the maintenance of the electrical elements and catenary; costs involved in the connection between traction substations and general electric grid; finally costs linked with the own installation of the whole electrical elements needed for the correct performance of the railway system. These are integrated inside the set has been collected taking into account own experience and research works. They are relevant to be controlled for our Methodology, just in case for the designers of this type of systems. The Methodology will cover the possibility that the final proposed power supply systems will be hold non-acceptable variations of costs, comparing with initial expected budgets, or directly assuming a threshold of budget for electrical elements in actual scenario, and achieving the cheapest in terms of commented costs from above. Analyzing direct and indirect costs, has been thought to divide their impact between two main categories. First one will be inside the Installation and the other category will comply with the costs often happens during Railway Operation time. These costs normally are opposed, that means when one is better the other turn into worse, in costs meaning. For this reason is necessary treating both objectives separately, in order to evaluate correctly the impact of each one into the final system. The objectives detailed before build the Methodology under three basic pillars: - Railway simulator Hamlet: This software has modules to configure many railway type of lines; mechanical and traction module to simulate the movement of rolling stock; signaling module; power supply module. This software has been developed using C++ and Matlab R13a - Previously has been mandatory to study how would be possible to work properly with a great number of feasible electrical systems. The target comprised the quick examination of these set of scenarios in terms of time. This point is talking about Maximum power demand peaks by railway operation plans. - Optimization algorithms. A railway infrastructure is a very complex system. At the beginning it was necessary to search about techniques and optimization algorithms, which could be adaptable to this complex system. Finally three genetic multiobjective algorithms were the chosen. Final decision was taken attending to reasons such as time complexity, able to multiobjective, easy to integrate in our problem and with a large application in engineering tasks. They are: NSGA-II, AMGA-II and ɛ-MOEA. - Designing objectives functions and equation model ready to work with the direct and indirect costs. The basic restrictions are not able to avoid, like budgetary or electrical, connected hardly with the recommended performance of elements, catenary and safety in a electrical railway systems. The battery of tests launched to the Methodology has been designed to be as real as possible. In fact, due to our work in Citef and with real Projects, has been integrated and configured three real railway lines, in order to evaluate correctly the final results collected by the Methodology. Another topic of our tests has been the comparison between the performances of the three algorithms chosen. Final step has been the comparison again with different possible good solutions, it means power supply system designs, provided by the Methodology, testing the validity of them. Once this work has been finished, the conclusions have been very satisfactory. Therefore this Thesis suggest a very interesting way of research and work, in terms of the results obtained and for the future opportunities can be created with the evolution of this. This Thesis has been developed with this idea in mind, so is expected this work could adhere another factor to work in the difficult task of validation and design of railway power supply systems.

STRBase: a short tandem repeat DNA database for the human identity testing community

The National Institute of Standards and Technology (NIST) has compiled and maintained a Short Tandem Repeat DNA Internet Database (http://www.cstl.nist.gov/biotech/strbase/) since 1997 commonly referred to as STRBase. This database is an information resource for the forensic DNA typing community with details on commonly used short tandem repeat (STR) DNA markers. STRBase consolidates and organizes the abundant literature on this subject to facilitate on-going efforts in DNA typing. Observed alleles and annotated sequence for each STR locus are described along with a review of STR analysis technologies. Additionally, commercially available STR multiplex kits are described, published polymerase chain reaction (PCR) primer sequences are reported, and validation studies conducted by a number of forensic laboratories are listed. To supplement the technical information, addresses for scientists and hyperlinks to organizations working in this area are available, along with the comprehensive reference list of over 1300 publications on STRs used for DNA typing purposes.

Adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros

Introdução: As precauções-padrão (PP) constituem um conjunto de medidas que têm como finalidade minimizar o risco de transmissão ocupacional de patógenos, sendo indispensável sua utilização por profissionais de saúde, sobretudo pelos enfermeiros. No entanto, a não adesão às PP constitui problemática amplamente discutida em todo o mundo. Embora haja diversos estudos brasileiros que visem avaliar a adesão às PP , ainda tem-se observado grande fragilidade no processo de construção e de validação dos instrumentos utilizados para avaliação deste construto. Objetivo: Realizar a adaptação cultural e validação da Compliance with Standard Precautions Scale (CSPS) para enfermeiros brasileiros. Metodologia: Trata-se de um estudo metodológico para a adaptação e validação da CSPS. Essa escala é composta por 20 itens com quatro opções de respostas, e destina-se a avaliar a adesão às PP. O processo de adaptação consistiu em Tradução, Consenso entre Juízes, Retrotradução e Validação Semântica. A primeira etapa foi a tradução do idioma original para o português do Brasil. Após foi realizado um comitê composto por sete juízes, a versão de consenso obtida na etapa anterior foi traduzida novamente para o idioma de origem. Foram avaliadas as propriedades psicométricas do instrumento, considerando-se as validades de face e de conteúdo, a validade de construto e a confiabilidade. A versão para o Português do Brasil da CSPS (CSPS-PB) foi aplicada em uma amostra de 300 enfermeiros que atuam na assistência a pacientes em um hospital localizado na cidade de São Paulo/SP. A confiabilidade foi avaliada por meio da consistência interna (alfa de Cronbach) e teste reteste (coeficiente de correlação intraclasse - ICC). Para a validação de construto, foi utilizada a comparação entre grupos diferentes, análise fatorial exploratória e análise fatorial confirmatória, segundo o Modelo de Equações Estruturais (SEM). Utilizou-se o software IBM® SPSS, 19.0. Para a análise fatorial confirmatória foi utilizado o módulo específico Analysis of Moment Structures (IBM® SPSS AMOS). Para a análise paralela utilizou-se o programa RanEigen Syntax. O nível de significância adotado foi ? = 0,05. Todos os aspectos éticos foram contemplados. Resultados: A tradução realizada por tradutores juramentados garantiu qualidade a esse processo. A validação de face e de conteúdo possibilitou a realização de modificações pertinentes e imperativas a fim de atender aos critérios de equivalências conceituais, idiomáticas, culturais e semânticas. Obteve-se ?=0,61 na avaliação da consistência interna, indicando confiabilidade satisfatória. O ICC indicou uma correlação de 0,87 quase perfeita para o teste reteste duas semanas após a primeira abordagem, conferindo estabilidade satisfatória. A validade de construto mostrou que a CSPS-PB foi capaz de discriminar as médias de adesão às PP entre grupos distintos referente à idade (F=5,15 p<=0,01), ao tempo de experiência clínica (F = 8,9 p<= 0,000) e a ter recebido treinamento (t = 2,48 p<=0,01). Na análise fatorial confirmatória, o modelo foi subidentificado. A análise fatorial exploratória indicou que todos os itens apresentaram cargas fatoriais adequadas (>=0,30), sendo identificados quatro fatores pela análise paralela. O total de variância explicada foi de 35,48%. Conclusão: A CSPS-PB, trata-se de um instrumento adequado, confiável e válido para medir a adesão às PP entre enfermeiros brasileiros

Elaboração e validação de um instrumento de avaliação da transferência do Tratamento Diretamente Observado da tuberculose segundo a perspectiva de profissionais de saúde de nível médio e superior (ATP-IINFOC-TB)

Compreendendo a tuberculose enquanto problema de saúde pública, desde meados dos anos 1990 a Organização Mundial da Saúde recomenda ações de controle da doença, dentre estas a Directly Observed Treatment Short-Course (DOTS) que, junto às demais recomendações, é transferida e executada em diferentes cenários, sendo essa transferência merecedora de atenção e aprofundamento, o que deve ocorrer por meio da utilização de métodos válidos e confiáveis. Trata-se de um estudo metodológico, cujo objetivo é elaborar e validar um instrumento voltado à avaliação da transferência da política do Tratamento Diretamente Observado, segundo a perspectiva de profissionais de saúde, por meio das dimensões \"Informação\", \"Conhecimento\" e \"Inovação\". O estudo foi realizado em três fases, a saber: validação semântica, primeira fase do estudo de campo e segunda fase do estudo de campo. A validação semântica contou com 24 profissionais; a primeira fase do estudo de campo, com 101 profissionais; e a segunda fase do estudo de campo, com 401 profissionais. Na validação semântica, o instrumento foi ajustado segundo as sugestões dos entrevistados, tendo ocorrido também a retirada de dois itens dos 49 inicialmente propostos. Na primeira fase do estudo de campo, o instrumento não apresentou efeito floor and ceiling e foram retirados 8 itens com carga fatorial < 0,30 na Análise Fatorial Exploratória. O instrumento apresentou um bom alfa de Cronbach (?=0,87), e a dimensão \"Conhecimento\" apresentou alfa baixo (?=0,645). Na segunda fase do estudo de campo, o efeito floor and ceiling manteve- se ausente, com baixo coeficiente de correlação linear de Pearson (r), baixo ajuste (55%) e baixo alfa de Cronbach (?=0,61) para a dimensão \"Conhecimento\", tendo as dimensões \"Informação\" e \"Inovação\" atingido valores aceitáveis. Para o instrumento como um todo, o Alfa de Cronbach foi de 0,872. O KMO e o Teste de Esfericidade de Bartlett foram satisfatórios, permitindo a Análise Fatorial Confirmatória. Entretanto, identificou-se baixo valor de ajuste do modelo no CFI e RMSEA (0,576 e 0,088, respectivamente), com uma baixa correlação entre as dimensões propostas. Conclui-se que o instrumento elaborado é capaz de avaliar a transferência do TDO segundo a perspectiva de profissionais de saúde de nível médio e superior de forma unidimensional, sem a utilização das três dimensões inicialmente propostas