Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy

Escala de Percepção de Risco sobre Covid-19/Isolamento Social: Propriedades Psicométricas / Escala de Percepción de Riesgo sobre Covid-19 y Aislamiento Social: Propiedades Psicométricas / Psychometric Properties of Risk Perception Scale about Covid-19 and Social Isolation (RPSCI)

Risk perception is a concept related to the decision-making process and allows people to perceive the hazards surrounding the context and choose the best preventive methods to avoid them. The COVID-19 pandemic was a remarkable era in which people had to adopt protective methods, such as social isolation, to reduce the possibility of being contaminated by the virus. This study covers the development, psychometric properties, and norms of a scale to assess Risk Perception regarding COVID-19 and Social Isolation. The analysis suggested good expert agreement regarding the adequacy of the scale content and items and factor analysis suggested two factors, called the emotional and cognitive domains. The composite reliability suggested the internal consistency of the scale and its factors. All the results of this study suggest that this scale presents evidence of construct validity, constituting a reliable instrument. This new instrument may be used to evaluate risk perception related to COVID-19 and Social Isolation.

La percepción del riesgo es un concepto relacionado con el proceso de toma de decisiones y permite a las personas percibir los peligros en el contexto y elegir los mejores métodos de prevención para evitarlos. La pandemia de COVID-19 es una era notable en la que las personas deben adoptar métodos, como el aislamiento social, para reducir la posibilidad de ser contaminados por el virus. Este estudio proporciona el desarrollo, las propiedades psicométricas y las normas de una escala para evaluar Percepción de Riesgo sobre el COVID-19 y el Aislamiento Social. El análisis sugirió un buen acuerdo de expertos sobre el ajuste del contenido y la escala de ítems y el análisis factorial apuntó dos factores denominados dominios emocional y cognitivo. La confiabilidad compuesta sugirió consistencia interna de la escala y sus factores. Todos los resultados de este estudio proponen que esta escala presenta evidencia de validez de constructo y es un instrumento confiable. Este nuevo instrumento podrá ser utilizado para evaluar la percepción de riesgo sobre el COVID-19 y el aislamiento social.

A percepção de risco é um conceito relacionado ao processo de tomada de decisão e permite que as pessoas percebam os perigos em torno do contexto e escolham os melhores métodos de prevenção para evitá-los. A pandemia do COVID-19 é uma era marcante em que as pessoas devem adotar métodos de proteção, como o isolamento social, para reduzir a possibilidade de serem contaminados pelo vírus. Este estudo fornece o desenvolvimento, as propriedades psicométricas e normas de uma escala para avaliar Percepção de Risco sobre COVID-19 e Isolamento Social. A análise sugeriu boa concordância dos especialistas sobre o ajuste de conteúdo e itens da escala, e a análise fatorial sugeriu dois fatores denominados domínios emocionais e cognitivos. A confiabilidade composta sugeriu a consistência interna da escala e seus fatores. Todos os resultados deste estudo sugerem que esta escala apresenta evidências de validade de construto, sendo um instrumento confiável. Este novo instrumento poderá ser utilizado para avaliar a percepção de risco sobre a COVID-19 e o Isolamento Social.

Análisis de confiabilidad y de constructo del instrumento FANTASTIC MEX-A para medir el estilo de vida de adultos mexicanos. Estudio piloto bicéntrico en un cuartel general y una universidad privada / Reliability and construction analysis of the FANTASTIC MEX-A instrument to measure the lifestyle of mexican adults. Bicentric pilot study in a headquarters and a private university

Resumen Objetivo: Realizar un análisis de confiabilidad y de constructo del instrumento FANTASTIC MEX-A a través de alfa de Cronbach (α) y análisis factorial exploratorio (AFE) en dos instituciones mexicanas localizadas en el estado de Guerrero: un cuartel general y una universidad privada, como un estudio piloto para determinar la factibilidad de realizarse a gran escala en adultos mexicanos. Diseño: Cuantitativo, transversal, no experimental, descriptivo. Muestreo aleatorio simple. Recolección de datos desde febrero del 2021 a noviembre del 2022. Variables: Nivel de estilo de vida (dependiente); ocupación, género, escolaridad, estado civil, tipo de familia, edad e índice de masa corporal (atributivas). Resultados: N=493, n=242, participación del 49% (NC=95%, IC=4.5%), la muestra se constituyó por 204 militares y 38 docentes-administrativos universitarios. Alfa de Cronbach=0.869 (buena), por el método de dos mitades se obtuvo para ítems nones α=0.76 y para ítems pares α=0.762, correlación rho entre mitades de 0.903 (correlación fuerte). Media de puntaje obtenido de 134.8±17.7 puntos, equivalente al 72.5%. Resultaron nueve factores con asociación teórica, que explican el 42.64% de la varianza acumulada en el AFE, 1: La protección de la salud mental e integridad física, 2: El distrés, 3: Las relaciones interpersonales afectivas, 4: El consumo de alcohol y sustancias de abuso, 5: La actividad física y la asociatividad, 6: El consumo de tabaco, 7: El sueño y la alimentación, 8: El control de salud y 9: La apariencia física. Conclusiones: A través del estadístico de Alfa de Cronbach por método de dos mitades se concluyó que el instrumento FANTASTIC MEX-A es consistente para la muestra estudiada. El AFE determinó validez de constructo para nueve factores con asociación teórica. Limitaciones: El estudio se realizó en el estado de Guerrero, México, la validación del instrumento en adultos mexicanos requiere una muestra representativa que considere sujetos de diversas regiones del país. Originalidad: No existen publicaciones que homologuen las versiones disponibles del instrumento en español. Se aporta una versión única que implicó la revisión y reconstrucción de cada ítem con ilustraciones de apoyo.

Abstract Objective: To carry out a reliability and construct analysis of the FANTASTIC MEX-A instrument through Cronbach's alpha (α) and exploratory factor analysis (EFA) in two Mexican institutions located in the state of Guerrero: a general headquarters and a private university, such as a pilot study to determine the feasibility of performing it on a large scale in Mexican adults. Design: Quantitative, cross-sectional, non-experimental, descriptive. Simple random sampling. Data collection from February 2021 to November 2022. Variables: Lifestyle level (dependent); occupation, gender, education, marital status, type of family, age and body mass index (attributive). Results: N=493, n=242, 49% participation (NC=95%, CI=4.5%), the sample consisted of 204 military personnel and 38 university teachers/administrators. Cronbach's alpha=0.869 (good), using the two-half method, α=0.76 was obtained for odd items and α=0.762 for even items, rho correlation between halves of 0.903 (strong correlation). Mean score obtained of 134.8 ± 17.7 points, equivalent to 72.5%. Nine factors with theoretical association were found, that explain 42.64% of the accumulated variance in the Exploratory Factor Analysis (EFA), 1: The protection of mental health and physical integrity, 2: Distress, 3: Affective interpersonal relationships, 4: The consumption of alcohol and substances of abuse, 5: Physical activity and associativity, 6: Tobacco consumption, 7: Sleep and diet, 8: Health control and 9: Physical appearance. Conclusions: Through the Cronbach's Alpha statistic by the two-half method, it was concluded that the FANTASTIC MEX-A instrument is consistent for the sample studied. The AFE determined construct validity for nine factors with theoretical association. Limitations: The study was conducted in the state of Guerrero, México, the validation of the instrument in Mexican adults requires a representative sample that considers subjects from various regions of the country. Originality: There are no publications that standardize the available versions of the instrument in Spanish. A unique version is provided that involved the revision and reconstruction of each item with supporting illustrations.

Sobrecarga del cuidador familiar en Colombia: revisión sistemática exploratoria / Family caregiver's overburden in Colombia: An exploratory systematic review / Sobrecarga do cuidador familiar na Colômbia: revisão sistemática exploratória

Objetivo:describir las tendencias metodológicas, las poblaciones estudiadas y los desafíos futuros reportados en la literatura sobre lasobrecarga delcuidador familiar colombiano.Métodos:revisión sistemática exploratoria en donde se consultaron las bases de datos PubMed, ScienceDirect, Lilacs, Cuiden, SciELO, EBSCO y BVS, específicamente artículos originalespublicados del 2016 al 2021. Resultados:en 20 artículos revisados, se encontró una relación directa entre condiciones socioeconómicas y la sobrecarga del cuidador. El contexto cultural y las condiciones socioeconómicas son factores que influyen en la percepción de la sobrecarga del cuidador. Conclusiones:son necesarias las intervenciones de enfermeríadirigidasa los cuidadores familiares para mejorar su percepción de la sobrecarga y consecuentemente la calidad de vida

Objective: To describe methodological trends, populations studied, and future challenges reported in the literature on Colombian family caregivers' overburden. Methods: An exploratory systematic review using PubMed, ScienceDirect, LILACS, Cuiden, SciELO, EBSCO, and VHL databases was conducted, specifically original articles published between 2016 and 2021 were reviewed. Results:In 20 articles reviewed, a direct relationship was found between socioeconomic conditions and caregiver's overburden. Cultural context and socioeconomic conditions are factors that influence the perception of caregiver's overburden. Conclusions:Nursing interventions aimed at family caregivers are needed to improve their perception of overburden and, consequently, their quality of life

Objetivo:Descrever as tendências metodológicas, as populações estudadas e os desafios futuros relatados na literatura desobrecarga do cuidador familiar colombiano. Métodos:Revisão sistemática exploratória na qual foram consultadas as bases de dados PubMed, ScienceDirect, Lilacs, Cuiden, SciELO, EBSCO e BVS, com artigos originais, publicados de 2016 a 2021. Resultados:Em 20 artigos revisados, foi encontrada uma relação direta entre condições socioeconômicas e a sobrecarga do cuidador. O contexto cultural e as condições socioeconômicas são fatores que influenciam na percepção da sobrecarga do cuidador. Conclusões:As intervenções de enfermagem voltadas a cuidadores familiares são necessárias para melhorar sua percepção de sobrecarga e, consequentemente, sua qualidade de vida.

Construcción de una escala para evaluar tipos de elogios otorgados por cuidadores primarios a infantes de 0 a 3 años / Construction of a scale to assess the types of praise given by primary caregivers to infants 0-3 years

Resumen Los elogios son definidos como devoluciones positivas otorgadas a personas sobre sus atributos, sobre la realización de una tarea o sobre los objetos o productos realizados. Los distintos tipos de elogios que los cuidadores primarios o padres utilicen con los infantes cuando ellos realicen una actividad impactarán en su desarrollo, en las creencias o percepción de sí mismos o de los modos de aprender, y en la motivación hacia esas tareas que la niña o el niño realice. Estos modos de elogiar no han sido estudiados en la Argentina y no existen instrumentos estandarizados psicométricos para evaluarlos. Por esto, el objetivo de este estudio fue la creación y validación de una técnica de auto-reporte para evaluar los elogios que otorgan los cuidadores a infantes de 0 a 3 años. Los participantes que conformaron la muestra (. = 128) fueron reclutados por medio de internet y completaron un cuestionario de escala Likert de aproximadamente cinco minutos de duración. A partir del análisis factorial exploratorio, se ajustó la técnica y se agruparon las preguntas del cuestionario en tres dimensiones: elogios de persona, proceso y producto. Esto permitiría hacer una evaluación breve y sencilla de los elogios utilizados, lo que en un futuro aportaría a intervenciones o estudios que pretendan favorecer elogios que beneficien un desarrollo adaptativo de los infantes. Sin embargo, aún es necesario un futuro estudio que indague cambios en la técnica con un mayor tamaño muestral para la realización de una validación más exhaustiva.

Abstract Praise is defined as positive feedback given to people about their attributes, their performance, the objects or products made by them. The different types of praise that primary caregivers or parents use with infants when they carry out an activity will impact on their development, beliefs or perception of themselves or types of learning, and motivation toward the tasks that the children perform. One type of praise is the praise directed towards an individual, which compliments their own attributes such as her intelligence. Another one is the product praise, which is directed towards the final objects or actions that the infant performs, such as a drawing or physical activities. Finally, a praise directed at the process aims to congratulate the infant during the task as a process, either for making an effort or for the strategies that they use to achieve something. This last kind of praise favors perseverance in the face of new tasks to a greater extent, while praise directed at the person could generate more frustration when the infant experiences failure. Therefore, the way caregivers interact with infants is relevant, since it modulates motivation and the development of different skills. For this reason, the main objective of this study was the creation and validation of a self-report technique to assess the praise that Argentinean caregivers give to infants from 0 to 3 years of age. The sample was made up of 128 primary caregivers (. = 128) who were recruited through the internet. They completed a Likert scale questionnaire of approximately 5 minutes of duration. The data was collected during preventive social isolation due to COVID-19. This could lead to changes in parental behavior, while it also provides ecological value for understanding the ways to praise in this context, where caregivers spend a lot of time with infants; however, it would be important to conduct future research outside of this context. An exploratory factor analysis was performed, which led to an adjustment in the technique by eliminating four items in order to improve the psychometric characteristics of the instrument. By this analysis, the formation of the three dimensions was justified by the types of praise: person, process, and product praise.The final instrument consisted of 13 phrases that represent possible compliments used by caregivers. Participants indicated how often they usually use those compliments on a scale from 1 (never) to 5 (very often). The items are divided by types of praise: six were assigned to the product dimension, three to the process dimension and four to the person dimension. The internal consistencies of the dimensions were process (α = .91), product (α = .74) and person (α = .73). This self-report technique for primary caregivers of infants would allow a short and simple evaluation of the praise used. In future research, this technique would allow an assessment of praise for the realization of studies that seek to expand the knowledge about how they affect child development. Likewise, it would contribute to the development of interventions with caregivers aimed to promote praise that benefits an adaptive development of infants. However, more studies are needed to investigate possible changes in the inventory, such as the inclusion of neutral praise or negative feedback. Furthermore, a larger sample size would be necessary to carry out a more exhaustive validation, performing a confirmatory factor analysis, convergent variance and factor invariance.

Life Threatening Retroperitoneal Haemorrhage in COVID-19 Patient -Surgical Treatment: A Case Report

@#Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus that emerged in late 2019. The COVID-19 pandemic has affected millions of people worldwide, causing severe respiratory distress, multi-organ failure, and death. Nevertheless, there are records of unusual presentations of COVID-19, which includes hemorrhagic complications. Retroperitoneal hemorrhage (RPH) is a rare but life-threatening complication that can occur in COVID-19 patients. In this paper, we present a case of a life-threatening spontaneous retroperitoneal haemorrhage who has successfully undergone an exploratory laparotomy and made a full recovery. We would like to highlight the importance of close monitoring and prompt recognition in patients with increased risk of bleeding.

Evaluation of ICUs and weight of quality control indicators: an exploratory study based on Chinese ICU quality data from 2015 to 2020 / 医学前沿

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.

Comparison of exploratory behavior of male and female woodlice (Armadillidium vulgare)

There are several studies in the literature showing that male and female rats explore novel environments and exhibit different exploration patterns when submitted to different apparatuses. In general, female rats spend more time moving and exploring the apparatuses than males do. A previous study showed that male woodlice (Armadillidium vulgare) explore novel environments in a very similar way to male rats (Rattus norvegicus) when tested in apparatuses analogous to the open-field test and light/dark box. Since that study was conducted only with male rats and woodlice, and since they exhibited very similar patterns of behavior, the present experiment aimed at investigating whether male and female woodlice explore novel environments with different behavioral patterns. Female and male woodlice were tested in the open-field and in the dry/moist box. Results obtained in the open-field test showed that both males and females remained longer in the corners than along the walls and avoided staying in the center. However, females remained longer along the walls and less in the corners. In the dry/moist box, there were no significant differences between the sexes: both females and males remained significantly longer in the moist compartment.

Leiomioma uterino gigante en adolescente mexicana de 14 años, un caso raro de sangrado uterino anormal. Reporte de caso / Giant uterine leiomyoma in a 14-year-old Mexican adolescent, a rare case of abnormal uterine bleeding. Case Report

Resumen ANTECEDENTES: Los leiomiomas son neoplasias benignas comunes durante la edad reproductiva. Su aparición en adolescentes es excepcional y un reto diagnóstico en menores de 18 años de edad. El caso aquí reportado se integra a los 26 casos asentados en la bibliografía y se trata del tumor más grande en la paciente más joven hasta ahora comunicado. CASO CLÍNICO: Paciente de 14 años, con inicio de sangrado uterino anormal, aumento del perímetro abdominal y tres semanas con hipermenorrea. El reporte inicial de la química sanguínea informó: anemia severa y el ultrasonido pélvico: un gran tumor anexial sólido. Luego de mejorar las condiciones hemodinámicas de la paciente por medio de transfusiones de concentrados eritrocitarios se practicó una laparotomía exploradora y se extirpó un leiomioma gigante, dependiente del útero. El informe histopatológico fue de: leiomioma de 16 cm de diámetro, con degeneración roja. La paciente cursó sin complicaciones posquirúrgicas y hasta la actualidad no ha experimentado datos de recurrencia ni sangrado uterino anormal. CONCLUSIÓN: La fisiopatología de la miomatosis uterina sigue aún sin comprenderse del todo. El tratamiento quirúrgico a una edad temprana debe tomar en consideración el deseo de embarazo y llevar a cabo un seguimiento estrecho para valorar: la fertilidad, recurrencia, atipia celular y trastornos menstruales.

Abstract BACKGROUND: Leiomyomas are common benign neoplasms during reproductive age. Its appearance in adolescents is exceptional and a diagnostic challenge in children under 18 years of age. The case reported here is one of the 26 cases reported in the bibliography and it is the largest tumor reported in the youngest patient to date. CLINICAL CASE: A 14-year-old patient with onset of abnormal uterine bleeding, increased abdominal circumference and three weeks with hypermenorrhea. Initial blood chemistry report: severe anemia and pelvic ultrasound: a large solid adnexal tumor. After improving the patient's hemodynamic conditions through transfusions of erythrocyte concentrates, an exploratory laparotomy was performed and a giant leiomyoma, dependent on the uterus, was removed. The histopathological report was: leiomyoma of 16 cm in diameter, with red degeneration. The patient had no postoperative complications and to date she has not experienced recurrence or abnormal uterine bleeding. CONCLUSION: The pathophysiology of uterine fibroids remains poorly understood. Surgical treatment at an early age should take into account the desire for pregnancy and carry out a close follow-up to assess: fertility, recurrence, cellular atypia and menstrual disorders.

Validation of the brazilian version of the Penn State College of Medicine Professionalism Questionnaire / Validação da versão brasileira do Questionário de Profissionalismo da Penn State College of Medicine

Abstract Introduction: Assessing professionalism represents a challenge for medical educators given the nature of its construct, which comprises diverse values, beliefs, and principles. Understanding this psychological phenomenon is fundamental for reaching the goals in medical education. Objective: This study aimed to translate into Brazilian Portuguese and to validate the Penn State College of Medicine Professionalism Questionnaire. Method: The questionnaire was translated, and cross-culturally adapted into Brazilian Portuguese using data from 249 medical students. An exploratory factor analysis was conducted, using a polychoric matrix and the Robust Diagonally Weighted Least Squares method of extraction. The following model adequacy indexes and criteria were used: Root Mean Square Error of Approximation (RMSEA) adjustment indexes <0.08, Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) >0.90. Result: The exploratory factor analysis obtained a KMO = 0.920, and a significant Bartlett's test of sphericity (2719.0, gl = 630; P <0.001). The parallel analysis yielded a three-factor solution, which showed adequate levels of reliability: Professional-Patient Relationship, Professional Development and Ethical Commitment. The three-factor solution was the best one found to represent the data. Conclusion: The questionnaire evidenced good psychometric properties and appropriateness to evaluate medical students' professionalism, contributing to reach more desirable ethical standards in medical education.

Resumo Introdução: Avaliar o profissionalismo representa um desafio para os educadores médicos dada a natureza de seu construto que compreende diversos valores, crenças e princípios. A compreensão desse fenômeno psicológico é fundamental para o alcance dos objetivos da educação médica. Objetivo: Este estudo teve como objetivos traduzir para o português brasileiro e validar o Questionário de Profissionalismo da Penn State College of Medicine. Método: O questionário foi traduzido e adaptado transculturalmente para o português brasileiro com dados de 249 estudantes de Medicina. Na condução da análise fatorial exploratória, utilizaram-se uma matriz policórica e o método de extração Robust Diagonally Weighted Least Squares. Os seguintes índices e critérios de adequação do modelo foram usados: índices de ajuste da raiz quadrada da média do erro de aproximação (RMSEA) < 0,08, índice de ajuste comparativo (CFI) e índice de Tucker-Lewis (TLI) > 0,90. Resultado: A análise fatorial exploratória obteve um KMO = 0,920 e um teste de esfericidade de Bartlett significativo (2719,0, gl = 630; P < 0,001). A análise paralela resultou em uma solução de três fatores que apresentou níveis adequados de confiabilidade: relacionamento profissional-paciente, desenvolvimento profissional e compromisso ético. A solução de três fatores foi considerada a melhor para representar os dados. Conclusão: O questionário evidenciou boas propriedades psicométricas e adequação para avaliar o profissionalismo dos estudantes de Medicina, contribuindo para o alcance de padrões éticos mais desejáveis na educação médica.

Vólvulo ileal secundario a síndrome adherencial posquirúrgico. Presentación de un caso

Se presentó el caso de una paciente de 71 años que tuvo durante tres meses previo a su ingreso dolor abdominal tipo cólico difuso a predominio de hemiabdomen inferior, acompañado de distensión abdominal intermitente, vómitos en cantidad y frecuencia no precisada de contenido alimentario. Al examen físico se apreció paciente en regulares condiciones, facies álgica, afebril, deshidratada. En la evaluación abdominal se evidenció abdomen distendido, con ruidos hidroaéreos disminuidos en intensidad, tono y frecuencia. Se decidió ingresar para manejo clínico y realización de estudios de apoyo diagnóstico. Se diagnosticó un síndrome adherencial, conjunto de signos y síntomas provocados por la formación de adherencias intraabdominales. Frente a un paciente con abdomen agudo obstructivo con antecedente de intervención quirúrgica previa, debe sospecharse en una complicación secundaria a síndrome adherencial, teniendo al vólvulo de íleon como una de sus expresiones clínicas.

The case of a 71-year-old patient was presented who had diffuse colicky abdominal pain predominantly in the lower abdomen for three months prior to admission, accompanied by intermittent abdominal distention, vomiting in an unspecified amount and frequency of food content. During the physical examination, the patient was found to be in fair condition, with pain, fever, and dehydration. The abdominal evaluation revealed a distended abdomen, with fluid sounds decreased in intensity, tone and frequency. It was decided to enter for clinical management and diagnostic support studies. An adhesion syndrome was diagnosed, a set of signs and symptoms caused by the formation of intra-abdominal adhesions. In a patient with acute obstructive abdomen with a history of previous surgical intervention, a complication secondary to adhesion syndrome should be suspected, with ileal volvulus as one of its clinical expressions.

Foi apresentado o caso de um paciente de 71 anos que apresentava cólica abdominal difusa predominantemente no baixo ventre há três meses antes da internação, acompanhada de distensão abdominal intermitente, vômitos em quantidade e frequência de conteúdo alimentar não especificadas. Durante o exame físico, o paciente apresentou-se em bom estado, com dor, febre e desidratação. A avaliação abdominal revelou abdômen distendido, com sons fluidos diminuídos de intensidade, tônus e frequência. Decidiu-se ingressar em estudos de manejo clínico e apoio diagnóstico. Foi diagnosticada uma síndrome de aderências, conjunto de sinais e sintomas causados pela formação de aderências intra-abdominais. Em paciente com abdome obstrutivo agudo e história de intervenção cirúrgica prévia, deve-se suspeitar de complicação secundária à síndrome de aderências, tendo o volvo ileal como uma de suas expressões clínicas.

Informed consent in anesthesiology: An exploratory study / El consentimiento informado en anestesiología: un estudio exploratorio / Consentimento informado em anestesiologia: um estudo exploratório

Abstract: In the literature Informed consent (IC) assumptions is well established. However, the different stages and the conditions under which the IC for anesthetic practices is obtained, is scarce. The aim of the present study is to explore the phases and conditions of IC in anesthesiology. Anonymized clinical records of 325 patients submitted to anesthetic procedures at the Institute of Oncology of Porto were analyzed. A total agreement between the anesthetic techniques established in the IC and those performed, was reach with 270 patients. The importance of IC in clinical practice is discussed and an ideal process for IC is argued.

Resumen: El consentimiento informado (CI) está bien establecido en la literatura. Sin embargo, la información sobre las diferentes fases y condiciones en las que se obtiene el CI para las prácticas anestésicas es escasa. El objetivo del presente estudio es explorar las fases y condiciones de obtención de la CI en anestesiología. Se analizaron las historias clínicas anónimas de 325 pacientes sometidos a procedimientos anestésicos en el Instituto de Oncología de Oporto. Se alcanzó una concordancia total entre las técnicas de anestesia establecidas en el CI y las realizadas con 270 pacientes. Se defiende la importancia del CI en la práctica clínica y se discute un proceso ideal para obtenerlo.

Resumo: Na literatura o Consentimento Informado (CI) é bem estabelecido. Contudo, a informação sobre as diferentes fases e as condições em que o CI para práticas anestésicas é obtido, é escassa. O objetivo do presente estudo é explorar as fases e condições da obtenção do CI em anestesiologia. Foram analisados os registos clínicos anónimos de 325 pacientes submetidos a procedimentos anestésicos no Instituto de Oncologia do Porto. Foi alcançado um acordo total entre as técnicas anestésicas estabelecidas no CI e as realizadas, com 270 pacientes. A importância do CI na prática clínica é defendida e discute-se um processo ideal para a obtenção do CI.

Atribuciones sobre las causas de la pobreza general e infantil en Argentina / Attributions on the causes of general and child poverty in Argentina

Resumen El estudio acerca de las causas de la pobreza ha sido influenciado por la teoría de la atribución, lo que permitió identificar los juicios predominantes que las personas establecen sobre tales causas. Los estudios locales sobre las atribuciones causales de la pobreza son escasos y no se ha identificado ninguno referido a las causas de la pobreza infantil, a pesar de las altas tasas de su incidencia en el país. Así, el presente estudio propone evaluar las atribuciones causales de la pobreza general e infantil por parte de adultos de Argentina, empleando dos cuestionarios (uno sobre las causas de la pobreza en general y el otro sobre la pobreza infantil en particular) implementados de manera virtual. La muestra incluyó a 1 659 participantes (17 a 90 años), quienes debieron indicar la importancia de cada ítem como causa de la pobreza en una escala tipo Likert de cinco puntos. En cuanto al cuestionario sobre las causas de la pobreza general, el análisis exploratorio permitió identificar una estructura de tres factores -similar a la identificada en otros estudios: individualista, estructurales y fatalistas-, la cual no fue verificada en el análisis confirmatorio. Con respecto al cuestionario sobre las causas de la pobreza infantil, se identificó y se confirmó un modelo de dos factores (que podrían estar relacionados con atribuciones estructurales y familiares) que representa una nueva evidencia en el campo. Los resultados sugieren diferencias en las atribuciones de las causas de pobreza general e infantil, cuyos posibles mecanismos (e. g., modulación por parte de factores individuales, contextuales y culturales) deberían explorarse en estudios futuros.

Abstract In the last decades, different studies have addressed the perspectives of people regarding the causes of poverty, as they could play a fundamental role in the development of individual and social attitudes, beliefs and expectations towards people living in such a condition, and in the strategies implemented to solve related problems and issues. In addition, many of those studies have investigated the causes of poverty using the theoretical model proposed by Feagin (1972), which suggests three broad explanations: (1) individualistic (i. e., causal attribution is placed on the poor themselves); (2) structural (i. e., poverty is due to external social and economic factors); and (3) fatalistic (i. e., poverty is attributed to factors such as bad luck). Most of those studies have been carried out considering the causes of poverty in general, which means that there is very little research aimed at studying specifically the causes of child poverty. Given the high incidence of poverty in Argentina the knowledge about such perspectives is of interest for multiple basic and applied purposes. In this sense, the present study proposed to evaluate the attributions of the causes of poverty in general and child poverty in particular, by adults from Argentina, through two virtual questionnaires (one asking for the causes of poverty in general, and the other for the causes of child poverty). The sample included responses from 1 659 citizens of Argentina from 17 to 90 years old (M = 45.72, SD = 16.94). The questionnaires included 32 items aimed at evaluating the attribution of causes of general poverty, and 30 items related to child poverty. Participants were asked to indicate the importance of each item as a cause of poverty on a five-point Likert-type scale (1 = does not matter; 5 = extremely important). Exploratory and confirmatory factor analyses were implemented (separately from the general and child questionnaires) and retained items with factor loadings at .40 or above. In addition, for the general questionnaire, a second approach was implemented to analyze if the factorial structure supported by different studies in the literature was confirmed in this sample. For such a purpose, confirmatory factor analyses were implemented. Regarding the questionnaire for the causes of general poverty, the exploratory analysis allowed identifying a three-factor structure (as in the case of other studies) (RMSEA = .071; CFI = .94; TLI = .93), which was not verified in the confirmatory analysis (RMSEA = .103; CFI = .88; TLI = .86). On the other hand, the results of the second approach suggest the confirmation of the two-factor model proposed in the literature (RMSEA = .083; CFI = .96; TLI = .95). This pattern of results suggests sensitivity to the inclusion of new items. In this sense, in future studies it would be important to invest efforts in determining new items from consultations with experts and other social actors. Regarding the questionnaire for the causes of poverty in children, two-factor model was identified and confirmed (RMSEA = .074; CFI = .94; TLI = .93), which is a new piece of evidence in the field, suggesting variability in the attribution of causes of poverty according to the considered age group, and whose potential mechanisms in comparison with the studies on adult poverty should be explored in future research (e. g., individual, contextual and cultural factors). Finally, this study confirms that having valid and reliable instruments to explore the causal attributions of general and child poverty would be important to advance in the understanding of poverty as a complex and multidimensional phenomenon.

Evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul / Validity evidence of the Young Compensation Inventory (YCI) for the population of Rio Grande do Sul / Evidencias de validez del Inventario de Compensación Young (YCI) para la población de Rio Grande do Sul

O objetivo deste estudo foi examinar a estrutura fatorial e as evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul. Contou-se com a participação de 504 adultos da população geral, com média de idade de 34,2 anos (DP = 12,9). Os instrumentos utilizados foram o Questionário de Esquemas de Young - Versão Breve (YSQ-S3), a Escala de Avaliação dos Sintomas (SCL-90-R) e o YCI. Os dados foram coletados através de plataforma online. Realizou-se a análise fatorial exploratória, para verificar a distribuição dos itens em fatores comuns, e a validade convergente, com correlação não paramétrica de Spearman com a SCL-90-R e o YSQ-S3. Foram interpretados quatro fatores: Dominação e Manipulação (α =0,85 ω=0,71); Obsessão e Organização (α =0,75 ω=0,75); Rebeldia e Independência (α =0,73 ω=0,69); e Busca de Reconhecimento (α =0,81 ω=0,91). A validade de construto mostrou-se adequada conforme a teoria. Concluiu-se que a versão adaptada apresenta boas propriedades psicométricas. (AU)

This study aimed to examine the factorial structure and evidence of validity of the Young Compensation Inventory (YCI) for the population of the state of Rio Grande do Sul. For this purpose, 504 adults from the general population participated, with a mean age of 34.2 years (SD = 12.9). The instruments used were the Young Schema Questionnaire - Brief Version (YSQ-S3), the Symptom Checklist-90 (SCL-90-R), and the YCI. Data were collected using an online platform. Exploratory factor analysis was performed to verify the distribution of items in common factors, and convergent validity, with a non-parametric Spearman correlation with SCL-90-R and YSQ-S3. Four factors were interpreted: Domination and Manipulation (α = 0.85 ω = 0.71); Obsession and Organization (α = 0.75 ω = 0.75); Rebellion and Independence (α = 0.73 ω = 0.69); and Search for Recognition (α = 0.81 ω = 0.91). The result of construct validity proved to be adequate according to the theory. It was concluded that the adapted version has good psychometric properties. (AU)

El objetivo de este estudio fue examinar la estructura factorial y las evidencias de validez del Young Compensation Inventory (YCI) para la población de Rio Grande do Sul. Participaron 504 adultos de la población general, con una edad media de 34,2 años (DS = 12,9). Los instrumentos utilizados fueron el Young Scheme Questionnaire - Versión breve (YSQ-S3), la Escala de Evaluación de Síntomas (SCL-90-R) y el YCI. Los datos se recogieron a través de una plataforma online. Se realizó un análisis factorial exploratorio para verificar la distribución de los ítems en factores comunes, y la validez convergente, con la correlación no paramétrica de Spearman con SCL-90-R y YSQ-S3. Se interpretaron cuatro factores: Dominación y Manipulación (α =0,85 ω=0,71); Obsesión y Organización (α =0,75 ω=0,75); Rebeldía e Independencia (α =0,73 ω=0,69); y Búsqueda de Reconocimiento (α =0,81 ω=0,91). La validez de constructo demostró ser adecuada según la teoría. Se concluyó que la versión adaptada presenta buenas propiedades psicométricas. (AU)

Planejamento e desenvolvimento de novos compostos com atividade frente a Leishmania spp: Síntese, avaliação da atividade e toxicidade de derivados 5-nitro-2-furfurilidênicos e estudos de relações estrutura-atividade / Design of new compounds against Leishmania spp: synthesis, biological evaluation and toxicity of 5-nitro-2-furfurylidene derivates and structure-activity relationship studies

A leishmaniose é uma zoonose de ampla distribuição mundial, causada pelos parasitas tripanossomatídeos do gênero Leishmania. Infelizmente, o arsenal terapêutico disponível é precário, mas vê-se crescente o interesse científico pela busca do potencial de derivados nitroheterocíclicos como alternativas terapêuticas. Nesse contexto, este trabalho analisou o potencial de derivados 5-nitro-2-furfurilidênicos contra diferentes cepas de Leishmania, assim como investigou um possível modo de ação para esta classe de nitrocompostos. Para tal, a quimioteca foi sintetizada de acordo com publicações prévias do grupo. O potencial de inibição de crescimento das culturas de promastigotas de L. (L.) infantum (Linf) e L. (L.) major (Lmaj) foi determinado, utilizando miltefosina (MILT) (Linf - IC50: 8,28±0,33 µM), anfotericina B (AMB) (Linf - IC50: 0,02±0,002 µM) e nifurtimox (NFX) (Lmaj - IC50: 3,5±0,09 µM) como referência. A maioria dos compostos apresentaram maior potencial que as referênias, destacando o composto 40 (Linf - IC50: 0,2±0,019 µM/ Lmaj - IC50: 0,087 ± 0,001 µM) como mais eficaz. Contra as formas amastigotas intracelulares, para Linf os compostos 40, 13 e 15 foram mais eficazes em reduzir a carga parasitária dos macrófagos infectados que fármacos de referência. Para Lmajor, o composto 40 (IC50: 0,006 ± 0,0003 µM) foi mais ativo que o NFX (IC50: 2,15 ± 0,01 µM). Também foi determinada a atividade da quimioteca frente a enzima nitrorredutase (NTR1), utilizando cepas de T. brucei superexpressantes de NTR1, e os compostos analisados foram até 18 vezes mais eficazes que à cepa wild-type. Ademais, a partir da análise exploratória de dados por análise de componentes principais (PCA) e de grupamentos hierárquicos (HCA), foi reconhecida a influência das propriedades relacionadas com o equilíbrio hidrófilo-lipófilo e da natureza estérica/geométrica das moléculas para atividade anti-Leishmania

Leishmaniasis is a worldwide zoonosis caused by trypanosomatid parasites of the genus Leishmania. Unfortunately, the available therapeutic arsenal is precarious, but there is growing scientific interest in searching the potential of nitroheterocyclic derivatives as therapeutic alternatives. In this context, this work analyzed the potential of 5-nitro-2-furfurylidene derivatives against different Leishmania strains, as well as investigated the potential mode of action for this nitro compounds class. To this end, the chemolibrary was synthesized according to our group's previous publications. The growth inhibitory potential potential for promastigote cultures of L. (L.) infantum (Linf) and L. (L.) major (Lmaj) was determined using miltefosine (MILT) (Linf - IC50: 8.28±0.33 µM), amphotericin B (AMB) (Linf - IC50: 0.02±0.002 µM) and nifurtimox (NFX) (Lmaj - IC50: 3.5±0.09 µM) as reference. Most of the compounds were more potent than the references, highlighting compound 40 (Linf - IC50: 0.2±0.019 µM/ Lmaj - IC50: 0.087 ± 0.001 µM) as the most effective. Against intracellular amastigote, for Linf, compounds 40, 13 and 15 were more effective in reducing the parasite load of infected macrophages than reference drugs. For Lmajor, compound 40 (IC50: 0.006 ± 0.0003 µM) was more active than NFX (IC50: 2.15 ± 0.01 µM). The activity against nitroreductase (NTR1) enzyme was determined using overexpressing NTR1 mutant T. brucei strains, and the analyzed compounds were up to 18 times more effective than wild-type. Furthermore, exploratory data analysis using principal component analysis (PCA) and hierarchical clustering (HCA) methods were used. The influence of properties related to the hydrophiliclipophilic balance and the steric/geometric nature of the molecules was associated with the anti-Leishmanial activity

Bidirectional genetic selection of behaviors involved in social interaction of Wistar rats

Bidirectional selection is a procedure in which an arbitrary characteristic is chosen as a selection criterion and animals exhibiting more of this characteristic are bred in one group and animals exhibiting less are bred in another group. The procedure is repeated along generations until the selected characteristic becomes stable, resulting in two strains that are opposite in relation to the chosen characteristic. The present study aimed at selectively breeding rats exhibiting either a high or a low tendency to socialize by using the proximity test. We tested male and female Wistar rats in a square open field with a communicating birdcage, separated by a grid, containing a co-specific rat and coupled on the outside. Subjects that remained more time in front of the birdcage, interacting with the co-specific rat were bred in a group considered of high sociability (SOC+). Likewise, subjects that remained little time in front of the birdcage, with little interaction with the co-specific rat, were bred in a second group considered of low sociability (SOC-). By the 10th generation, the bidirectional selection resulted in SOC+ rats that spent a large amount of time in front of the cage sniffing and rearing in interaction with the co-specific rat and spent less time in the corners, exploring and grooming. It also resulted in SOC- rats that spent a small amount of time in front of the cage sniffing and rearing in interaction with the co-specific rat and spent more time in the corners and used most of their time grooming.

Comparison of female and male behavior in the elevated gradient of aversion

The elevated gradient of aversion (EGA) is an apparatus for investigating the exploratory behavior of rats in 3-min sessions, consisting of three different sections of the same size: tunnel, closed arm, and open arm. Factorial analyses have defined three factors: exploration, impulsivity, and self-protection. In general, male rats are placed in the tunnel end and tend to hesitate leaving this starting point. Then, they hesitate leaving the tunnel and entering the closed arm, which they explore and tend to avoid entering the open arm or even just stick their head in and not enter it at all. Since females were not used for this test and are reported to be more explorative than male rats, the present work aimed to compare the behavior of male and female rats in the EGA. Thirty male and 34 female Wistar rats were submitted to 3-min sessions in the EGA. In general, results indicated that females were different from males: they explored more (Factor 1 - Exploration), are more impulsive (Factor 2 - Impulsivity), and are less anxious/fearful (Factor 3 - Self-protection). These results confirmed the results of other studies obtained with other apparatuses and show that females exhibit higher locomotion than males and are less anxious/fearful.

Development and application of blood donor role identity scale (BDRIS) / 中国输血杂志

【Objective】 To further determine the relationship between blood donor role cognition and blood donation behavior, then prepare of blood donor role identity scale(BDRIS). 【Methods】 The preparation of the scale was divided into five stages. It includes literature retrieval, expert interview, construction of the basic framework of the scale, scale test and statistical index test. The study focused on items selection, dimensions identification, measurement reliability, content and structural validity. 【Results】 The blood donor role identity scale consisted of 35 items. Exploratory factor analysis divided the items into six common factors, including role identity, role expectation, current situation of blood collection and supply, role conflict, external reward and blood donation experience. The α of scale was 0.840. 【Conclusion】 The reliability and validity of the scale meet the basic measurement requirements, and the framework of the blood donor role scale is basically formed. It can be used as one of the means to explore the ways and mechanisms of the role identity of blood donors in blood donation behavior.

Construction of assessment index system on the capacity of clinical medical postgraduate tutor and analysis of its reliability and validity / 中华医学教育探索杂志

Objective:To establish an assessment index system on the capacity of clinical medical postgraduate tutor.Methods:On the basis of "literature optimization method", the index system was initially constructed by 14 experts with "Delphi method". Then, through the survey of 109 people, the reliability and validity were tested by Cronbach's α coefficient and exploratory factor analysis. And analytic hierarchy process was used to calculate the weight coefficient of each index. SPSS 26.0 and AMOS 26.0 were applied for statistical analysis. Results:The assessment index system consisted of 2 first-level indexes, 5 second-level indexes and 27 third-level indexes. The Cronbach's α coefficient of the total index system, first-level indexes and second-level indexes ranged from 0.833 to 0.931. Five common factors were extracted by exploratory factor analysis, and the connotation of factors were basically consistent with the theoretical structure. A confirmatory factor model was established with 5 second-level indexes as the first-order factors, what's more, the theoretical model fitted well with the actual data. The combined weight values of "teaching attitude of the tutor", "medical ethics of the tutor", "scientific research projects of the tutor", "dissertation quality of the graduate students", "the quality of the scientific research and training of the graduate students", "the quality of the clinical training of the graduate students", and "disposable scientific research funds of the tutor" ranked in the top 7 weights of third-level indexes. Conclusion:This assessment index system has good reliability and validity with reasonable connotation, which could be used as a reference for tutor evaluation.