Quality of acute coronary syndrome care and in hospital outcome in a resource-poor setting in Northern Ghana

Introduction: African countries are facing an epidemic of cardiovascular diseases. Information on the quality of acute coronary syndrome care offered in underserved communities in Ghana is limited. Using objective criteria, we examined the quality of acute coronary syndrome care offered to patients presenting to a tertiary referral center in Northern Ghana. Methods: we conducted a retrospective review of patients ≥ 18 years old with acute coronary syndrome managed in Tamale Teaching Hospital. We assessed in-hospital outcomes and the extent of compliance to key performance and quality indicators as contained in the 2017 American Heart Association/American College of Cardiology guideline for adults with myocardial infarction. Results: sixty-two (62) patients with a mean age of 56.0 ± 16.1 years were recruited. The median delay to presentation was 24 hours (IQR 15-96 hours). 33.9% had ST-elevation myocardial infarction, of which only 14.3% received reperfusion therapy. About three-quarters of patients received dual antiplatelet therapy at discharge, with fewer patients receiving recommended high-intensity statin therapy (65.5%) or beta-blockers (69.1%). Only 38.2% of patients had their left ventricular ejection fraction documented. No cardiac rehabilitation program existed. Risk stratification of patients with non-ST-elevation myocardial infarction or stress testing for conservatively managed patients was not part of routine practice. Conclusion: acute coronary syndrome management remains a challenging issue in Northern Ghana. Several gaps exist in the care quality, timeliness of interventions and rehabilitation of affected patients. There is an urgent need for measures to improve the delivery of acute coronary syndrome care alongside primary prevention strategies.

Phenotypic plasticity in adults of Anticarsia gemmatalis exposed to sub-doses of Bt-based bioinsecticide / Plasticidade fenotípica morfométrica em adultos de Anticarsia gemmatalis Hübner, 1818 expostos a subdoses de Bacillus thuringiensis Berliner, 1911

Anticarsia gemmatalis Hünber, 1818 is one of the main defoliating species in the soybean crop. Bacillus thuringiensis Berliner, 1915, is a bacterium used in the biological control of this pest species. Resistant populations and their sublethal effects caused by the use of the bacteria have already been reported; however, there are no studies on phenotypic plasticity in adulthood exposed to Bt-based bioinsecticide sub-doses. This study aimed to evaluate the morphometry of A. gemmatalis adults under laboratory conditions submitted to the Bt-based bioinsecticide Dipel® over the three generations. The body segments mensuread were width, length, and area of the anterior and posterior wings, the weight of the integument, chest, abdomen, wings, and the whole adult of males and females. Among the treatments, LC5 in the first generation and LC10 in the second generation were those with lower thresholds in relation to the weight of the chest and abdomen, considering the proportions of the body smaller than the females. The female's weight adulthood was reduced by 10% about males, and, only in the first generation. Males have larger body size and more pronounced phenotypic plasticity than females. Here, we demonstrate the first study assessing the phenotypic plasticity of A. gemmatalis adults.

Anticarsia gemmatalis Hünber, 1818 é uma das principais espécies desfolhadoras da cultura da soja. Bacillus thuringiensis Berliner, 1915, é uma bactéria utilizada no controle biológico dessa espécie de praga. Populações resistentes e seus efeitos subletais causados pelo uso da bactéria já foram relatados, no entanto, não há estudos sobre a plasticidade fenotípica na idade adulta exposta a subdoses de bioinseticida à base de Bt. Este trabalho teve como objetivo avaliar a morfometria de adultos de A. gemmatalis em condições de laboratório submetidos ao bioinseticida Dipel® ao longo de três gerações. Os segmentos corporais mensuráveis eram largura, comprimento e área das asas anterior e posterior, o peso do tegumento, tórax, abdômen, asas e todo o adulto de machos e fêmeas. Dentre os tratamentos, CL5 na primeira geração e CL10 na segunda geração foram aqueles com limiares mais baixos em relação ao peso do tórax e abdômen, considerando as proporções do corpo menores que as do sexo feminino. O peso da fêmea na idade adulta foi reduzido em 10% em relação aos machos e, apenas na primeira geração. Os machos têm tamanho corporal maior e plasticidade fenotípica mais pronunciada do que as fêmeas. Este estudo demonstra o primeiro estudo avaliando a plasticidade fenotípica de adultos de A. gemmatalis.

Phenotypic plasticity in adults of Anticarsia gemmatalis exposed to sub-doses of Bt-based bioinsecticide

Abstract Anticarsia gemmatalis Hünber, 1818 is one of the main defoliating species in the soybean crop. Bacillus thuringiensis Berliner, 1915, is a bacterium used in the biological control of this pest species. Resistant populations and their sublethal effects caused by the use of the bacteria have already been reported; however, there are no studies on phenotypic plasticity in adulthood exposed to Bt-based bioinsecticide sub-doses. This study aimed to evaluate the morphometry of A. gemmatalis adults under laboratory conditions submitted to the Bt-based bioinsecticide Dipel® over the three generations. The body segments mensuread were width, length, and area of the anterior and posterior wings, the weight of the integument, chest, abdomen, wings, and the whole adult of males and females. Among the treatments, LC5 in the first generation and LC10 in the second generation were those with lower thresholds in relation to the weight of the chest and abdomen, considering the proportions of the body smaller than the females. The females weight adulthood was reduced by 10% about males, and, only in the first generation. Males have larger body size and more pronounced phenotypic plasticity than females. Here, we demonstrate the first study assessing the phenotypic plasticity of A. gemmatalis adults.

Resumo Anticarsia gemmatalis Hünber, 1818 é uma das principais espécies desfolhadoras da cultura da soja. Bacillus thuringiensis Berliner, 1915, é uma bactéria utilizada no controle biológico dessa espécie de praga. Populações resistentes e seus efeitos subletais causados pelo uso da bactéria já foram relatados, no entanto, não há estudos sobre a plasticidade fenotípica na idade adulta exposta a subdoses de bioinseticida à base de Bt. Este trabalho teve como objetivo avaliar a morfometria de adultos de A. gemmatalis em condições de laboratório submetidos ao bioinseticida Dipel® ao longo de três gerações. Os segmentos corporais mensuráveis eram largura, comprimento e área das asas anterior e posterior, o peso do tegumento, tórax, abdômen, asas e todo o adulto de machos e fêmeas. Dentre os tratamentos, CL5 na primeira geração e CL10 na segunda geração foram aqueles com limiares mais baixos em relação ao peso do tórax e abdômen, considerando as proporções do corpo menores que as do sexo feminino. O peso da fêmea na idade adulta foi reduzido em 10% em relação aos machos e, apenas na primeira geração. Os machos têm tamanho corporal maior e plasticidade fenotípica mais pronunciada do que as fêmeas. Este estudo demonstra o primeiro estudo avaliando a plasticidade fenotípica de adultos de A. gemmatalis.

The Brazilian version of the High-Activity Arthroplasty Score: cross-cultural adaptation

ABSTRACT BACKGROUND: The High Activity Arthroplasty Score (HAAS) is a self-administered questionnaire, developed in British English, that reliably and validly measures the levels of sports activities in patients following hip and knee arthroplasty surgery. OBJECTIVE: To cross-culturally adapt the HAAS to Brazilian Portuguese language. DESIGN AND SETTING: A cross-sectional study was conducted at a public university hospital in Brazil. METHODS: The Brazilian version of the HAAS was created through a six-step process: translation, synthesis, committee review, pretesting, back-translation, and submission to developers. The translation step was conducted by two independent bilingual translators, both native speakers of Brazilian Portuguese. The back-translation was performed by an independent translator, a native speaker of British English. To ensure the questionnaire's comprehensibility, 46 volunteers (51% men; average age 34-63) participated in the pre-testing step. RESULTS: The cross-cultural adaptation process necessitated modifications to certain terms and expressions to achieve cultural equivalence with the original HAAS. CONCLUSION: The HAAS has been translated from English into Brazilian Portuguese and culturally adapted for Brazil. The validation process for HAAS-Brazil is currently underway.

Incidence and impacts of pain in intensive care units: systematic review / Incidência e impactos da dor em unidades de terapia intensiva: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: In Intensive Care Units (ICU), patients are exposed to multiple procedures that can be painful, and health professionals are not always aware of the pain in these patients. Inadequate pain assessment and management, in turn, has been associated with several adverse outcomes, including an increased rate of infection, prolonged mechanical ventilation, hemodynamic disturbances, delirium, and compromised immunity. Thus, this study aimed to summarize the scientific evidence about the incidence and impacts of pain in critically ill patients. CONTENTS: A systematic review of observational studies (Pubmed and EMBASE databases) was performed with predetermined eligibility criteria. In the 32 studies included, it was identified that 10.1% to 61% of patients had pain at rest and 27.4% to 94% during procedures. In addition, there was evidence of improvement in patient outcomes after using validated instruments for pain measurement, including decreased length of ICU stay, duration of mechanical ventilation, mortality, delirium, adverse events, and disease severity. CONCLUSION: Through the present study, it was observed that pain is a common phenomenon in ICU and that its identification and management constitute a realistic goal and depend on the evaluation. Furthermore, pain appears to be associated with worse clinical outcomes. Therefore, efforts must be made to provide comprehensive care for critically ill patients, aiming not only at their survival, but also at alleviating their suffering.

RESUMO JUSTIFICATIVA E OBJETIVOS: Nas Unidades de Terapia Intensiva (UTI) os pacientes são expostos a múltiplos procedimentos que podem ser dolorosos, e nem sempre os profissionais de saúde estão alertas para a dor nesses pacientes. A avaliação e o manejo inadequado da dor, por sua vez, têm sido associados a uma série de resultados adversos, incluindo aumento da taxa de infecção, ventilação mecânica prolongada, distúrbios hemodinâmicos, delírio e imunidade comprometida. Dessa forma, este estudo teve como objetivo sumarizar as evidências científicas acerca da incidência e dos impactos da dor em pacientes críticos. CONTEÚDO: Foi realizada uma revisão sistemática de estudos observacionais (bases de dados Pubmed e EMBASE) com critérios de elegibilidade predeterminados. Nos 32 estudos incluídos, foi identificado que de 10,1% a 61% dos pacientes apresentaram dor em repouso, e de 27,4% a 94% apresentaram dor durante os procedimentos. Além disso, houve evidências de melhora nos resultados dos pacientes após o uso de instrumentos validados para a mensuração da dor, incluindo diminuição do tempo de permanência na UTI, duração da ventilação mecânica, mortalidade, delírio, eventos adversos e gravidade da doença. CONCLUSÃO: Através do presente estudo foi observado que a dor representa um fenômeno comum nas UTI e que a sua identificação e manejo constitui uma meta realista e dependente da avaliação. Além disso, a dor parece estar associada a piores desfechos clínicos. Sendo assim, deve-se voltar esforços para o cuidado integral ao paciente crítico, objetivando não só sua sobrevivência, mas também o alívio do seu sofrimento.

Validez convergente y discriminante del síndrome de quemarse por el trabajo en maestros mexicanos

Objetivo: explorar la validez convergente y discriminante del maslach burnout Inventory human services survey (MBI-HSS) y del Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT) en población mexicana. Método: Se evaluaron 483 profesores de 100 escuelas de educación básica (primarias y secundarias) de la Ciudad de México. Se utilizó el CESQT validado en México por Gil-Monte, Unda y Sandoval (2009) y el MBI-HSS validado en población mexicana por Placencia et al. (2013), ambos son escalas likert que presentaron una confiabilidad aceptable. En el análisis de datos se realizó una matriz multirasgo-multimétodo (MRMM), que es un enfoque desarrollado por Campbell y Fiske (1959) para analizar la validez convergente y divergente. Resultados: En la MRMM se presentaron correlaciones significativas, positivas y diferentes a cero entre los mismos rasgos medidos por diferente método, Ilusión por el trabajo y realización personal (r=0,40**) desgaste psíquico y cansancio emocional (r=0,87**), e Indolencia y Despersonalización (r=0,52**) lo cual supone validez convergente, además, se pueden observar que todas las Alfas de Cronbach son aceptables salvo la de Despersonalización (subescala del MBI). El MBI-HSS presenta recurrentemente Alfas de Cronbach inferiores a 70 % en la subescala de despersonalización, en especial en población no angloparlante. Conclusión: Conforme a los resultados del presente estudio y las dificultades psicométricas presentadas por el MBI-HSS, se concluye que el CESQT es el instrumento recomendado para la evaluación del Burnout en población mexicana.

Objective: to explore the convergent and discriminant validity of the maslach burnout inventory human services survey (MBI-HSS) and the Spanish Burnout Inventory (SBI) in Mexican population. Method: 483 teachers from 100 basic education schools (primary and secondary) were evaluated in Mexico City. The mexican validated SBI by Gil-Monte, Unda and Sandoval (2009) and MBI-HSS validated in Mexican population by Placencia et al. (2013) were implemented, both are Likert scales that showed acceptable reliability. In the data analysis, a Multi-treat-Multi-method matrix (MTMM) was performed, which is an approach developed by Campbell and Fiske (1959) to analyze convergent and divergent validity. Results: MTMM showed significant positive and non-zero correlations between the same traits measured by different method, enthusiasm toward the job and personal accomplishment (r = 0,40 **) psychic exhaustion and emotional exhaustion (r = 0,87 **), and indolence and depersonalization (r = 0,52 **) which supposes convergent validity, in addition, it can be observed that all cronbach's alphas are acceptable except for depersonalization (subscale of MBI). The MBI-HSS recurrently presents cronbach's alphas lower than 0,70 on the depersonalization subscale, especially in non-English-speaking population. Conclusion: According to the results of this study and the psychometric difficulties presented by the MBI-HSS, the SBI is the recommended instrument for the evaluation of Burnout in the Mexican population.

Desafios para a saúde de adolescentes: reflexões sobre diversidade, dignidade e direitos humanos / Challenges for adolescents' health: reflections on diversity, dignity, and human rights

RESUMO O estudo analisa o sistema socioeducativo como um meio de enfrentar violências, refletindo sobre seus desafios e destacando a importância de políticas públicas que promovam a diversidade e respeitem a dignidade dos adolescentes. Adiciona-se e reavalia-se o direito à expressão da sexualidade desses sujeitos. Para coletar dados, utilizaram-se técnicas de relato de experiência, observação participante e diálogos informais. Os resultados revelam tratamentos preconceituosos, negação e negligência de direitos, além da manutenção de um sistema com ações ultrapassadas que se perpetuam. Essas descobertas ressaltam a celeridade em superar as barreiras de acesso por meio do fortalecimento da educação, de investimentos em recursos humanos, parcerias governamentais e interinstitucionais. O estudo identifica lacunas no conhecimento sobre o sistema socioeducativo e propõe abordagens mais humanizadas e inclusivas para lidar com as adversidades dos adolescentes em cumprimento de medidas socioeducativas. Além disso, sugerem-se recomendações concretas visando a uma consciência social com valores éticos, políticos, sociais e de cidadania, melhorando assim a qualidade do cuidado e promovendo os direitos humanos desses jovens.

ABSTRACT The study examines the socio-educational system as a means of addressing violence, reflecting on its challenges, and highlighting the importance of public policies that promote diversity and respect the dignity of adolescents The right to express their sexuality was also added and re-evaluated. The data was collected using experience reports, participant observation and informal dialogues. What emerged were prejudiced treatments, denial, and neglect of rights as well as the maintenance of a system with outdated actions that perpetuate themselves. These findings highlight the need to overcome access barriers quickly by strengthening education, investing in human resources, government and inter-institutional partnerships. The study identifies gaps in the knowledge about the socio-educational system and proposes more humanized and inclusive approaches to dealing with the difficulties faced by adolescents undergoing socio-educational measures. It also suggests concrete recommendations for raising social awareness with ethical, political, social and citizenship values, thus improving the quality of care and protecting the human rights of these young people.

Cuestionario de Gratitud-20 (G-20): evidências psicométricas e parâmetros de seus itens no Brasil / Gratitude Questionnaire-20 (G-20): psychometric evidences and parameters of their items in Brazil / Cuestionario de Gratitud-20 (G-20): evidencias psicométricas y parámetros de sus ítems en Brasil

Objetivou-se explorar os parâmetros psicométricos do Cuestionario de Gratitud por meio da Teoria de Resposta ao Item (TRI), utilizando o Modelo de Resposta Graduada. Para tanto, participaram 533 respondentes (M idade = 29,9), a maioria mulheres (67,7%). Inicialmente, checou-se a dimensionalidade da escala, que apoiou uma estrutura quadrifatorial (CFI = 0,99; TLI = 0,99). Os parâmetros dos itens foram realizados separadamente para cada fator, e os resultados indicaram que todos os itens discriminam adequadamente os participantes. Os itens do fator Reconhecimento de Dons exigiram uma maior quantidade de theta para serem completamente endossados e o fator Gratidão Interpessoal demandou menor quantidade de theta para ser a opção de reposta, talvez por ser melhor aceito socialmente. Estima-se que os objetivos do estudo foram alcançados, conhecendo evidências psicométricas de uma medida que avalia a gratidão numa perspectiva mais integradora, recomendando-se o seu uso em possibilidades futuras. (AU)

The aim of this study was to explore the psychometric parameters of the Gratitude Questionnaire through the Item Response Theory (IRT), using the Graduated Response Model. Therefore, 533 respondents participated (Mage = 29.9), mostly women (67.7%). At the beginning, we checked the dimensionality of the scale, which supported a quadratic structure (CFI = 0.99; TLI = 0.99). The parameters of the items were performed separately for each factor, and the results indicated that all items adequately discriminate participants. The items of the Gift Recognition factor required a greater amount of theta to be fully endorsed and the Interpersonal Gratitude factor required less amount of theta to be the answer option, perhaps because it is better accepted socially. It is estimated that the objectives of the study were reached, knowing psychometric evidence of a measure that evaluates gratitude in a more inclusive perspective, recommending its use in future possibilities. (AU)

Se objetivó conocer los parámetros psicométricos del Cuestionario de Gratitud por medio de la Teoría de Respuesta al Item (TRI), utilizando el Modelo de Respuesta Graduada. Participaron 533 sujetos (M edad = 29,9), la mayoría mujeres (67,7%). Inicialmente, se verificó las dimensiones de la escala, que apoyó una estructura cuadrifatorial (CFI = 0,99; TLI = 0,99). Los parámetros de los ítems fueron realizados separadamente para cada factor, y los resultados indicaron que los ítems discriminan adecuadamente a los participantes. Los elementos del factor Reconocimiento de Dons requirieron una mayor cantidad de theta para ser completamente endosados y el factor Gratitud Interpersonal demandó menor cantidad de theta para ser la opción de respuesta, tal vez por ser mejor aceptado socialmente. Se estima que los objetivos del estudio se alcanzaron, conociendo evidencias psicométricas de una medida que evalúa la gratitud en una perspectiva más integradora, recomendándose su uso en posibilidades futuras. (AU)

Adaptation to Brazilian Portuguese and Latin-American Spanish and psychometric properties of the Mental Illness Clinicians' Attitudes Scale (MICA v4)

Abstract Objective To describe translation to Spanish and Portuguese and adaptation of the Mental Illness Clinicians' Attitudes Scale version 4 (MICA v4). Methods The questionnaire was administered to primary care physicians (PCPs) from four Latin-American countries, Brazil, Bolivia, Chile, and Cuba. The validation process included four phases: 1) translation of the questionnaire to Spanish and Portuguese; 2) assessment of face validity; 3) assessment of reliability; and 4) evaluation of construct validity with confirmatory factor analysis (CFA). Results The study sample comprised 427 PCPs. The mean age of the Spanish-speaking sample (n = 252) was 40.1 (S.D = 9.7) years and the mean age of the Portuguese-speaking sample (n = 150) was 40.2 (S.D = 10.9) years. Both models demonstrated "appropriate" internal reliability. Total omega was 0.91 for the Spanish-speaking sample and 0.89 for the Portuguese-speaking sample. The CFA of both questionnaires showed an appropriate fit for a three-factor model (Portuguese: CFI = 0.927; TLI = 0.913; RMSEA = 0.066; Spanish: CFI = 0.945; TLI = 0.935; RMSEA = 0.068). Conclusion The Latin-American versions of the MICA v4 in Spanish and Brazilian Portuguese have appropriate psychometric properties, good internal consistency, and are applicable to and acceptable in the Latin-American context. The instrument proved its validity for collecting data on stigmatizing attitudes among health professionals in different contexts and cultures.

Factors Associated with Anxiety and its Self-Care Measures among Nursing Students During the Covid-19 Pandemic

@#Introduction: One of the rising mental health issues among university students during the COVID-19 pandemic is anxiety. As future healthcare front-liners, nursing students are expected to perform good self-care to deliver quality care to patients. The purpose of the present study is to examine the factors associated with anxiety and its’ self-care measures among nursing students. Methods: The study recruited over 200 students in the East Coast region of Malaysia and the online survey was conducted during the COVID-19 pandemic between December 2020 and January 2021. The questions were in 3 parts: Socio-demographic, Self-care assessment worksheet (SCAW), and Burns Anxiety Inventory. Descriptive statistics, correlational analysis, and multiple linear regression were used to answer the research aim. Results: The range of anxiety levels among the nursing students was from no anxiety (7.5%) to severe anxiety or panic (28.9%, 17.9%). Multiple linear regression analysis revealed two predictors associated with higher level of anxiety were the first-year nursing students (bb =10.90, CI=4.49, 17.30), and respondents who stated having fairly satisfied with the nursing program (bb =13.50, CI=5.10, 21.90). Among the self-care components, result revealed that higher levels of physical care throughout the semester predicted lower anxiety (bb =-0.85, CI=-1.328, -0.372, p<0.05). Conclusion: The study’s overall finding is that nursing students’ participation in self-care, particularly physical care, may help to lessen anxiety. Our findings are significant because self-care can complement psychiatric interventions for people with high levels of anxiety and is a significant contributor to mental well-being.

Research progress in predicting the difficulty of surgery for middle and low rectal cancer based on pelvic measurement / 中华消化外科杂志

Total mesorectal excision (TME) has become the basic principle of surgical treat-ment for middle and low rectal cancer. Some of patients with ultra-low rectal cancer require under-going intersphincteric resection (ISR). Due to the limitation of the narrow pelvis, TME and ISR put forward higher requirements for the precise separation of the anatomical level and the protection of neurological function during the operation. At present, evaluation of the difficulty of surgery for middle and low rectal cancer is mainly based on the subjective judgment of chief surgeon, and there is no unified and objective scoring system or prediction model that can classify the difficulty of surgery for middle and low rectal cancer before surgery. The authors review relevant literatures and summarize the existing studies related to pelvic measurement for predicting the difficulty of surgery for middle and low rectal cancer, in order to provide significant guidance for the selection of surgical approach for patients with middle and low rectal cancer.

Monitoring of Inpatient Rehabilitation in Child and Parent Pairs with the Canadian Occupational Performance Measure / The Japanese Journal of Rehabilitation Medicine

Objective：Our institute provides inpatient intensive rehabilitation to severely disabled children and their parents. Rehabilitation aims are patient-specific, thus using individual scales to evaluate rehabilitation is essential. Here, we adopted the Canadian Occupational Performance Measure (COPM) to perform this evaluation in thirty-one cases.Methods：For the COPM, patients set goals in five subjects, and evaluates their performance levels and satisfaction levels on a scale of 1-10, before and after rehabilitation, and the mean scores are compared.Results：The COPM scores were significantly elevated in all cases at discharge. Patient had an average increase of 3.9 points for both performance and satisfaction scores. The scores of children with medical complexity tended to exceed those who did not require complex medical care. We identified a correlation between satisfaction and performance scores.Conclusion：We quantitatively measured the development of patients to measure the effectiveness of our intervention for two months using the COPM, which cannot be clarified by other objective evaluation tools for gross motor skills, functional independence, etc.. Although satisfaction scores are subjective, herein, their validity was shown by the correlation to the performance scores. Overall, COPM can contribute to top-down approaches to rehabilitation.

Application of Canadian Occupational Performance Measure combined with activity analysis in clients with hand injuries / 中国康复理论与实践

ObjectiveTo explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions. MethodsFrom January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM. ResultsA cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001). ConclusionThe occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.

Spatiotemporal characteristics and prevention and control measures of SARS-CoV-2 Omicron pandemic in Shanghai / 上海预防医学

ObjectiveTo analyze the spatiotemporal characteristics and prevention and control measures of the pandemic caused by the SARS-CoV-2 Omicron variant in Shanghai in 2022， aiming to optimize future prevention and control strategies. MethodsDescriptive statistical method was used to analyze data on daily infections released by the Shanghai Municipal Health Commission from March 1 to June 30， 2022. ResultsAs of 30 June， a total of 627 110 infections and 588 deaths had been reported in Shanghai. Most of the cases were in Pudong New Area （35.47%）， Minhang District （10.18%） and Huangpu District （9.27%）. The cumulative infection rate was 8.78% in Huangpu District， which was the highest among all the districts. With the progress of the pandemic， the prevention and control measures were strengthened from a “precise prevention and control” strategy to “block and grid” screening， and then upgraded to city-wide lockdown. All daily new infections were identified from the quarantined population on April 29， 2022， reaching the goal of “clearance of community transmission”. ConclusionThe cumulative infections in Shanghai exceeded any previous epidemics in mainland China. Given the enhanced transmissibility and vaccine-induced immune escape of the Omicron variant， timely and strong public health measures are needed to suppress the pandemic under the general policy of "Dynamic zero-COVID".

Monitoring of Inpatient Rehabilitation in Child and Parent Pairs with the Canadian Occupational Performance Measure / The Japanese Journal of Rehabilitation Medicine

Objective：Our institute provides inpatient intensive rehabilitation to severely disabled children and their parents. Rehabilitation aims are patient-specific, thus using individual scales to evaluate rehabilitation is essential. Here, we adopted the Canadian Occupational Performance Measure (COPM) to perform this evaluation in thirty-one cases.Methods：For the COPM, patients set goals in five subjects, and evaluates their performance levels and satisfaction levels on a scale of 1-10, before and after rehabilitation, and the mean scores are compared.Results：The COPM scores were significantly elevated in all cases at discharge. Patient had an average increase of 3.9 points for both performance and satisfaction scores. The scores of children with medical complexity tended to exceed those who did not require complex medical care. We identified a correlation between satisfaction and performance scores.Conclusion：We quantitatively measured the development of patients to measure the effectiveness of our intervention for two months using the COPM, which cannot be clarified by other objective evaluation tools for gross motor skills, functional independence, etc.. Although satisfaction scores are subjective, herein, their validity was shown by the correlation to the performance scores. Overall, COPM can contribute to top-down approaches to rehabilitation.

Heterogeneity of Outcomes Reporting in Trials Evaluating Traditional Chinese Medicine Breast Massage for Stasis Acute Mastitis: A Methodological Review / 中国医学科学杂志(英文版)

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.

Work-related musculoskeletal disorders and their prevention and control / 环境与职业医学

Work-related musculoskeletal disorders (WMSDs) are chronic and cumulative disorders that are affected by multiple ergonomic factors. They are widespread in occupational populations and have a high prevalence. They have caused a substantial economic and social burden, which has become a major occupational health problem worldwide. The mechanism of WMSDs needs to be clarified. More authoritative and unified diagnostic criteria and specific therapeutic drugs are required. Therefore, an in-depth epidemiological investigation on WMSDs involving occupational ergonomics is of great scientific value and practical significance, which aims to improve hazard identification and ergonomic load risk assessment and to facilitate the prevention, control, and intervention of WMSDs. This article introduced the concept, status report, risk factors, ergonomic assessment methods, and preventive measures of WMSDs. This special column on "occupational ergonomics and work-related musculoskeletal disorders" presented the prevalence and related risk factors of WMSDs in different industries, as well as working condition simulation studies for specific tasks, aiming to provide objective and detailed scientific data for the prevention and control of WMSDs.

Research progress on the influence of Modic changes on lumbar interbody fusion and its treatment measure / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of Modic changes and its influence on lumbar interbody fusion.@*METHODS@#The domestic and foreign literature related to Modic changes and its influence on lumbar interbody fusion was extensively reviewed. The etiology of Modic changes was summarized, and the treatment measures of Modic changes on lumbar interbody fusion were discussed.@*RESULTS@#The etiology of Modic changes is not clear, which may be related to mechanical factors, autoimmune factors, low toxic infection factors, and genetic factors. Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion. Preoperative evaluation of endplate sclerosis, reduction of iatrogenic endplate injury, fine operating of intervertebral space, management of osteoporosis, and selection of appropriate cage can prevent or reduce fusion failure or cage subsidence.@*CONCLUSION@#Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion, and active perioperative intervention of Modic changes is helpful to improve the clinical prognosis.

Adolescência e ato infracional: por que os adolescentes se submetem à criminalidade? / Adolescence and infraction: why do adolescents submit to criminality? / Adolescence et infraction: pourquoi les adolescents se soumettent-ils à la criminalité ? / Adolescencia e infracción: ¿por qué los adolescentes se someten a la criminalidad?

Resumo Este estudo contribui com a tessitura de uma análise das relações sociais e das formas políticas à luz da psicanálise, e propõe reflexões sobre o desamparo e modalidades de subjetivação de adolescentes em risco de envolvimento com a criminalidade. O estudo foi desenvolvido a partir de escuta clínica de adolescentes em cumprimento de medida socioeducativa e teve como objetivo investigar a inserção no laço social pela via do ato infracional. Para isso, foram resgatadas expressões produzidas pelos adolescentes e analisadas a partir de três dimensões: desamparo, pacto com o grupo e violência. Concluiu-se que modalidades de sujeição e exclusão social, nos contextos culturais colonizados, produzem efeitos significativos na subjetividade dos adolescentes, sendo o ato infracional uma possível via de solução para o desamparo, uma inserção no laço social e uma modalidade de identificação.

Abstract This study contributes with weaving an analysis of the social relations and the political forms in the light of psychoanalysis and proposes reflections on the helplessness and subjectivity modalities of adolescents at risk of involvement with crime. The study was developed from the clinical listening of adolescents in a socio-educational measure and aimed to investigate the insertion in the social bond via the infraction. To that end, the expressions produced by the adolescents were recovered and analyzed from three dimensions: helplessness, pact with the group, and violence. In conclusion, the modalities of subjection and social exclusion, in the colonized cultural contexts, produce significant effects on the subjectivity of adolescents, with the crime being a possible solution to helplessness, as well as an insertion in the social bond, and an identification modality.

Résumé Cette étude contribue au tissage d'une analyse des relations sociales et des formes politiques à la lumière de la psychanalyse et propose des réflexions sur les modalités d'impuissance et de subjectivité des adolescents à risque d'implication dans la criminalité. L'étude a été développée à partir de l'écoute clinique d'adolescents dans le respect d'une mesure socio-éducative et visait à enquêter sur l'insertion dans le lien social à travers l'infraction. Pour cela, des expressions produites par les adolescents ont été récupérées et analysées à partir de trois dimensions : l'impuissance, le pacte avec le groupe et la violence. Il a été conclu que les modalités d'assujettissement et d'exclusion sociale, dans les contextes culturels colonisés, produisent des effets significatifs sur la subjectivité des adolescents, l'infraction étant un moyen de rechercher une solution à l'impuissance, ainsi qu'une insertion dans le lien social, et une modalité d'identification.

Resumen Este estudio contribuye con un análisis de las relaciones sociales y formas políticas a la luz del psicoanálisis, además de proponer reflexiones sobre el desamparo y las modalidades de subjetividad de los adolescentes en riesgo de involucrarse en la criminalidad. A partir de la escucha clínica de adolescentes en cumplimiento de una medida socioeducativa, este estudio tuvo como objetivo investigar la inserción en el vínculo social a través de la infracción. Así, se tomaron los relatos de los adolescentes, para analizarlos bajo tres dimensiones: desamparo, pacto con el grupo y violencia. Se concluyó que las modalidades de sometimiento y exclusión social, en los contextos culturales colonizados, producen efectos significativos sobre la subjetividad de los adolescentes, y es la infracción un medio de búsqueda de una posible solución al desamparo, una inserción en el vínculo social y una modalidad de identificación.

Propriedades psicométricas da GAD-7 no Brasil / Psychometric properties of GAD-7 in Brazil / Propiedades psicométricas de GAD-7 en Brasil

Este trabalho objetivou avaliar as propriedades psicométricas da escala Generalized Anxiety Disorder (GAD-7) em uma amostra não clínica brasileira. Para tanto, foi realizada Análise Fatorial Confirmatória e de invariância de medida, assim como investigada evidências de fidedignidade e de validade baseada na relação com outras variáveis. Além disso, rastreou-se os níveis de ansiedade no contexto da pandemia da COVID-19 e verificou-se a relação com o sexo e a escolaridade da amostra. Participaram 4805 pessoas, de ambos os sexos e de todas as regiões do país, com idade média de aproximadamente 30 anos. Os resultados evidenciaram unidimensionalidade da GAD-7 e sua invariância de medida entre indivíduos com diferentes níveis de escolaridade e sexo. Os participantes apresentaram, em sua maioria, nível moderado e severo de ansiedade. Observou-se que o sexo feminino e menor nível de escolaridade aumentaram as chances de apresentar sintomatologia ansiosa significativa

This paper aimed to evaluate the psychometric properties of the Generalized Anxiety Disorder scale (GAD-7) in a Brazilian non-clinical sample. To this end, a Confirmatory Factor Analysis and measurement invariance were performed, as well as investigating evidence of reliability and validity based on the relationship with other variables. In addition, anxiety levels were tracked in the context of the COVID-19 pandemic and their relationship with sociodemographic characteristics was verified. 4805 people participated, of both sexes and from all regions of the country, with an average age of 31.3 years (SD = 11.91). The results showed onedimensionality of GAD-7 and its measurement equivalence between individuals with different levels of education and sex. The scale showed validity converging with the Questionnaire on Patient Health. Most of the participants had a moderate and severe level of anxiety. It was observed that the female gender and lower education level increased the chances of significant anxious symptoms

Este trabajo evaluó las propiedades psicométricas de la escala de Trastorno de Ansiedad Generalizada (GAD-7) en una muestra brasileña no clínica. Se realizó un Análisis Factorial Confirmatorio e invarianza de medida, y se investigó evidencias de confiabilidad y validez en base a la relación con otras variables. Además, se rastreó los niveles de ansiedad en el contexto de la pandemia de COVID-19 y se verificó su relación con las variables sociodemográficas. Participaron 4805 personas, de ambos sexos y de todas las regiones del país, con una edad media de 31,3 años (DE = 11,91). Los resultados mostraron unidimensionalidad de GAD-7 y su equivalencia de medida entre individuos con diferentes niveles de educación y sexo. La escala mostró validez convergente con el Cuestionario de Salud del Paciente. La mayoría de la muestra presentaba un nivel de ansiedad moderado y severo. Se observó que el sexo femenino y el menor nivel educativo aumentaron las posibilidades de presentar síntomas ansiosos