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Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.
Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.
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Aims: This study aimed to evaluate the intraoperative pain (IOP) occurrence in situations of symptomatic irreversible pulpitis (SIP) and symptomatic apical periodontitis (SAP). Materials and Methods: Patients who sought emergency care presenting a diagnosis of SIP or SAP were included. IOP was measured with a Visual Analogue Scale (VAS) after five minutes of local anesthesia, during access to the pulp chamber, root canal exploration and at the end of procedures. In cases where pain was reported during treatment, supplementary anesthesia was performed. Pain scores were recorded and analyzed using a generalized estimating equation model with posthoc comparisons. Results: 56 patients were included. 35 had a diagnosis of SIP; and 21 a diagnosis of SAP. Mean preoperative pain scores for SAP and SIP were 6.69 (±1.54) and 6.39 (±1.48), respectively (p>0.05). In patients with SIP, significant differences were observed between: preoperative scores and other time points; scores after five minutes of local anesthesia and other time points; scores during pulp chamber access and at the end of procedures; and scores during root canal exploration and at the end of procedures (p<0.05). In patients with SAP, significant differences were observed between preoperative pain scores with all other time points (p<0.05). Chi-square test indicated an association between diagnosis and the need for supplementary anesthesia (p<0.05). Conclusions: In conclusion, there is a strong relationship between reduction of moderate/severe pain after application of local anesthesia. The need for supplemental anesthesia is significantly associated to the diagnosis of symptomatic irreversible pulpitis.
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Objetivo: Relacionar las complicaciones y el riesgo de muerte en pacientes neurocríticos admitidos en la unidad de cuidados intensivos (UCI) del Hospital Universitario de Caracas durante un período de 5 meses. Métodos: investigación observacional, prospectiva, descriptiva. La muestra estuvo conformada por 65 pacientes neurocríticos, ≥ 18 años, con patologías médicas o quirúrgicas, ingresados en la UCI. El análisis estadístico incluyó la determinación de frecuencias, promedios, porcentajes y medias para descripción de variables y el T de Student. Resultados: La edad promedio fue 50,98 ± 16,66 años; la población masculinarepresentó el 50,76%. Entre las complicaciones, la mayor incidencia correspondió a las no infecciosas (70,77 %) y los trastornos ácido-básicos de tipo metabólico, la anemia y las alteraciones electrolíticas fueron las más frecuentes; el 29,23% de los pacientes presentaron complicaciones infecciosas, y la neumonía asociada a ventilación mecánica fue la más frecuente (73,91 %). La comorbilidad con mayor incidencia fue hipertensión arterial sistémica (53,84%). El 90.70% requirió ventilación mecánica y el tiempo en VM fue 4.29 ± 6.43 días. La estancia en UCI fue 5.96 ± 7.72 días. El 29,23% presentó un puntaje en la escala APACHE II entre 5-9; el SAPS II presentó mayor incidencia entre los 6-21 y 22-37 puntos con (66,70%); el SOFA al ingreso se reportó < 15 puntos en 98,46% y > 15 en 1,53%. La mortalidad del grupo fue 23,08 % (n=15). Conclusiones: Las complicaciones no infecciosas predominaron sobre las infecciosas las primeras íntimamente relacionadas con la mortalida(AU)
Objective: To relate complications and the risk of death in neurocritical patients admitted to the intensive care unit (ICU) of the University Hospital of Caracas during a period of 5 months. Methods: observational, prospective, descriptive research. The sample was made up of 65 neurocritical patients, ≥ 18 years old, with medical or surgical pathologies, admitted to the ICU.The statistical analysis included the determination of frequencies, averages, percentages and meansfor description of variables and Student's T.Results: The average age was 50.98 ± 16.66 years; the male population represented 50.76%. Among the complications, the highest incidence corresponded to non-infectious complications (70.77%) and metabolic acid-base disorders, anemia and electrolyte alterations were the most frequent; 29.23% of patients presented infectious complications, and pneumonia associated with mechanical ventilation was the most frequent (73.91%). The comorbidity with the highest incidence was systemic arterial hypertension (53.84%), 90.70% required mechanical ventilation and the time on MV was 4.29 ± 6.43 days. The ICU stay was 5.96 ± 7.72 days. 29.23% had a score on the APACHE II scale between 5-9; SAPS II presented the highest incidence between 6-21 and 22-37 points with (66.70%); The SOFA upon admission was reported to be < 15 points in 98.46% and > 15 in 1.53%. The mortality of the group was 23.08% (n=15). Conclusions: Non-infectious complications predominated over infectious complications, the former being closely related to mortalit(AU)
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Humains , Mâle , Femelle , Mortalité , Soins de réanimation , AnémieRésumé
Introducción: El envejecimiento de la población en todo el mundo es un fenómeno progresivo y Chile no se queda atrás frente a esto. Actualmente existe un subprograma de climaterio mujeres entre los 45 a 64 años, que presenta diversas acciones y propósitos. Objetivo: Describir la cobertura de la aplicación de la Menopause Rating Scale (MRS) e indicación de terapia de reemplazo hormonal en mujeres inscritas en los CESFAM de la comuna de Pedro Aguirre Cerda. Método: Descriptivo transversal. Resultados: La cobertura de aplicación de MRS en mujeres entre 45-64 años fue de un 62,6%. Un 34,3% de mujeres presentaron un puntaje MRS alterado, indicándose terapia hormonal en un 37,8% de los casos, en las indicaciones un 21,8% eran usuarias candidatas acorde a criterios médicos y un 78,2% no lo eran. Conclusiones: Se debe aumentar la cobertura de MRS y recursos para exámenes de laboratorio, de imágenes y capacitaciones, esto para mejorar la entrega de las prestaciones en el subprograma climaterio.
Introduction: The aging of the population worldwide is a progressive phenomenon and Chile is not lagging behind in this. Currently, there is a climacteric subprogram for women between 45 and 64 years of age, which has various actions and purposes. Objective: To describe the coverage of the application of the Menopause Rating Scale (MRS) and indication of hormone replacement therapy in women enrolled in the CESFAM of the commune of Pedro Aguirre Cerda. Method: Cross-sectional descriptive study. Results: The coverage of the MRS application in women between 45-64 years old was 62.6%. A 34.3% of women presented an altered MRS score, indicating hormone therapy in 37.8% of the cases, 21.8% of the indications were candidates according to medical criteria and 78.2% were not. Conclusions: There is a lack of labs and images tests in the climacteric controls, resulting in a mayor number of women no candidates to the hormonal therapy according to medical criteria.
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Introducción: La diabetes mellitus 2 es una enfermedad frecuente en adultos mayores, con múltiples complicaciones que pueden llegar a afectar el equilibrio y la marcha e incrementar el riesgo de caída. Objetivo: Determinar el riesgo de caídas en dos grupos de adultos mayores, uno con padecimiento de DM2 y otro sin este padecimiento. Metodología: Estudio de enfoque cuantitativo, alcance descriptivo, diseño observacional, y de cohorte transversal; muestra poblacional de 120 adultos mayores en la ciudad de Guayaquil divididos en dos grupos: grupo A con 60 adultos mayores que no padecían DM2 y grupo B con 60 adultos mayores con DM2; que cumplen con los criterios de inclusión y a quienes se evalúan mediante las técnicas: observación, evaluación y entrevista; y los instrumentos: Escala de Berg, Mini-BESTest y formulario estándar. Se utilizó la prueba estadística Chi cuadrado para la comparación de los resultados obtenidos. Resultados: Los resultados indican que, en la determinación del riesgo de caídas, se encontraron diferencias estadísticamente significativas (p0.05). El estudio además encontró que los resultados obtenidos, en las dos pruebas de riesgo de caídas, difieren entre sí. Conclusiones: Los adultos mayores diabéticos presentan un mayor riesgo de caída a comparación de adultos mayores no diabéticos.
Introduction: Diabetes mellitus 2 is a common disease in older adults, with multiple complications that can affect balance and gait and increase the risk of falling. Objective: To determine the risk of falls in two groups of older adults, one with and the other without DM2. Methodology: Quantitative approach study, descriptive scope, observational design, and cross-sectional cohort; population sample of 120 older adults in the city of Guayaquil divided into two groups: group A with 60 older adults who did not suffer from DM2 and group B with 60 older adults with DM2; who meet the inclusion criteria and who are evaluated by means of the techniques: observation, evaluation and interview; and the instruments: Berg scale, Mini-BESTestest and standard form. The Chi-square statistical test was used to compare the results obtained. Results: The results indicate that, in the determination of the risk of falls, statistically significant differences (p0.05) were found. The study further found that the results obtained, in the two fall risk tests, differed from each other. Conclusions: Diabetic older adults present a higher risk of falling compared to non-diabetic older adults.
Introdução: O diabetes mellitus tipo 2 é uma doença comum em idosos, com múltiplas complicações que podem afetar o equilíbrio e a marcha e aumentar o risco de quedas. Objetivo: Determinar o risco de quedas em dois grupos de idosos, um com DM2 e outro sem essa condição. Metodologia: Estudo com abordagem quantitativa, escopo descritivo, desenho observacional e coorte transversal; amostra populacional de 120 idosos da cidade de Guayaquil dividida em dois grupos: grupo A com 60 idosos que não sofriam de DM2 e grupo B com 60 idosos com DM2; que atendam aos critérios de inclusão e que sejam avaliados pelas técnicas: observação, avaliação e entrevista; e os instrumentos: Escala de Berg, Mini-BESTest e formulário padrão. O teste estatístico Qui-quadrado foi utilizado para comparação dos resultados obtidos. Resultados: Os resultados indicam que, na determinação do risco de quedas, foram encontradas diferenças estatisticamente significativas (p0,05). O estudo também constatou que os resultados obtidos nos dois testes de risco de queda diferem entre si. Conclusões: Idosos diabéticos apresentam maior risco de queda em comparação aos idosos não diabéticos.
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HumainsRésumé
La diabetes mellitus tipo 2 (DM2) es una amenaza para la salud por las complicaciones derivadas de un diagnóstico tardío, donde la identificación oportuna es primordial. Con el objetivo de establecer la relación entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score) como determinantes del riesgo de padecer DM2 a largo plazo, se realizó este estudio predictivo transversal con adultos de 18 y 60 años atendidos en el Centro de Salud Primero de Julio del municipio de Mixco, Guatemala. Participaron 80 adultos, seleccionados por un muestreo aleatorio simple. El instrumento de recolección de datos estuvo conformado por tres secciones: información general de la persona, parámetros antropométricos y la encuesta de FINDRISC. Se generaron modelos lineales generalizados para identificar relaciones entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score). El 36.2% presentó riesgo de desarrollar DM2 a largo plazo; encontrándose un 21.2% en el nivel de riesgo alto y muy alto. Se comprobó que únicamente existe relación significativa entre el ICT y el puntaje de la escala de FINDRISC como determinante del riesgo de padecer DM2 a largo plazo. Se concluye que la implementación de la medición del ICT constituye una herramienta útil para identificar personas con riesgo de desarrollar DM2, siendo su aplicación sencilla, no invasiva, económica y de fácil acceso en los servicios de salud.
Type 2 diabetes mellitus (T2DM) is a health threat due to the complications derived from a late diagnosis, where timely identification is essential. This study aimed to establish the relationship between waist-height index (WHR), waist-hip index (WHR) and the FINDRISC (Finnish Diabetes Risk Score)scale as determinants of the risk of suffering from T2DM in the long term. A cross-sectional predictive study was carried out with a simple random sample of 80 adults between 18 and 60 years old treated at the Primero de Julio Health Center in Mixco, Guatemala. The data collection instrument was structured into three sections: general information, anthropometric parameters and the FINDRISC survey. Generalized linear models were generated to identify relationships between waist-height ratio (WHR), waist-hip ratio (WHR) and the FINDRISC scale score (Finish Diabetes Risk Score). The results shows that 36.2% of the participants were at risk of developing T2DM in the long term; 21.2% being at the high and very high risk level. It was found that there is only a significant relationship between the WHR and the FINDRISC scale score as a determinant of the risk of suffering from T2DM in the long term. The implementation of the waist height index measurement constitutes a useful tool to identify people at risk of developing T2DM, its application being simple, non-invasive, economical and easily accessible in health services.
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Background@#The medical curriculum is one of the most stressful academic curricula worldwide. Studies indicate that great levels of stress, that encompass academics to personal life, may be connected to a number of worrying statistics for the mental health of Philippine medical students.@*Objectives@#To develop a validated stressor-coping style scale for students in a public medical school.@*Methods@#The study employed a sequential mixed-methods design. An open-ended questionnaire was used to determine the common stressors and coping styles through convenience sampling. A scale was constructed from this data and was statistically tested for concurrent validity and reliability from a random sample.@*Results@#Following thematic analysis, an initial six stressor domains and eleven coping mechanisms were identified. However, after item analysis and principal component analysis of responses, the scale was transformed to seven stressor domains and five coping mechanism domains. All of which are deemed internally consistent (α>0.6). Scores from the scale were also convergent with the scores of Brief COPE (r=0.5 to 0.9). @*Conclusions@#The developed stressor-coping style scale for medical students is a reliable and valid tool for Filipino medical students in a public medical school.
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Étudiant médecineRésumé
To develop a traditional Chinese medicine （TCM） diagnostic scale for type 2 diabetes mellitus with turbid-toxin accumulation syndrome and to validate the performance of the scale. A candidate pool was established through literature review and expert consultation， and a clinical case information collection form was developed accordingly. Patients with type 2 diabetes mellitus admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from July 2021 to January 2022 were investigated， and 312 valid clinical case information collection forms were obtained， which were randomly divided into 235 cases in the study group and 77 cases in the validation group. Four statistical methods， namely， differentiation analysis， Cronbach's coefficient， correlation coefficient， and stepwise regression， were used to screen out the candidate items， and Logistic regression analysis and factor analysis were used to assign weights to the items， and the final diagnostic model was determined by the receiver operating characteristic （ROC） curve， and the diagnostic thresholds were calculated for the Yoden index. The final TCM diagnostic scale for type 2 diabetes mellitus was composed of 8 items： turbid dirt coating （with a weight value of 23， the same below）， sticky stools （16）， fullness in the epigastrium and abdomen （12）， dark complexion （12）， irritability （11）， brown spots on the skin （11）， heaviness of head （10）， and chest stuffiness （5）， and the degree score was 0， 0.5， 1.0， and 1.5 points corresponding to no， mild， moderate and severe symptoms， respectively. The total score was the sum of the degree score multiplied by the weighted value of each item， and when the total score reached 33 points， it is diagnosed as the turbid-toxin accumulation syndrome. The established scale was tested and evaluated in the study group and the validation group， and the results showed that the sensitivity of the study group and the validation group was 89.38% and 89.47%， with the specificity of 95.90% and 89.74%， the Yoden index of 0.85 and 0.79， the positive predictive value of 95.28% and 89.47%， the negative predictive value of 90.70% and 89.74%， the diagnostic advantage ratios of 198.18 and 72.67， and the Kappa values of 0.86 and 0.79， which indicated that the TCM diagnostic scale for turbid-toxin accumulation syndrome of type 2 diabetes mellitus showed good diagnostic ability.
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Objectives To analyze the spatial and temporal aggregation of multidrug resistant pulmonary tuberculosis (MDR-TB) incidence in Nanning at the township / street scale from 2017 to 2021, to explore the spatial and temporal characteristics of the spread of MDR-TB in Nanning, and to provide a scientific reference basis for the health administrative departments to achieve the precise implementation of MDR-TB prevention and control. Methods Based on the data of MDR-TB cases in Nanning from 2017 to 2021, the spatial-temporal scanning analysis software SaTScan v9.7 was used to retrospectively detect and analyze the areas where MDR-TB cases gathered. Results Through simple spatial scanning analysis, it was found that there were three first-class aggregation areas (the aggregation center was Fujiayuan Street, Jiangnan District, 2017, Xinyang Street, Xixiangtang District, 2019, and Zhonghe Town, Yongning District, 2020), and one second-class aggregation area (the aggregation center was Jinchai Town, Mashan County, 2020). Simple time scanning showed that the clustering occurred from May 2019 to December 2020. Temporal and spatial aggregation analysis showed that Xinyang Street in Xixiangtang District was the center of the first-class aggregation area, Zhonghe Town in Yongning District was the center of the second-class aggregation area, and Jinchai Town in Mashan County was the center of the third-class aggregation area. Conclusion The multidrug resistant pulmonary tuberculosis epidemic in Nanning is distributed in an aggregated manner, especially in Xinyang Street, Xixiangtang District, which has the highest spatial and temporal aggregation. It is necessary to focus on and take regional prevention and control measures to control the epidemic.
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Abstract Background: End-stage renal diseases patients have a high risk of postoperative nausea and vomiting (PONV), which is multifactorial and need acute attention after renal transplantation for a successful outcome in term of an uneventful postoperative period. The study was done to compare the efficacy of palonosetron and ondansetron in preventing early and late-onset PONV in live donor renal transplantation recipients (LDRT). Methods: The prospective randomized double-blinded study was done on 112 consecutive patients planned for live donor renal transplantation. Patients of both sexes in the age group of 18-60 years were randomly divided into two groups: Group O (Ondansetron) and Group P (Palonosetron) with 56 patients in each group by computer-generated randomization. The study drug was administered intravenously (IV) slowly over 30 seconds, one hour before extubation. Postoperatively, the patients were accessed for PONV at 6, 24, and 72 hours using the Visual Analogue Scale (VAS) nausea score and PONV intensity scale. Results: The incidence of PONV in the study was found to be 30.35%. There was significant difference in incidence of PONV between Group P and Group O at 6 hours (12.5% vs. 32.1%, p = 0.013) and 72 hours (1.8% vs. 33.9%, p < 0.001), but insignificant difference at 24 hours (1.8% vs. 10.7%, p = 0.113). VAS-nausea score was significantly lower in Group P as compared to Group O at a time point of 24 hours (45.54 ± 12.64 vs. 51.96 ± 14.70, p = 0.015) and 72 hours (39.11 ± 10.32 vs. 45.7 ± 15.12, p = 0.015). Conclusion: Palonosetron is clinically superior to ondansetron in preventing early and delayed onset postoperative nausea and vomiting in live-related renal transplant recipients.
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Abstract Background: The present study explored the role of continuous erector spinae plane (ESP) block for analgesia as well as its impact on pulmonary functions in patients with multiple rib fractures. Methods: Ten patients with multiple rib fractures were enrolled after getting informed and written consent. Ultrasound-guided ESP block was performed at the level midway between the fractured ribs followed by the insertion of the catheter. Pre- and post-block VAS score, hemodynamics, respiratory rate (RR), peripheral oxygen saturation (SpO2), inspiratory capacity (IC), blood gases (PaO2 and PCO2), and complications were compared. Results: Pain scores at rest as well as on movement showed a significant reduction from 5.9 and 7.5 pre block to 1.6 and 2.5 respectively at 96 hours (p < 0.0001). Similarly, RR, SpO2, IC, and PaO2 were significantly better after the block placement (p < 0.001). Conclusion: Continuous ESP block provide adequate analgesia with better respiratory functions in patients with multiple rib fractures.
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Abstract Objectives To analyze the clinical utility of a clinical risk scale to predict the need for advanced airway management in patients with deep neck abscess. Methods Observational, analytical, cross-sectional study. Patients over 18 years old, both genders, with surgical management of a deep neck abscess, between January 1st, 2015 to December 31th, 2021, who were applied the clinical risk scale (https://7-414-5-19.shinyapps.io/ClinicalRiskScore/). The sensitivity, specificity, and predictive values of the scale were calculated based on the identified clinical outcomes. A p < 0.05 was considered significant. Results A sample of 213 patients was obtained, 121 (56.8%) men, of whom 50 (23.5%) required advanced airway management. Dyspnea was the variable with the most statistical weight in our study, (p = 0.001) as well as the multiple spaces involvement, (p = 0.001) the presence of air corpuscles, (p = 0.001) compromise of the retropharyngeal space (p = 0.001) and age greater than 55 years (p = 0.001). Taking these data into account, were found for the clinical risk scale a sensitivity of 97% and a specificity of 65% (p = 0.001, 95% CI 0.856-0.984). Conclusions The clinical risk scale developed to predict advanced airway management in patients with a diagnosis of deep neck abscess may be applicable in our environment with high sensitivity and specificity. Level of evidence: IV.
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Abstract Introduction Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. Objectives To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. Methods This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. Results The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. Conclusion The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.
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RESUMO Nas competições de fisiculturismo são analisados a proporção, a definição, a simetria e o volume muscular, o que faz da incansável busca pelo corpo perfeito pelos atletas, uma insatisfação com a imagem corporal. Por isso, este trabalho objetivou-se em elaborar e validar uma escala de silhuetas específica para atletas de fisiculturismo feminino e masculino (Escala Shape), que aconteceu em três fases. 1) Elaboração de onze desenhos de imagem corporal que representassem as categorias de competição; 2) Concordância (teste de Kappa) entre especialistas/profissionais de fisiculturismo nacionais e internacionais na ordenação dos desenhos em ordem crescente e progressiva de muscularidade; 3) Aplicação e validação da Escala Shape em atletas amadores e profissionais ativos e filiados à Federações Nacionais e Internacionais de Fisiculturismo em ambos os sexos. Participaram da pesquisa 180 atletas (50 mulheres e130 homens). A escala apresentou adequada confiabilidade de estabilidade temporal (Kappa teste-reteste≥0,95). O instrumento apresentou validade de critério ao mostrar que atletas de categorias de competição distintas escolheram silhuetas compatíveis com suas categorias (p<0,001). Conclusão: a Escala Shape feminina e masculina apresentou evidências de confiabilidade e validade para a amostra, podendo ser utilizada para avaliar a satisfação com a imagem corporal de fisiculturistas de diferentes categorias.
ABSTRACT In bodybuilding competitions, proportion, definition, symmetry and muscle volume are analyzed, which makes the tireless search for the perfect body by athletes, a dissatisfaction with body image. Therefore, this work aimed to develop and validate a specific silhouette scale for female and male bodybuilding athletes (Shape Scale), which took place in three phases. 1) Elaboration of eleven body image drawings that represented the competition categories; 2) Agreement (Kappa test) between national and international bodybuilding specialists/professionals in ordering the drawings in ascending and progressive order of muscularity; 3) Application and validation of the Shape Scale in active amateur and professional athletes affiliated to National and International Bodybuilding Federations in both sexes. 180 athletes (50 women and 130 men) participated in the research. The scale showed adequate temporal stability reliability (Kappa test-retest≥0.95). The instrument showed criterion validity by showing that athletes from different competition categories chose silhouettes compatible with their categories (p<0.001). Conclusion: the female and male Shape Scale showed evidence of reliability and validity for the sample, and can be used to assess satisfaction with the body image of bodybuilders from different categories.
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Abstract Background Skepticism has traditionally been associated with critical thinking. However, philosophy has proposed a particular type of skepticism, termed naive skepticism, which may increase susceptibility to misinformation, especially when contrasting information from official sources. While some scales propose to measure skepticism, they are scarce and only measure specific topics; thus, new instruments are needed to assess this construct. Objective This study aimed to develop a scale to measure naive skepticism in the adult population. Method The study involved 446 individuals from the adult population. Subjects were randomly selected for either the pilot study (phase 2; n = 126) or the validity-testing study (phase 3; n = 320). Parallel analyses and exploratory structural equation modelling were conducted to assess the internal structure of the test. Scale reliability was estimated using Cronbach's alpha and McDonald's omega coefficients Finally, a multigroup confirmatory factor analysis was performed to assess invariance, and a Set- Exploratory Structural Equation Modeling was applied to estimate evidence of validity based on associations with other variables. Results The naive skepticism scale provided adequate levels of reliability (ω > 0.8), evidence of validity based on the internal structure of the test (CFI = 0.966; TLI = 0.951; RMSEA = 0.079), gender invariance, and a moderate inverse effect on attitudes towards COVID-19 vaccines. Conclusions The newly developed naive skepticism scale showed acceptable psychometric properties in an adult population, thus enabling the assessment of naive skepticism in similar demographics. This paper discusses the implications for the theoretical construct and possible limitations of the scale.
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ABSTRACT Introduction: measuring the severity of traumatic injuries is crucial for predicting clinical outcomes. Whereas the Injury Severity Score (ISS) has limitations in assigning scores to injuries at the same site, the New Injury Severity Score (NISS) corrects for this problem by taking into account the three most severe injuries regardless of the region of the body. This study seeks to comprehend the clinical and epidemiological profile of trauma patients while comparing the effectiveness of scales for predicting mortality. Methods: a descriptive, observational and retrospective study using records of patients who underwent thoracotomy at the Hospital das Clínicas of the Federal University of Triângulo Mineiro between 2000 and 2019. Demographic data, mechanisms of injury, affected organs, length of stay and mortality were analyzed. Injury severity was assessed using the ISS and NISS, and statistical analyses were conducted using MedCalc and SigmaPlot. Results: 101 patients were assessed, on average 29.6 years old, 86.13% of whom were men. The average duration of hospitalization was 10.9 days and the mortality rate was 28.7%. The ROC curve analysis revealed a sensitivity of 68.97%, specificity of 80.56% and area under the curve of 0.837 for the ISS, and 58.62%, 94.44% and 0.855 for the NISS, respectively. The Youden index was 0.49 for the ISS and 0.53 for the NISS. Conclusion: the study demonstrated comparable efficacy of NISS and ISS in predicting mortality. These findings hold significance in the hospital setting. Professionals must be familiar with these scales to utilize them competently for each patient.
RESUMO Introdução: a medição da gravidade das lesões traumáticas é essencial para prever os desfechos clínicos. Enquanto o Injury Severity Score (ISS) tem limitações ao atribuir pontuações às lesões no mesmo local, o New Injury Severity Score (NISS) corrige esse problema ao considerar as três lesões mais graves independentemente da região corporal. Este estudo visa entender o perfil clínico-epidemiológico dos pacientes traumatizados, comparando a eficácia das escalas para prever mortalidade. Métodos: estudo descritivo, observacional e retrospectivo utilizando registros de pacientes submetidos à toracotomia no Hospital das Clínicas da Universidade Federal do Triângulo Mineiro entre 2000 e 2019. Dados demográficos, mecanismos de lesão, órgãos afetados, tempo de internação e mortalidade foram analisados. A gravidade das lesões foi avaliada usando o ISS e NISS, e as análises estatísticas foram conduzidas no MedCalc e SigmaPlot. Resultados: Foram avaliados 101 pacientes, em média com 29,6 anos, sendo 86,13% homens. A média da internação foi de 10,9 dias e a taxa de mortalidade foi de 28,7%. A análise da curva ROC revelou uma sensibilidade de 68,97%, especificidade de 80,56% e área sob a curva de 0,837 para o ISS, e 58,62%, 94,44% e 0,855 para o NISS, respectivamente. O índice de Youden indicou 0,49 para o ISS e 0,53 para o NISS. Conclusão: o estudo demonstrou semelhante eficácia entre o NISS e o ISS na previsão de mortalidade. Esses resultados geram implicações importantes na aplicação dessas escalas no ambiente hospitalar. É essencial que os profissionais conheçam tais escalas para aplica-las adequadamente no contexto de cada paciente.
Résumé
ABSTRACT BACKGROUND AND OBJECTIVES: Lumbar disorders, which contribute to significant workplace absenteeism and chronic disability, are associated with a considerable financial and social burden. Although a conservative approach provides satisfactory pain relief, biomechanical improvement and is associated with a low risk of adverse effects, there is lack of consensus in the literature regarding the best therapeutic strategy in such cases. METHODS: This retrospective longitudinal study used secondary data from the institutional medical records of patients who completed a multidisciplinary program for the treatment of low back pain between 2019 and 2021. Data regarding pain levels and motor skills were obtained from patients who completed the care program at a private hospital in Bento Gonçalves, RS. The following step-wise treatment algorithm was used: evaluation by a specialist physician for the etiological diagnosis of pain, pharmacological management and dry needling, followed by standard rehabilitation intervention performed by the physiotherapy team and exercises by the physical education team. The visual analogue scale (VAS) was used to measure pain at the start and at the completion of the intervention, and the Oswestry Disability Index (ODI) was used to measure motor skills at the start and at 6 and 12 months following the multiprofessional intervention for rehabilitation. RESULTS: A reduction in pain and motor disability in patients who completed all stages of the treatment program was observed. Pain by the VAS presented the following scores: baseline 7 [5-8] and after treatment 2 [0-4]; and the scores of the ODI were: at baseline 0.34 [0.26 - 0.40], at 6 months 0.16 [0.08 - 0.26] and after treatment 0.12 [0.04 - 0.21]. CONCLUSION: The treatment program reduced the pain and disability associated with low back pain and can serve as the basis for further studies carried out to confirm the effectiveness of this intervention.
RESUMO JUSTIFICATIVA E OBJETIVOS: As doenças lombares, que contribuem para um absenteísmo significativo no local de trabalho e para a incapacidade crônica, estão associadas a um encargo financeiro e social considerável. Embora a abordagem conservadora proporcione alívio satisfatório da dor, melhore a biomecânica e esteja associada a baixo risco de efeitos adversos, não há consenso na literatura sobre a melhor estratégia terapêutica nesses casos. MÉTODOS: Neste estudo longitudinal retrospectivo, foram utilizados dados secundários dos prontuários médicos institucionais de pacientes que completaram um programa multidisciplinar para tratamento de dor lombar entre 2019 e 2021. Dados sobre níveis de dor e habilidades motoras foram obtidos de pacientes que completaram o programa assistencial de um hospital privado de Bento Gonçalves, RS. Foi utilizado o seguinte tratamento passo a passo: avaliação por médico especialista para diagnóstico etiológico da dor, manejo farmacológico e agulhamento a seco, seguido de intervenção de reabilitação padrão realizada pela equipe de fisioterapia e exercícios pela equipe de educação física. A escala analógica visual (EAV) foi utilizada para medir a dor no início e após a conclusão da intervenção, e o Índice de Incapacidade de Oswestry (ODI) foi usado para medir as habilidades motoras no início e aos 6 e 12 meses após a intervenção multiprofissional para reabilitação. RESULTADOS: Observou-se redução na dor e na incapacidade motora em pacientes que completaram todas as etapas do programa de tratamento. A intensidade da dor medida pela EAV apresentou as seguintes pontuações: basal 7 [5-8] e após tratamento 2 [0-4]; enquanto o ODI apresentou as pontuações: basal 0,34 [0,26 - 0,40], até 6 meses 0,16 [0,08 - 0,26] e após o tratamento 0,12 [0,04 - 0,21]. CONCLUSÃO: O programa de tratamento reduziu a dor e a incapacidade associadas à dor lombar e pode servir de base para novos estudos realizados para confirmar a eficácia desta intervenção.
Résumé
ABSTRACT Objective: To evaluate the focus of pediatricians' gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians' pain perception: absent/mild (score: 0-5) and moderate/intense (score: 6-10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5-8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.
RESUMO Objetivo: Avaliar o foco do olhar do pediatra durante a punção do calcanhar de neonatos. Métodos: Estudo prospectivo no qual pediatras, utilizando óculos de rastreamento visual, avaliaram a dor neonatal antes/depois de uma punção de calcanhar. Os pediatras pontuaram a dor de acordo com a sua percepção por meio de uma escala analógica verbal (0=sem dor; 10=dor máxima). Os desfechos analisados foram o número e o tempo das fixações visuais na face superior, face inferior e mãos, em dois períodos de 10 segundos, antes (PRÉ) e depois da punção (PÓS). Os resultados foram comparados entre os períodos e segundo a percepção da dor do pediatra: ausente/leve (escore: 0-5) e moderada/grave (escore: 6-10). Resultados: Vinte e quatro pediatras (31 anos, 92% sexo feminino) avaliaram 24 neonatos. A mediana do escore atribuído à dor do recém-nascido durante a punção do calcanhar foi 7,0 (intervalo interquartil: 5-8). Comparado ao período PRÉ, no período PÓS, o maior número de pediatras fixou o olhar na face inferior (63 vs. 92%; p=0,036) e o número de fixações visuais foi maior na face inferior (2,0 vs. 5,0; p=0,018). Não houve diferença no número e no tempo das fixações visuais de acordo com a intensidade da dor. Conclusões: À beira do leito, os pediatras mudam seu foco de atenção visual na face do recém-nascido após um procedimento doloroso, focando o olhar principalmente na parte inferior da face.
Résumé
O mieloma múltiplo é uma neoplasia maligna caracterizada pela proliferação clonal de plasmócitos na medula óssea. O objetivo deste trabalho foi avaliar as possíveis associações entre o estado nutricional, força muscular e capacidade funcional de pacientes ambulatoriais portadores de mieloma múltiplo. Trata-se de estudo transversal realizado em amostra não probabilística de pacientes com mieloma múltiplo atendidos no Hospital das Clínicas, em Goiânia. Os dados foram coletados entre agosto e dezembro de 2015, utilizando-se de entrevistas e informações dos prontuários. O estado nutricional foi avaliado aplicando-se a Avaliação Subjetiva Global Produzida pelo Próprio Paciente; a força muscular medida por meio da Força do Aperto de Mão e a capacidade funcional, pela Escala de Performance de Karnofsky. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do referido hospital. Foram avaliados 52 pacientes, em que 48,1% estavam desnutridos, 30,8% apresentavam baixa força muscular e 73,1%, comprometimento da capacidade funcional. A força muscular e a capacidade funcional foram menores nos desnutridos. Observou-se que aqueles que utilizavam corticoides apresentaram 18% menos chance de se tornarem desnutridos (OR=0,18; IC=0,05-0,62; p=0,011) porém, é importante considerar as possíveis causas de viés; por outro lado, os pacientes com baixa força muscular ou faziam quimioterapia apresentaram, aproximadamente, quatro vezes mais chances de desnutrição, respectivamente (OR=3,46; IC=0,99-12,08; p=0,047) (OR=3,64; IC=1,13-11,69; p=0,027). Concluiu-se que a desnutrição é comum nos pacientes portadores de mieloma múltiplo, indicando a necessidade premente de intervenção nutricional apropriada e precoce.
Multiple myeloma is a malignant neoplasm characterized by the clonal proliferation of plasma cells in the bone marrow. The objective of this study was to evaluate possible associations between nutritional status, muscle strength and functional capacity of outpatients with multiple myeloma. This is a cross-sectional study carried out on a non-probabilistic sample of patients with multiple myeloma treated at Hospital das Clínicas, in Goiânia. Data were collected between August and December 2015, using interviews and information from medical records. Nutritional status was assessed using the Patient Generated Subjective Global Assessment; muscular strength measured using Hand Grip Strength and functional capacity, using the Karnofsky Performance Scale. The study was approved by the Ethics and Research Committee of that hospital. 52 patients were evaluated, of which 48.1% were malnourished, 30.8% had low muscle strength and 73.1% had impaired functional capacity. Muscle strength and functional capacity were lower in malnourished individuals. It was observed that those who used corticosteroids were 18% less likely to become malnourished (OR=0.18; CI=0.05-0.62; p=0.011), however, it is important to consider the possible causes of bias; on the other hand, patients with low muscle strength or undergoing chemotherapy were approximately four times more likely to be malnourished, respectively (OR=3.46; CI=0.99-12.08; p=0.047) (OR=3.64; CI=1.13-11.69; p=0.027). It was concluded that malnutrition is common in patients with multiple myeloma, indicating the pressing need for appropriate and early nutritional intervention.
Résumé
ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.
RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.