Cross-cultural adaptation of the Science Motivation Questionnaire II (SMQ-II) for Portuguese-speaking Brazilian secondary school students

Introduction: Science motivation is important for students' scientific literacy. Yet, there is a lack of valid and reliable measurement tools for the Brazilian context. This study presents the Brazilian Portuguese version of the Science Motivation Questionnaire (SMQ-II) and motivational baseline data. Method: The instrument was translated into Brazilian Portuguese using cross-cultural validation procedures. For structural validity evidence, the responses of 646 secondary school students were subjected to exploratory and confirmatory factor analysis, as well as measurement invariance. For reliability evidence, Cronbach's alpha (a) and McDonald's omega (w) were calculated. Students' motivation was analysed using 2 (gender) x 4 (grade levels) x 3 (study modality) MANOVA. Results: 24 items measuring intrinsic motivation, career motivation, grade motivation, and self-efficacy supported a four-factor structure with adequate reliability against the original five-factor structure (self-determination was not salient). Measurement invariance was established across the gender and study modalities, but not for grade levels. Higher-grade level Brazilian students were less motivated, and girls reported higher intrinsic and career motivation, but lower self-efficacy than boys. Conclusion: These findings lay the foundation for the assessment of Brazilian students' science motivation, although they also reveal problems in the latent structure of the SMQ-II and call for the development of instruments rooted in contemporary motivational theories.

Introdução: A motivação científica é importante para a alfabetização científica dos estudantes. No entanto, há uma falta de ferramentas de medição válidas e confiáveis para o contexto brasileiro. Este estudo apresenta a versão em português brasileiro do Questionário de Motivação Científica (SMQ-II) e dados de base motivacionais. Método: O instrumento foi traduzido para o português brasileiro utilizando procedimentos de validação transcultural. Para construir provas de validade, as respostas de 646 alunos do ensino médio foram submetidas à análise exploratória e confirmatória de fatores, bem como invariância de medidas. Para a evidência de confiabilidade, foram calculados o alfa de Cronbach (a) e o ômega de McDonald's (w). A motivação dos estudantes foi analisada usando 2 (gênero) x 4 (notas) x 3 (modalidade de estudo) MANOVA. Resultados: 24 itens medindo a motivação intrínseca, motivação de carreira, motivação de grau e auto-eficácia suportaram uma estrutura de quatro fatores com confiabilidade adequada contra a estrutura original de cinco fatores (a autodeterminação não foi saliente). A invariância da medição foi estabelecida através de gênero e modalidade de estudo, mas não para o nível de nota. Os estudantes brasileiros de grau superior estavam menos motivados, e as meninas relataram maior motivação intrínseca e de carreira, mas menor auto-eficácia do que os meninos. Conclusão: Estas descobertas abrem o caminho para a avaliação da motivação científica dos estudantes brasileiros, mas também revelam problemas na estrutura latente do SMQ-II e exigem o desenvolvimento de instrumentos enraizados em teorias motivacionais contemporâneas.

Adherence to treatment of children and adolescents recently diagnosed with auto-immune Rheumatic Diseases during the COVID-19 pandemic

Abstract Objectives Adherence problems have a great impact on auto-immune Rheumatic Diseases (AIRD). The COVID-19 pandemic may have worsened treatment adherence. The aims of this study were to measure treatment adherence to identify an earlier risk of poor adherence and measure families' satisfaction with the health service during the pandemic. Methods Prospective observational study with 50 parents/children and adolescents with recent AIRD diagnosis. Initially, they answered questions (demographic data, disease) and completed the Pediatric Rheumatology Adherence Questionnaire (PRAQ), after 6 months they completed the Morisky-Green Test (MGT), Brief Medication Questionnaire (BMQ), Compliance Questionnaire for Rheumatology (CQR-19) and Pediatric Quality of Life Inventory Questionnaire 3.0 (PedsQlTM-SSS). The patient's medical records from the previous 12 weeks were reviewed for global and medication adherence data. Results The mean global adherence score was 94.3 ± 10.0, for medication adherence 97.3 ± 9.3, and for PRAQ questionnaire 5.2 ± 1.5. The authors observed agreement between MGT, BMQ, CQR-19, PedsQLTM-SSS scores and medication adherence rate, but not with global adherence rate. There were no associations between demographic characteristics, disease diagnosis, and adherence. No associations between PRAQ scores and values and global/medication adherence rates were observed. No variables were shown to be predictors of good adherence. The mean PedsQLTM-SSS rate was 92.1 ± 6.8. Conclusion The high values of MGT, BMQ, CQR-19 questionnaire scores were in agreement with the medication adherence rate. Despite the pandemic, the global and medication adherence rates were good. It was not possible to demonstrate the PRAQ's predictive power. The authors weren't able to establish an association between families' satisfaction and treatment adherence rates.

Relación entre autoestima y comprensión lectora en estudiantes de secundaria / Relationship between self-esteem and reading comprehension in secondary school students / Relação entre autoestima e compreensão de leitura em alunos do ensino médio

El artículo tiene como finalidad dar a conocer la relación que hay entre la autoestima y la comprensión lectora del alumnado del VI ciclo de la Educación Básica Regular (EBR). La metodología desarrollada fue cuantitativa, no experimental, explicativa, contando con 60 educandos que oscilan entre los 12 y 14 años de edad, siendo 50% mujeres y 50% varones; a quienes se les aplicó dos instrumentos que presentaron validez y confiabilidad. Asimismo, los resultados mostraron que la autoestima equilibrada sobresalió en un 52%, la sobreelevada obtuvo un 32% y la de menor cantidad fue la autoestima media con16%; mientras que en la comprensión lectora el puntaje más alto estuvo enfocado en la dimensión literal con un 78% nivel medio, 15% en el nivel bajo y el menor reconocido fue la dimensión critica con 63% considerando las interrogantes planteadas y solo 7% en un nivel alto. Se concluye que el factor autoestima influyó más en la dimensión inferencial y crítica, mas no en el nivel literal corroborando los estudios realizados; por ello se propone incentivar el fomento del desarrollo del auto concepto con fines de mejorar los resultados del rendimiento escolar en los niveles literal y crítico de la compresión lectora en los estudiantes del VI ciclo de la EBR y aplicar diversas estrategias practicando este hábito.

The purpose of the article is to make known the relationship between self-esteem and reading comprehension of the students of the VI cycle of Regular Basic Education (EBR). The methodology developed was quantitative, not experimental, explanatory, with 60 students ranging between 12 and 14 years of age, 50% being female and 50% male; to whom two instruments that presented validity and reliability were applied. Likewise, the results showed that balanced self-esteem stood out by 52% and the one that obtained the lowest amount was mean self-esteem with 16%; while in reading comprehension the highest score was in the literal dimension with 78% medium level and the lowest was the critical dimension with 63% according to the questions raised. It is concluded that the self-esteem factor influenced more in the inferential dimension and has not influenced in the literal level according to the inferential analysis; For this reason, it is proposed to encourage the promotion of the development of self-concept in order to improve the results of school performance in the literal and critical levels of reading comprehension in students of the VI cycle of the EBR and apply various strategies practicing this habit.

O objetivo do artigo é dar a conhecer a relação entre autoestima e compreensão leitora dos alunos do VI ciclo do Ensino Básico Regular (EBR). A metodologia desenvolvida foi quantitativa, não experimental, explicativa, com 60 alunos na faixa etária de 12 a 14 anos, 50% mulheres e 50% homens; aos quais foram aplicados dois instrumentos que apresentaram validade e confiabilidade. Da mesma forma, os resultados mostraram que a autoestima equilibrada se destacou em 52%, a superalta obteve 32% e o menor valor foi a autoestima média com 16%; alto nível. Conclui-se que o fator autoestima teve maior influência na dimensão inferencial e crítica, mas não no nível literal, corroborando os estudos realizados; Por isso, propõe-se estimular o desenvolvimento do autoconceito para melhorar os resultados do desempenho escolar nos níveis literal e crítico de compreensão leitora nos alunos do VI ciclo da EBR e aplicar diversas estratégias praticando esse hábito.

Autoexamen de mama: Representaciones sociales en mujeres del litoral Pacífico en Colombia

En la prevención del cáncer de mama se hace necesario tener en cuenta los aspectos culturales de las personas involucradas para lograr un acercamiento al fenómeno de la salud y estos cómo influyen en el comportamiento del autocuidado. Objetivo: comprender las representaciones sociales sobre el cáncer y el autoexamen de mama de las mujeres del litoral Pacífico en Colombia durante el año 2019. Metodología: estudio con enfoque cualitativo interpretativista a través del análisis de las representaciones sociales, para la recolección de la información y construcción del fenómeno de estudio se realizaron entrevistas estructuradas a 21 mujeres entre los 19 y 71 años, habitantes de los municipios de Santa Bárbara de Iscuandé y Mosquera del departamento de Nariño y de los municipios de Guapi y Timbiquí del departamento del Cauca. Resultados: el autoexamen de mama para las mujeres es un concepto y práctica que se configura y se comprende a través de categorías teóricas y emergentes como las creencias, percepciones, conocimientos que tienen de la enfermedad, métodos de detección, consecuencias y vivencias. Conclusión: el cáncer de mama se asocia con malignidad, muerte y emociones negativas, reconocen que causa sufrimiento, afectando su entorno familiar y social, la representación social sobre el autoexamen está relacionada con la enfermedad y sus implicaciones, destacando las creencias, percepciones y categorías permeadas por los aspectos socioculturales.

It is necessary to take into account the cultural aspects of the people involved in the prevention of breast cancer to achieve an approach to the phenomenon of health and how these aspects influence the self-care behavior. Objective: To understand the social representations of cancer and breast self-examination of women on the Pacific coast in Colombia during the year 2019. Method: The study uses a qualitative interpretative approach through the analysis of Social Representations. Structured interviews were conducted for the collection of data and construction of the study phenomenon with 21 women between 19 and 71 years old, inhabitants of the municipalities of Santa Bárbara de Iscuandé and Mosquera in the department of Nariño and the municipalities of Guapi and Timbiquí in the department of Cauca. Results: Breast self-examination for women is a concept and practice that is configured and understood through theoretical and emergent categories such as beliefs, perceptions, knowledge they have about the disease, detection methods, consequences and life experiences. Conclusions: Breast cancer is associated with malignancy, death and negative emotions. Women recognize that it causes suffering and affects their family and social environment. The social representation of self-examination is related to the disease and its implications, highlighting beliefs, perceptions, and categories influenced by sociocultural aspects.

Na prevenção do câncer de mama é necessário ter em conta os aspectos culturais das pessoas envolvidas para obter um acercamento ao fenômeno da saúde e estes como influem no comportamento do autocuidado. Objetivo: compreender as representações sociais sobre o câncer e o auto-exame de mama das mulheres no litoral Pacífico na Colômbia durante o ano 2019. Metodologia: estudo com enfoque qualitativa interpretativa a través da análise das representações sociais, para a coleta da informação e construção do fenómeno de estudo se realizaram entrevistas estruturadas a 21 mulheres entre os 19 e 71 anos, habitantes dos municípios de Santa Bárbara de Iscuandé e Mosquera do departamento de Nariño e dos municípios de Guapi e Timbiquí do departamento do Cauca. Resultados: o auto-exame de mama para as mulheres é um conceito e prática que se configura e se compreende a través de categorias teóricas e emergentes como as crenças, percepções, conhecimentos que tem da doença, métodos de detecção, consequências e vivências. Conclusão: o câncer de mama se associa com malignidades, morte e emoções negativas, reconhecem que causa sofrimento, afetando seu entorno familiar e social, a representação social sobre o auto-exame está relacionada com a doença e suas implicações, destacando as crenças, percepções e categorias permeadas pelos aspectos socioculturais.

Risk factors of self-extubation in intensive care. Retrospective cohort study

Introduction Acute respiratory failure remains one of the three leading causes of admission to the intensive care unit (ICU). Self-extubation is an adverse outcome requiring reintubation in 50% of cases. Objective To assess for determinants (risk factors) of self-extubation and mortality in the ICU by using a generalized estimation equation model (GEE). Methods The data was collected from a retrospective cohort study from 2017-2020 including all patients admitted to the ICU with mechanical ventilation. Univariate and bivariate analyses were performed. Then, a GEE model was conducted to predict the risk of self-extubation and mortality. Results A total of 857 subjects were included, with a mean age of 60.5 +/- 17 years-old. Most of the subjects were males (55.2%). An 8.99-fold risk (95%CI 3.83-21.1, p<0.0i) of self-extubation was identified in patients with agitation. Exposure to infusion of neuromuscular blockade was also found to increase the risk of self-extubation 3.37 times (95%CI 1.31-8.68, p=0.01). No associations were identified between immobilization and self-extubation (OR 1.38 95%CI 0.76-2.51, p=0.29). Finally, light sedation according to the Richmond Sedation Scale (RASS) between 0 to -2 rather than moderate (RASS-3) reduces the risk of mortality (OR 0.57, 95%CI 0.38-0.83, p<0.01). Conclusions The main factors resulting in self-extubation were: agitation, delirium, and infusion of neuromuscular blocking agents. An association was found between light sedation and a lower risk of mortality. No association was found between the use of physical restraint and the desired outcome.

Introducción: La insuficiencia respiratoria aguda continúa siendo una de las tres causas principales de ingreso a la unidad de cuidado intensivo (UCI). La auto-extubación es un desenlace adverso que requiere re-intubación en un 50% de los casos. Objetivo: Evaluar los determinantes (factores de riesgo) de la auto-extubación y la mortalidad en UCI mediante el uso de un modelo de ecuaciones de estimación generalizadas (EEG). Métodos: Estudio de una cohorte retrospectiva realizada durante el periodo 2017-2020 incluyendo a todos los pacientes ingresados a UCI con ventilación mecánica invasiva. Se realizaron análisis univariado y bivariado. Adicionalmente, se utilizó un modelo EEG para predecir el riesgo de auto-extubación y mortalidad. Resultados: Se analizó un total de 857 pacientes con un promedio de edad entre 60,5 +/-17 años, siendo hombres en su mayoría (55,2%). Se encontró un riesgo 8,99 veces mayor (IC95% 3,83-21,1, p<0,01) de auto-extubación en los pacientes con agitación. La infusión de relajación muscular incrementó el riesgo de auto-extubación en 3,37 veces (IC95% 1,318,68, p=0,01). No se encontró asociación entre inmovilización y auto-extubación (OR 1,38 IC95% 0,76-2,51, p=0,29). Finalmente, una sedación ligera según la Escala de Sedación de Richmond (RASS) entre 0 a -2 en lugar de moderada (RASS-3) redujo el riesgo de mortalidad (OR 0,5 IC95% 0,38-0,83, p<0.01). Conclusiones: Los principales factores asociados a auto-extubación fueron agitación, delirium e infusión de relajantes musculares. Se encontró asociación entre una sedación ligera y menor riesgo de mortalidad. No se encontró asociación entre el uso de la restricción física y el desenlace de interés.

Economic Conditions Of Auto Drivers In Mysore City - An Analytical Study

The changes in socio-economic and technological factors have caused auto drivers in Mysore city, as well as other cities in India, to experience a variety of economic challenges. The current study work explores the economic issues vehicle drivers in Mysore City experience, as well as the elements that contribute to these issues. A survey of 80 Auto drivers in Mysore city served as the basis for the study. The results indicate that drivers of autos have a range of financial issues, including poor pay, high operating costs, competition from cab services that operate through apps and a lack of social security benefits. The study finishes with suggestions for legislative changes to enhance the financial circumstances of Mysore city's auto drivers. The study identifies the serious economic issues that affect Mysore city's auto drivers and makes recommendations for potential policy changes that the government may take to help them. Policymakers can guarantee that auto drivers can continue to offer residents vital transport services while also raising their level of life by addressing these issues.

Auto-reporte de Periodontitis en diabéticos. Estudio transversal en Montevideo, Uruguay

Objetivo: Conocer la ocurrencia de periodontitis a partir de un cuestionario de auto-reporte en una población de diabéticos en Montevideo, Uruguay. Materiales y métodos: Fueron invitados los participantes del 1er Encuentro de Diabetes en Uruguay, con diagnóstico de diabetes según auto-reporte, con al menos 18 años de edad y que firmaron el consentimiento informado. En todos los casos, fue aplicado un cuestionario con ocho preguntas previamente validadas al español de forma de estimar la ocurrencia de la Periodontits además de identificar indicadores asociados. Resultados: Un total de 37 personas respondieron el cuestionario suministrado, en su mayoría correspondientes al sexo femenino y de 45 años de edad promedio. La ocurrencia de periodontits fue del 68% de los encuestados, no existiendo diferencias significativas para el tipo de diabetes y las franjas etarias consideradas. Sin embargo las personas que presentaban periodontits tuvieron menos dientes naturales (según auto-reporte) al ser comparados con quienes no tenían periodontitis (27.5 vs. 20.4, p=0.01). Conclusiones: Los resultados del estudio permiten apreciar una condición oral deficitaria en aquellos diabéticos con periodontitis auto-reportada debido a la ocurrencia elevada de la misma así como la menor cantidad de dientes naturales.

Objective: To determine the occurrence of periodontitis from a self-report questionnaire in a population of diabetics in Montevideo, Uruguay. Materials and methods: Participants of the 1st Diabetes Meeting in Uruguay, with a diagnosis of diabetes according to self-report, with at least 18 years of age and signed the informed consent, were invited. In all cases, a questionnaire with eight questions previously validated in Spanish was applied in order to estimate the occurrence of Periodontits in addition to identifying associated indicators. Results: A total of 37 people answered the supplied questionnaire, mostly corresponding to the female sex and an average age of 45 years. The occurrence of periodontitis was 68%, with no significant differences for the type of diabetes and the age groups considered. However, people with periodontitis had fewer natural teeth (according to self-report) when compared to those who did not have periodontitis (27.5 vs. 20.4, p = 0.01). Conclusions: The results of the study allow us to appreciate a poor oral condition in those diabetics with self-reported periodontitis due to its high occurrence as well as the lower number of natural teeth.

Bond strength of composite resin/universal adhesive to dentin submitted to radiotherapy / Fuerza de unión de resina compuesta/adhesivo universal a dentina sometida a radioterapia

Aim: To evaluate the bond strength of a universal adhesive system to dentin submitted to radiotherapy. Materials and Methods: Sixty extracted human teeth were divided into two groups (n = 30): without radiotherapy (control); with radiotherapy, according to the adhesive protocol (n=15): ER-etch-and-rinse (acid + Single Bond Uni-versal); SE-self-etch (Single Bond Universal). The analyzes were shear bond strength (SBS) (n=10), failure pattern (n=10) and scanning electron microscopy (n=5). Data was analyzed by a two-way ANOVA (α =0.05). Results: The radiotherapy decreased SBS of the restorative material to dentin (p<0.0001). The ER protocol provided lower bond strength values (p<0.001). The predominant type of fracture without radiotherapy was mixed (SE), cohesive to the material (ER). Both protocols presented adhesive failures with radiotherapy. Teeth had a hybrid layer and long resin tags (without radiotherapy) and few tags (with radiotherapy). Conclusions: The SE adhesive mode favors the shear bond strength of resin to dentin in teeth submitted to radiotherapy.

Objetivo: Evaluar la fuerza de adhesión de un sistema adhesivo universal a la dentina sometida a radioterapia. Materiales y Métodos: Sesenta dientes humanos extraídos se dividieron en dos grupos (n = 30): sin radioterapia (control); con radioterapia, según protocolo adhesivo (n=15): ER-grabado y enjuague (ácido + Single Bond Universal); autograbado SE (Single Bond Universal). Los análisis ejecutados fueron resistencia al cizallamiento (SBS) (n=10), patrón de falla (n=10) y microscopía electrónica de barrido (n=5). Los datos se sometieron al test de ANOVA de dos vías (α =0,05). Resultados: La radioterapia disminuyó la SBS del material restaurador a la dentina (p<0,0001). El protocolo ER proporcionó valores de fuerza de unión más bajos (p<0,001). El tipo de fractura predominante sin radioterapia fue mixta (SE), cohesiva al material (ER). Ambos protocolos presentaron fallas adhesivas con radioterapia. Los dientes tenían una capa híbrida y colas de resina largas (sin radioterapia) o pocas colas de resina (con radioterapia). Conclusión: El modo adhesivo SE favorece la resistencia al corte de la resina a la dentina en dientes sometidos a radioterapia.

Predictores de la identificación de las mujeres con el feminismo en Chile / Predictors of identification of women with feminism in Chile

Resumen El feminismo es un movimiento que busca transformar el orden social imperante, establecido a partir de la jerarquización de la diferencia surgida de una concepción binaria sexo-génerica, y que ha situado a las mujeres en una situación histórica de opresión y explotación. A pesar de la vigencia del feminismo y el aporte de este en las democracias actuales, no todas las personas y, en particular, las mujeres, se identifican con este movimiento social. El objetivo principal de este estudio es identificar los predictores de la identificación feminista en mujeres en Chile. Con base en los resultados de un cuestionario online respondido por 389 mujeres, se realizó un análisis de regresión lineal múltiple (R. = .53, F (3,385) = 107.1, p < .001) en el que se utilizó como variable dependiente la identificación feminista. Las variables con mayor poder predictivo fueron: la predisposición a la participación feminista (. = .54); el sexismo hostil (. = -.20), y la orientación política (. = -.16). Lo anterior indicaría que aquellas mujeres dispuestas a participar en actividades feministas, que rechazan las formas de sexismo hostil y que adhieren a posiciones políticas de izquierda, son quienes mayormente se identifican con el feminismo en Chile. Este modelo relacionaría procesos identitarios que involucran una toma de consciencia de la ilegitimidad que implica que un grupo domine a otro o se encuentre en una situación de privilegio injustificados respecto de otros, y el consecuente reconocimiento de la puesta en acción para la transformación social. Esta relación entre toma de conciencia y acción, a su vez, permitiría explicar la imbricación de las luchas sociales durante el estallido social de octubre 2019 y el movimiento feminista chileno. Finalmente, se discute sobre las limitaciones del presente estudio y lineamientos para futuros.

Abstract The data obtained were subjected to a descriptive analysis (mean and standard deviation) and test score reliability (Cronbach´s Alpha). Then, Pearson´s partial correlations were calculated in order to contrast with the dependent variable feminist identification. From the total sample, 74.8 % self-identified with feminism to various degrees (from a form of private acceptance, but not public; up to activism); while 6 % self-declared as not feminist, and 19 %, well in-line with the objectives, did not self-identify as feminist. Feminism is a movement that looks to transform the current social order, established from the hierarchization based on the difference suggested of a binary sex/gender conception. This order has historically situated women in a position of oppression and exploitation. In spite of the relevance and support for feminism in current democracies, not everyone, in particular women, identify with this social movement. Considering this, the main objective of this study is to identify the predictors of feminist identification in women in Chile. This study, of quantitative type, has a sample size made up of 389 women. The type of sample was not probabilistic, rather self-selected. The participants answered an online survey that explored the variables: feminist identification, political orientation (left-right), support of the movement and feminist objectives, predisposition to feminist action, ambivalent sexism (hostile and benevolent sexism) (Glick & Fiske, 1996), social orientation domination SDO (Prato et al., 1994), right wing authoritarianism RWA (Altemeyer, 1996), and socio-demographic variables as well. Also, the participants signed an informed consent form, endorsed by the corresponding ethics committee. The ages of the participants fluctuated between 18 and 72 (M = 27.4; DT = 11.52). The data obtained were subjected to a descriptive analysis (mean and standard deviation) and test score reliability (Cronbach´s Alpha). Then, Pearson´s partial correlations were calculated in order to contrast with the dependent variable feminist identification. From the total sample, 74.8 % self-identified with feminism to various degrees (from a form of private acceptance, but not public; up to activism); while 6 % self-declared as not feminist, and 19 %, well in-line with the objectives, did not self-identify as feminist. Later on, the variables that showed a significant relationship with the dependent variable were subjected to a multiple linear regression analysis (R2 = .53, F (3,385) = 107.1 p < .001). The variables with the highest predictive power were predisposition to feminist participation (β = .54), hostile sexism (β = -.20), and political orientation (β = -.16). This would indicate that those women willing to participate in feminist activities, who reject hostile forms of sexism and adhere to leftist political positions are those who mostly identify with feminism in Chile. This model would relate identarian processes that involve an awareness of the legitimacy that implies that one group dominates another or finds itself in a position of unjustified privilege with respect to others, and the acknowledgement of the need for transformational social action. This relationship between awareness and action, likewise, would explain the overlapping social struggles during the social outbreak of October 2019 and the feminist movement in Chile. Finally, limitations of the present study are discussed with respect to the difficulty to generalize the results due to the type of sample (self-selected); and the characteristics of the sample, referring to the difficult access to women older than 50. These women presented difficulty in forms of access and in completing the survey online. Furthermore, it is considered that due to the bias of explicit attitude studies with regards to social desirability at the moment of response, it would be of great importance to complete this work with implicit attitude measures. Also, the study proposes that as future line of research a study that investigates what do women themselves understand about feminism in order to make realizations of the plurality of this social movement.

Conocimiento y autoeficacia de la enfermera: o profesional para la aplicación del proceso de enfermería en un hospital de tercer nivel de atención / Knowledge and self-efficiency of the professional nursing for the application of the nursing processes in a hospital of a tercer level of attention / Conhecimento e autoeficácia do profissional enfermeiro para a aplicação do processo de enfermagem em um hospital de terceiro nível de assistência

Introducción: El proceso de enfermería (PE) es la herramienta metodológica que permite al profesional de enfermería brindar cuidados centrados en la persona; por lo que su conocimiento y aplicación a nivel hospitalario permite la evaluación del cuidado formal de enfermería. La autoeficacia es a la creencia que posee el profesional de enfermería para desempeñar las acciones necesarias para obtener los resultados deseados. Metodología: Tipo de estudio analítico, trasversal, prospectivo muestra de 213 enfermeros, 181 licenciatura y 32 de especialidad, se aplicó una encuesta y se analizaron los datos mediante SPSS V.25 se utilizó de estadística descriptiva e inferencial, para la correlación de variables se utilizó Pearson y para comparación de los grupos t de student. Resultados: se observó diferencia estadísticamente significativa en el promedio de conocimientos del PE en los grupos de estudios y en la autoeficacia, en la etapa de diagnóstico (t: -2.986, gl 46, p= 0.005), y de evaluación (t: -2.029, gl 50, p= 0.048), y en la autoeficacia en la dimensión de Persuasión verbal (t= -2.364, gl = 211, p= 0.019). Discusión: Los resultados concuerdan con varios autores respecto a que entre mayor es el grado académico mayor es nivel de conocimientos y de la autoeficacia para aplicar el proceso de enfermería. Conclusiones: Se tiene mayor conocimientos y autoeficacia del PE por parte de los enfermeros especialistas. No existe relación entre las variables de autoeficacia y conocimiento

Introduction: The nursing process (EP) is the methodological tool that allows the nursing professional to provide person-centered care; therefore, its knowledge and application at the hospital level allows the evaluation of formal nursing care. Self-efficacy is the belief held by the nursing professional to perform the necessary actions to obtain the desired results. Objective: To compare and analyze the relationship between the level of knowledge and self-efficacy of nursing graduates and specialists in the application of the EP in a third level of care institution. Method: Analytical, prospective, cross-sectional study, sample of 213 nurses, 181 undergraduate and 32 specialty nurses, a survey was applied, and data were analyzed using SPSS V.25, descriptive and inferential statistics were used, Pearson was used for correlation of variables and Student's t-test was used for comparison of groups. Results: A statistically significant difference was observed in the average PE knowledge in the study groups and in self-efficacy, in the diagnosis stage (t: -2.986, gl 46, p=: 0.005), and evaluation (t: -2.029, gl 50, p=: 0.048), and in self-efficacy in the Verbal Persuasion dimension (t= -2.364, gl = 211, p= 0.019). Discussion: The results agree with several authors regarding that the higher the academic degree, the higher the level of knowledge and self-efficacy to apply the nursing process. Conclusions: There is greater knowledge and self-efficacy of EP by specialist nurses. There is no relationship between the variables of self-efficacy and knowledge

Antecedentes: O processo de enfermagem (EP) é a ferramenta metodológica que permite ao profissional de enfermagem prestar cuidados centrados na pessoa; portanto, o seu conhecimento e aplicação a nível hospitalar permite a avaliação dos cuidados de enfermagem formais. Auto-eficácia é a crença do profissional de enfermagem de realizar as acções necessárias para obter os resultados desejados. Objectivo: Comparar e analisar a relação entre o nível de conhecimentos e a auto-eficácia dos licenciados e especialistas de enfermagem na aplicação do PE numa instituição de cuidados de terceiro nível. Método: Estudo observacional, prospectivo, transversal, comparativo, amostra de 213 enfermeiros, 181 licenciados e 32 especialistas, foi aplicado um inquérito e os dados foram analisados usando SPSS V.25. Foram usadas estatísticas descritivas e inferenciais, Pearson foi usado para a correlação de variáveis e o teste t de Student foi usado para a comparação de grupos. Resultados: Foram observadas diferenças estatisticamente significativas no conhecimento médio de EP nos grupos de estudo e na auto-eficácia, na fase de diagnóstico (t: -2,986, gl 46, p=: 0,005), e na avaliação (t: -2,029, gl 50, p=: 0,048), e na auto-eficácia na dimensão de Persuasão Verbal (t= -2,364, gl = 211, p= 0,019). Discussão: Os resultados concordam com vários autores quanto ao grau académico, maior o nível de conhecimento e auto-eficácia para aplicar o processo de enfermagem. Conclusões: Há um maior conhecimento e auto-eficácia do PE por enfermeiros especializados. Não há relação entre as variáveis de auto-eficácia e de conhecimento

Feasibility study of automatic uARC planning for esophageal cancer using simultaneous integrated boost radiotherapy / 中华放射肿瘤学杂志

Objective:To compare dosimetric and radiobiological parameters between automatic and manual uARC plans in the treatment of esophageal cancer patients, aiming to provide reference for clinical application.Methods:High-quality uARC plans of 100 patients with esophageal cancer were selected, and the mean values of the dosimetric parameters in the target area and organs at risk (OAR) were counted, and the goal table of uRT-TPOIS intelligent plan was established. Automatic and manual uARC plans were generated with UIH (United Imaging) treatment planning system (TPS) for 21 esophageal cancer patients. The differences in mean dose (D mean), approximate minimum (D 98%) and maximum (D 2%) dose of planning target volume (PTV), homogeneity index (HI) and conformity index (CI), dose of OAR, mean planning time, monitor unit (MU), tumor control probability (TCP) and normal tissue complication probability (NTCP) were compared between automatic and manual uARC plans. Normally distributed data between two groups were compared by paired t-test, and non-normally distributed data were assessed by nonparametric Wilcoxon test. Results:The D 98% (PTV 60 Gy: P<0.001, PTV 54 Gy: P=0.001) , CI (PTV 60 Gy: P<0.001, PTV 54 Gy: P=0.002) and target volume of area covered by prescription dose (V 54 Gy: P<0.001) of the automatic uARC plans were better than those of manual uARC plans (all P<0.05). There was no significant difference in D mean or HI between the two plans [PTV 54 Gy (59.32±1.87) Gy vs. (59.13±1.64) Gy, (0.19±0.02) vs. (0.18±0.02), all P>0.05]. The D mean and D max of spinal cord of the automatic plan were better than those of the manual plan [(13.22±4.27) Gy vs. (13.75±4.44) Gy, P=0.020 and (36.99±1.67) Gy vs. (38.14±1.31) Gy, P=0.011]. There was no significant difference in the mean dose of V 20 Gy of the lung between two plans ( P>0.05), whereas the mean doses of V 5 Gy and V 10 Gy of the lung of the manual plan were less than those of the automatic plan ( both P<0. 001). Automatic uARC plan had a significantly shorter mean planning time than manual uARC plan [(11.79±1.71) min vs. (53.36±8.23) min, P<0.001]. MU did not significantly differ between two plans [(762.84±74.83) MU vs. (767.41±80.63) MU, P>0.05]. The TCP of the automatic plan was higher than that of the manual plan (PTV 60 Gy 89.15%±0.49% vs. 86.75%±6.46%, P=0.004 and PTV 54 Gy 79.79%±3.48% vs. 77.51%±5.04%, P=0.006). However, manual plan had a lower NTCP of the lung than automatic uARC plan (0.46%±0.40% vs. 0.35%±0.32%, P<0.001). There was no significant difference in NTCP of heart and spinal cord between two plans (all P>0.05). Conclusion:It is feasible to generate automatic uARC plan with uRT-TPOIS TPS for esophageal cancer patients, which can increase the target CI and shorten the plan design time.

Study of the effect of mid-ventricular obstruction on left ventricular systolic function in patients with hypertrophic cardiomyopathy by four-dimensional automatic left ventricular quantitation technology / 中华超声影像学杂志

Objective:To investigate the effect of mid-ventricular obstruction (MVO) on left ventricular systolic function in patients with hypertrophic cardiomyopathy(HCM) by four-dimensional automatic left ventricular quantitation technology(4D Auto LVQ).Methods:Fifty-seven hypertrophic obstructive cardiomyopathy patients were selected from December 2020 to October 2022 in the First Affiliated Hospital of Zhengzhou University. According to the presence of MVO, HCM patients were divided into two groups: HCM 1 group, HCM without MVO ( n=34); HCM 2 group, HCM with MVO ( n=23). In addition, 25 healthy subjects in the same period were selected as the control group. Conventional ultrasound parameters were collected, and 4D Auto LVQ technology was used to obtain the mechanical parameters of left ventricular myocardium, including left ventricular longitudinal strain (GLS), circumferential strain (GCS), area strain (GAS), radial strain (GRS), segmental longitudinal strain (SLS) and area strain (SAS). The differences of these parameters among the three groups were compared. Results:①Compared with the control group, the thickness of the maximum basal segment of interventricular septum, the thickness of the middle segment of the maximum interventricular septum, the thickness of the apical segment of the interventricular septum, the thickness of the left ventricular posterior wall and left atrium diameter were significantly increased. Six-minute walk distance and the left ventricular end-diastolic diameter was decreased in the two groups of HCM(all P<0.05). Left ventricular outflow tract gradients in HCM 1 group was higher than HCM 2 group( P<0.05), but there was no significant difference in left ventricular ejection fraction among the three groups( P>0.05). There was significant difference in the incidence of left ventricular apical aneurysm among the three groups( P<0.05). ②Compared with the control group, the GLS in both HCM groups was lower, and it was lower in the HCM 2 group than in the HCM 1 group(all P<0.05) the GRS and GAS in both HCM groups were lower than in the control group ( P<0.05), and there was no significant difference between the two groups of HCM, and there was no significant difference in GCS among the three groups(all P>0.05). ③Compared with the control group, the SLS of basal segment, middle segment, apical cap, posterior septum, inferior wall and lateral wall in HCM group were significantly lower than those in control group. The SLS of apical segment of posterior septum, anterior septum, anterior wall, posterior wall, inferior wall and apical segment of posterior septum, lateral wall and inferior wall in HCM 2 group were significantly lower than HCM 1 group(all P<0.05), but there was no significant difference in SLS of posterior septum, anterior septum, anterior wall, lateral wall and inferior wall between the two groups(all P>0.05). ④Compared with the control group, the SAS of posterior septal basal segment, middle segment, anterior septal middle segment, anterior wall basal segment, middle segment, apical segment, lateral wall basal segment, middle segment, apical segment, posterior wall basal segment, middle segment, inferior wall basal segment, middle segment and apical cap in HCM groups were significantly lower than the control group(all P<0.05), but there was no significant difference in SAS between the two groups of HCM( P>0.05). Conclusions:4D Auto LVQ can quantitatively evaluate the damage of MVO on the left ventricular systolic function in patients with HCM, especially for the evaluation of local myocardial function damage in the medial segment and apical segment.

Evaluation of functional tricuspid regurgitant valves and right heart structural and functional changes by four-dimensional auto quantitative techniques / 中华超声影像学杂志

Objective:To comprehensively evaluate the tricuspid valve, right heart anatomical characteristics and related dynamic parameters in patients with different degrees of functional tricuspid regurgitation (FTR) using four-dimensional auto tricuspid valve quantitative(4D Auto TVQ), four-dimensional auto right ventricle quantitative(4D Auto RVQ), and four-dimensional auto left atrium quantitative(4D Auto LAQ), and to investigate the structural and functional changes of the tricuspid valve and right heart in them.Methods:Sixty-three patients with FTR diagnosed by echocardiography at the First Affiliated Hospital of Guangxi Medical University from February to July 2022 were prospectively selected as the case group, including 30 patients with mild FTR and 33 patients with moderate or above FTR, and 30 healthy subjects were selected as the control group. Transthoracic echocardiography was used for two-dimensional and three-dimensional image acquisition of the heart. The tricuspid regurgitation volume, left ventricular ejection fraction (LVEF), right ventricular global strain (RVGS) were measured by 2D images, and pulmonary artery systolic pressure (PASP) were measured from the tricuspid regurgitation pressure difference. The 3D images were imported into EchoPAC 204 to obtain the tricuspid valve, right heart structure and related dynamic parameters. The annulus area (AA), annulus perimeter(AP), spherical index (SI), annulus area change fraction (AC), coaptation point height (CPH), and tenting volume (TV) were measured by 4D Auto TVQ. The right atrial maximum volume (RAVmax) and right atrial minimum volume (RAVmin) were measured by 4D Auto LAQ. Right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE) were measured by 4D Auto RVQ. After standardizing the dimension parameters with body surface area (BSA), the differences in the above parameters were compared between the three groups, the correlation between regurgitant volume and each parameter was compared by correlation analysis, and the independent factors of increased tricuspid regurgitant volume were investigated by univariate and multivariate linear regression analysis.Results:There were statistically significant differences in PASP, AA/BSA, AP/BSA, AC, TV, RAVmax/BSA, RAVmin/BSA, RVFAC, RVGS, and TAPSE between the three groups (all P<0.05). There were statistically significant differences in LVEF, CPH, RVEDV/BSA, and RVESV/BSA in the moderate and above FTR group compared with the control and mild FTR groups (all P<0.05). Correlation analysis showed that RAVmin was the most highly correlated with tricuspid regurgitant volume ( r=0.875, P<0.001) and TV and end-systolic annulus area(ESAA) were highly correlated with tricuspid regurgitant volume ( r=0.747, 0.683; both P<0.001) in patients with FTR. Multifactorial linear regression showed that RAVmin, TV and regurgitant volume were independently positively correlated (β=0.721, 0.205; both P<0.05). Conclusions:The four quantification technique can provide valid structural and functional information by quantifying the tricuspid valve as well as the right heart in patients with FTR, and RAVmin and TV are independent correlates of increased tricuspid regurgitant volume.

Study of left ventricular myocardial mechanics in patients with different risk stratifications of hypertrophic cardiomyopathy by four-dimensional automatic left ventricular quantitation technology / 中华超声影像学杂志

Objective:To explore the application value of four-dimensional automatic left ventricular quantitation(4D Auto LVQ) technology, in evaluating the myocardial mechanics in patients with different risk stratifications of hypertrophic cardiomyopathy(HCM).Methods:A total of 88 HCM patients and 20 healthy volunteers were selected from February 2020 to February 2022 in the First Affiliated Hospital of Zhengzhou University. According to the HCM Risk-SCD score, HCM patients were divided into 3 groups: low-risk group( n=49), intermediate-risk group( n=21), and high-risk group( n=18). Conventional ultrasound parameters were collected, and 4D Auto LVQ technology was used to obtain the mechanical parameters of left ventricular myocardium, including global longitudinal strain(GLS) , global circumferential strain(GCS), global area strain(GAS), global radial strain(GRS), twist and torsion. The differences in these parameters among the four groups were compared. The predictive values of conventional ultrasound parameters and myocardial mechanical parameters in patients with intermediate- and high-risk HCM patients were analyzed by ROC curve. Results:①Left ventricular end-diastolic diameter, left ventricular end-diastolic volume, left ventricular end-systolic volume, and peak systolic velocity of mitral annulus in the low-, intermediate-, and high-risk groups were lower than those in the control group while left ventricular maximal wall thickness(LVMWT) and early diastolic peak velocity of mitral value orifice/early diastolic peak velocity of mitral annulus(E/e′) were higher, left atrial diameter(LAD) and left ventricular outflow tract gradients(LVOTG) in the intermediate- and high-risk groups were higher than the low-risk group(all P<0.05). ②Compared with the control group, the GLS of HCM patients was lower, and the GLS of the intermediate- and high-risk groups was lower than the low-risk group. GCS and GRS in the intermediate- and high-risk groups were lower than those in the low-risk group. GAS in the high-risk group was lower than the low-risk and the control group, but higher than the intermediate-risk group(all P<0.05). Compared with the control group, the twist and torsion in the intermediate- and high-risk groups were higher, but lower than the low-risk group, and the differences were statistically significant(all P<0.05). ③The ROC results showed that the area under the curve(AUC) of the model containing conventional ultrasound parameters(LVWMT, LAD, and LVOTG) for predicting intermediate- and high-risk HCM patients was 0.811, with a sensitivity of 0.769 and a specificity of 0.755. The AUC of the conventional ultrasound parameters combined with myocardial mechanical parameters was 0.904, as the sensitivity was 0.667 and the specificity was 0.980. Conclusions:4D Auto LVQ can evaluate the mechanical characteristics of LV myocardium in HCM patients with different risk stratifications. Myocardial mechanical parameters combined with conventional ultrasound parameters can improve the diagnostic performance of patients with intermediate- and high-risk HCM.

Research progress of metformin in the pathogenesis of pulmonary fibrosis / 中国临床药理学与治疗学

Pulmonary fibrosis is a chronic, progressive and irreversible respiratory disease characterized by hyperposition of extracellular matrix leading to inflammation and extensive lung remodeling. There is currently no effective treatment. Multiple studies have shown that metformin is a classic antiglycemic drug with antifibrotic potential. However, at present, there is no consensus on the specific mechanism of metformin's anti-fibrosis effect, and this paper reviews the research progress of metformin in the field of pulmonary fibrosis in recent years, mainly from IGF-1/IGF-1R/PI3K signaling, AMPK/mTOR signaling, TGF-β/Smad signaling pathway, and intervening in myofibroblast proliferation and apoptosis, improving oxidative stress, inhibiting epithelial interstitial transformation and transglutaminase. In order to be able to more deeply and comprehensively understand the antifibrosis mechanism and clinical application scope of metformin in the future, and provide new ideas for the treatment of pulmonary fibrosis.

Spatial-temporal distribution of pulmonary tuberculosis registered in Fuling District of Chongqing during the 13th Five-Year Plan period / 中国热带医学

@#Abstract: Objective To analyze the spatial-temporal characteristics of the active pulmonary tuberculosis (PTB) and the pathogenic positive PTB in Fuling District of Chongqing during the 13th Five-Year Plan period, so as to explore the clustering areas, and provide scientific basis for the precise prevention and control of tuberculosis in Fuling District. Methods The PTB registration data of 27 townships in Fuling District from 2016 to 2020 were collected. The descriptive analysis were used to describe the temporal and spatial distribution characteristics of patients, SaTScan9.0 and ArcGis10.6 was used for spatial-temporal scanning analysis and local auto-correlation analysis. The results were visualized by ArcGis10.6. Results A total of 4 038 case of active PTB patients were registered and a downward trend was observed in PTB during the 13th Five-Year Plan period in Fuling District. The average annual registration rate of PTB was 70.17/100 000, and the annual PTB registration rate declined by 8.21%. The peak of active PTB and etiological positive PTB were mainly concentrated in March and June respectively. The top five streets of cumulative active PTB patients registered were Lizhi street, Dunren street, Chongyi street, Ma 'an street and Jiangdong street, accounting for 60.18% of the total registered PTB patients during the 13th Five-Year Plan period. The top three average annual registration rates were Dunren street (101.35/100 000), Chongyi street (101.34/100 000) and Wulingshan Township (99.21/100 000). The registered PTB from 2016 to 2020 showed a global auto-correlation (Moran's I=0.64, P<0.0001). The "high-high" area of active PTB and the etiological positive PTB all covered Lizhi street, Jiangdong street and Longqiao street. By scanning analysis of spatial-temporal, the primary cluster of active PTB concentrated in the main urban area south of the Yangtze River in Fuling during January 2016 to December 2017, and the primary cluster of pathogenic positive PTB concentrated in the main urban area south of the Yangtze River in Fuling and Jiangdong street during January 2019 to December 2020. Conclusions During the 13th Five-Year Plan period, there was the spatial-temporal clustering of PTB in Fuling District, which mainly gathered in the main urban area south of the Yangtze River in Fuling district and surrounding streets centered on Lizhi street.

Manifestaciones clínicas "no criterio" del Síndrome Antifosfolipídico. Presentación de una cohorte nacional

Introducción: El síndrome antifosfolipídico (SAF) es una afección de origen autoinmune caracterizada por trombosis, pérdidas fetales recurrentes y anticuerpos antifosfolipídicos (aFL). Existen manifestaciones clínicas no contempladas en los criterios clasificatorios, que se denominan manifestaciones no criterio. Objetivo: Analizar las manifestaciones clínicas del SAF, enfatizando las manifestaciones no criterio y su relación con el perfil de autoanticuerpos en un hospital general de Montevideo, Uruguay. Métodos: Se realizó un estudio retrospectivo de las historias clínicas de pacientes con diagnóstico definitivo o sospecha de SAF en un servicio de medicina ambulatoria de enfermedades autoinmunes, en el Hospital Maciel, asistidos entre el 2010 y 2019. Resultados: Se incluyeron 78 pacientes, con edad media de 50,3 ± 14,5 años, 69 (88,5%) correspondió a sexo femenino. Cuarenta y seis (59,0%) pacientes presentaron SAF secundario, de los cuales 28 (35,9%) asociaron LES. La trombosis venosa de miembros inferiores fue la manifestación más frecuente (51,3%). Dieciocho (24,0%) pacientes presentaron trombosis arteriales en forma de accidente cerebrovascular. Cincuenta y nueve (75.6%) casos presentaron, además de las manifestaciones clasificatorias, alguna de las manifestaciones "no criterio" y éstas se manifestaron de forma aislada en 10 (12.8%) pacientes. Las manifestaciones no clasificatorias más frecuentes fueron artralgias, livedo reticularis, migraña y trombocitopenia. Se observó una asociación significativa entre la presencia de anti-ß2GPI con manifestaciones cutáneas y de trombocitopenia con al menos una manifestación trombótica. Conclusiones: Las manifestaciones "no criterio" del SAF se presentaron en casi 3 de cada 4 casos, frecuencia similar a la observada en otras series. La presencia aislada de manifestaciones "no criterio" podrían hacer sospechar un SAF y en algunos casos, conducir a la solicitud de anticuerpos.

Introduction: Antiphospholipid syndrome (APS) is an autoimmune condition characterized by thrombosis, recurrent fetal loss, and antiphospholipid antibodies. There are clinical manifestations not contemplated in the classification criteria, which are called non-criterion manifestations. Objective: To analyze the clinical manifestations of APS, emphasizing the non-criterion manifestations and their relationship with the autoantibody profile in a general hospital in Montevideo, Uruguay. Methods: A retrospective analysis of the medical records of patients with a definitive or suspected diagnosis of APS in an outpatient medicine service for autoimmune diseases, at the Maciel Hospital, assisted between 2010 and 2019, was carried out. Results: 78 patients were included, with a mean age of 50.3 +/- 14.5 years, 69 (88.5%) were female. Forty-six (59.0%) patients presented secondary APS, of which 28 (35.9%) associated SLE. Venous thrombosis of the lower limbs was the most frequent manifestation (51.3%). Eighteen (24.0%) patients presented arterial thrombosis in the form of cerebrovascular accident. Fifty-nine (75.6%) cases presented, in addition to the classification manifestations, some of the "non-criterion" manifestations and these manifested in an isolated way in 10 (12.8%) patients. The most frequent non-classifying manifestations were arthralgia, livedo reticularis, migraine and thrombocytopenia. A significant association was observed between the presence of anti-ß2GPI with cutaneous manifestations and thrombocytopenia with at least one thrombotic manifestation. Conclusions: Non-criterion manifestations of APS occurred in almost 3 out of 4 cases, a frequency similar to that observed in other series. The isolated presence of "non-criterion" manifestations could lead to suspicion of APS and, in some cases, lead to the request for antibodies.

Introdução: A síndrome antifosfolipídica (SAF) é uma doença de origem auto-imune caracterizada por trombose, perdas fetais recorrentes e anticorpos antifosfolípidos (aFL). Existem manifestações clínicas não abrangidas pelos critérios de classificação, que são designadas por manifestações não-critério. Objetivo: Analisar as manifestações clínicas da SAF, enfatizando as manifestações não-critério e sua relação com o perfil de auto-anticorpos em um hospital geral de Montevidéu, Uruguai. Métodos: Foi realizado um estudo retrospectivo dos prontuários de pacientes com diagnóstico definitivo ou suspeita de SAF em um serviço ambulatorial de doenças autoimunes do Hospital Maciel, atendidos entre 2010 e 2019. Resultados: Foram incluídos 78 pacientes, com idade média de 50,3 +/- 14,5 anos, sendo 69 (88,5%) do sexo feminino. Quarenta e seis (59,0%) pacientes apresentavam PFS secundária, dos quais 28 (35,9%) tinham LES associado. A trombose venosa dos membros inferiores foi a manifestação mais frequente (51,3%). Dezoito (24,0%) doentes apresentaram trombose arterial sob a forma de acidente vascular cerebral. Cinquenta e nove (75,6%) casos apresentaram, para além das manifestações classificatórias, algumas das manifestações "não-critério" e estas manifestações foram isoladas em 10 (12,8%) doentes. As manifestações não classificatórias mais frequentes foram artralgias, livedo reticularis, enxaqueca e trombocitopenia. Foi observada uma associação significativa entre a presença de anti-ß2GPI com manifestações cutâneas e trombocitopenia com pelo menos uma manifestação trombótica. Conclusões: As manifestações "não-critério" de SAF ocorreram em quase 3 de cada 4 casos, frequência semelhante à observada noutras séries. A presença isolada de manifestações "não-critério" pode levantar a suspeita de SAF e, nalguns casos, levar à pesquisa de anticorpos.

Factors associated with physical activity levels in adolescents / Factores asociados a los niveles de actividad física en adolescentes / Fatores associados ao nível de atividade física em adolescentes

ABSTRACT Objective: to analyze the factors associated with physical activity levels in adolescents. Method: cross-sectional, quantitative study, conducted with adolescents enrolled in two educational institutions in a capital of the midwest region of Brazil. Data collection occurred from April to October 2021, through a self-administered questionnaire composed of validated scales. The association between the variables was verified by logistic regression. Results: 219 adolescents participated in the study, with a mean age of 15.7 years, more than half were girls (52.5%) from medium economic class (51.1%); 55.3% were very active/active; 39.3% had low self-esteem; 17.8% were at risk for developing an eating disorder; 12.3% at risk for severe anxiety symptoms; and 13.3% at risk for moderate depression symptoms. The factors associated with the level of physical activity were self-esteem and risk for depression. Conclusion: Early screening of adolescents with low self-esteem and risk for symptoms of depression is proposed as an initial strategy to direct actions that encourage the practice of physical activity.

RESUMEN Objetivo: analizar los factores asociados a los niveles de actividad física en adolescentes. Método: estudio transversal, cuantitativo, realizado con adolescentes matriculados en dos instituciones educativas de una capital de la región Centro-Oeste de Brasil. La recolección de datos ocurrió de abril a octubre de 2021, a través de un cuestionario autoadministrado compuesto por escalas validadas. La asociación entre las variables se verificó por regresión logística. Resultados: Participaron del estudio 219 adolescentes, con una edad media de 15,7 años, más de la mitad eran niñas (52,5%) de clase económica media (51,1%); el 55,3% eran muy activos/activos; el 39,3% tenía baja autoestima; el 17,8% tenían riesgo de desarrollar un trastorno alimentario; 12,3% en riesgo de síntomas de ansiedad severa; y 13,3% en riesgo de síntomas de depresión moderada. Los factores asociados al nivel de actividad física fueron la autoestima y el riesgo de depresión. Conclusión: El cribado precoz de adolescentes con baja autoestima y riesgo de síntomas depresivos puede constituir una estrategia inicial para encaminar acciones que incentiven la práctica de actividad física.

RESUMO Objetivo: analisar os fatores associados ao nível de atividade física em adolescentes. Método: estudo transversal, de abordagem quantitativa, realizado com adolescentes matriculados em duas instituições de ensino de uma capital da região Centro-Oeste brasileira. A coleta de dados ocorreu no período de abril a outubro de 2021, por meio de questionário autoaplicado composto por escalas validadas. A associação entre as variáveis foi verificada por meio de regressão logística. Resultados: participaram do estudo 219 adolescentes, com média de idade de 15,7 anos, mais da metade eram meninas (52,5%) e de classe econômica média (51,1%); 55,3% eram muito ativo/ativo; 39,3%, com autoestima baixa; 17,8% apresentaram risco para desenvolver transtorno alimentar; 12,3% risco para sintomas de ansiedade grave; e 13,3%, risco para sintomas de depressão moderada. Os fatores associados ao nível de atividade física foram a autoestima e o risco para depressão. Conclusão: O rastreamento precoce de adolescentes com baixa autoestima e risco para sintomas de depressão pode constituir estratégia inicial para direcionar ações de estímulo à prática de atividade física.

Validación de la escala de autoevaluación del aprendizaje práctico cibisa en estudiantes de enfermería peruanos

Objetivo: Determinar la validez y confiabilidad de la escala CIBISA para la autoevaluación del aprendizaje práctico de estudiantes de enfermería. Material y Método: Estudio instrumental, transversal, con estudiantes de enfermería que estuvieron realizando prácticas clínicas, en el que se analizaron las propiedades psicométricas de la escala CIBISA, tales como la validación de contenido y consistencia interna a través del cálculo de V de Aiken y posteriormente Análisis factorial confirmatorio (AFC), respectivamente. Finalmente, se calculó la confiabilidad de la escala. Resultados: Se obtuvo una V de Aiken de 0,9. Asimismo, los valores de asimetría y curtosis del ítem 1 y 28 superaron el valor +/- 1,5. Los índices de bondad de ajuste del modelo original mostraron valores deficientes; por lo que, a través de la técnica de modificación de índices se eliminaron los ítems 8, 10, 18, 21, 25, 28, 13 y 26 donde los índices de bondad de ajuste mostraron que el modelo de 20 ítems era satisfactorio (χ2 = 4776,826; df= 190; p= 0,000; CFI= 0,938; TLI= 0,930; RMSEA= 0,080 y SRMR< 0,080). La confiabilidad de la escala presenta un coeficiente α de Cronbach= 0,91. Conclusión: La escala CIBISA de 20 ítems es válida y confiable para medir la autoevaluación del aprendizaje práctico del estudiante de enfermería.

Objective: To determine the validity and reliability of the CIBISA scale for the self-assessment of practical learning of nursing students. Material and Method: Instrumental, cross-sectional study, with nursing students who were doing clinical practices, in which the psychometric properties of the CIBISA scale were analyzed, such as the validation of content and internal consistency through the calculation of Aiken's V and subsequently confirmatory factor analysis (CFA), respectively. Finally, the reliability of the scale was calculated. Results: Aiken's V of 0.9 was obtained. Likewise, the values of asymmetry and kurtosis of item 1 and 28 exceeded the value +/- 1.5. The goodness of fit indices of the original model showed deficient values; Therefore, through the index modification technique, items 8, 10, 18, 21, 25, 28, 13 and 26 were eliminated, where the goodness-of-fit indices showed that the 20-item model was satisfactory (χ2= 4776.826; df= 190; p= 0.000; CFI= 0.938; TLI= 0.930; RMSEA= 0.080 and SRMR< 0.080). The reliability of the scale presents a Cronbach's α coefficient=0.91. Conclusion: The 20-item CIBISA scale is valid and reliable to measure the self-assessment of practical learning of nursing students.

Objetivo: Determinar a validade e confiabilidade da escala CIBISA para a autoavaliação da aprendizagem prática de estudantes de enfermagem. Material e Método: Estudo instrumental, transversal, com estudantes de enfermagem que realizavam práticas clínicas, no qual foram analisadas as propriedades psicométricas da escala CIBISA, como a validação de conteúdo e consistência interna através do cálculo do V de Aiken e posteriormente confirmatório análise fatorial (CFA), respectivamente. Por fim, calculou-se a confiabilidade da escala. Resultados: Obteve-se V de Aiken de 0,9. Da mesma forma, os valores de assimetria e curtose dos itens 1 e 28 ultrapassaram o valor +/- 1,5. Os índices de qualidade de ajuste do modelo original apresentaram valores deficientes; portanto, através da técnica de modificação do índice, os itens 8, 10, 18, 21, 25, 28, 13 e 26 foram eliminados, onde os índices de qualidade de ajuste mostraram que o modelo de 20 itens foi satisfatório (χ2= 4776,826; df= 190; p= 0,000; CFI= 0,938; TLI= 0,930; RMSEA= 0,080 e SRMR< 0,080). A confiabilidade da escala apresenta coeficiente α de Cronbach= 0,91. Conclusão: A escala CIBISA de 20 itens é válida e confiável para medir a autoavaliação da aprendizagem prática de estudantes de enfermagem.