Cross-cultural adaptation and translation into Brazilian Portuguese of the instruments Sick Control One Stone Fat Food Questionnaire (SCOFF), Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment Questionnaire (CIA)

Abstract Introduction Eating disorders (EDs) affect up to 13% of young people and are associated with significant morbidity and mortality. Nevertheless, important, internationally recognized instruments for brief ED screening (Sick Control One Stone Fat Food Questionnaire [SCOFF]), symptom severity assessment and diagnosis (Eating Disorder Examination Questionnaire [EDE-Q]) and assessment of ED-associated psychosocial impairment (Clinical Impairment Assessment Questionnaire [CIA]) were not yet available in Brazilian Portuguese. Our objective was to perform the cross-cultural adaptation and translation into Brazilian Portuguese of the instruments SCOFF, EDE-Q and CIA. Method The process involved a series of standardized steps, as well as discussions with experts. First, the relevance and adequacy of the scales' items to our culture and population were extensively discussed. Then, two independent groups translated the original documents, creating versions that were compared. With the participation of external ED experts (i.e., who did not take part in the translation process), synthesized versions were produced. The syntheses were then applied to a focal group of patients with ED (n = 8). After that step, a preliminary version of the three scales in Brazilian Portuguese was produced and sent for back-translation by two English native speakers, who worked independently. A synthesis of the back-translations, along with the preliminary versions in Brazilian Portuguese, were sent to the original authors. Results The Brazilian Portuguese versions of SCOFF, EDE-Q and CIA were approved by the original authors and are now available for use. Conclusion This study provides important tools for the ED research field in Brazil.

A Reliability and Validity Study of the Korean versions of the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) / 정신신체의학

OBJECTIVES: The Eating Disorder Examination Questionnaire, version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) measure attitudes and behavioral features of eating disorders and impairments secondary to eating disorders, respectively. The aims of this study were to examine the reliability and the validity of the Korean versions of the EDE-Q version 6.0 and the CIA. METHODS: Four hundred nineteen participants (370 female university students and 49 women with eating disorders) completed the EDE-Q version 6.0, the CIA, the Body Shape Questionnaire (BSQ) and the Weight Concern Scale (WCS). RESULTS: Excellent internal consistencies were obtained for the EDE-Q version 6.0 (Cronbach's α=0.92) and the CIA (Cronbach's α=0.91). Exploratory factor analysis of CIA extracted the 3 factors of personal, social, and cognitive impairments, as the original CIA had. The EDE-Q version 6.0 and the CIA were well correlated with the BSQ and the WCS, in respect to their contextually concordant variables. Patients with eating disorders had higher scores both in the EDE-Q 6.0 and the CIA than university women had, supporting good discriminant validity. CONCLUSIONS: The EDE-Q version 6.0 and the Korean versions of the CIA had adequate reliability and validity. These data will help clinicians and researchers to use the EDE-Q and the CIA in diagnosis, prevention and intervention of eating disorders in Korea.

Análisis de los criterios médico legales para la valoración del perjuicio estético en el rostro en la clínica médico forense: estudio de casos penales en el año 2011 / Analysis of legal medical criteria for the assessment of disfigurement on the face in forensic medical clinic: study of criminal cases in 2011

El presente trabajo busca responder a la necesidad de contar con un estudio actualizado sobre valoración del perjuicio estético en el rostro en el campo de la medicina legal en Costa Rica. Para este estudio se utilizó una población de 239 casos valorados por secuelas de lesiones en el rostro extraídos de los expedientes de la Sección de Clínica Médico Forense del Departamento de Medicina Legal en el año 2011. Se utilizaron variables sociodemográficas y variables utilizadas en la caracterización y valoración del perjuicio estético en el rostro. dentro de los resultados más relevantes del estudio se evidenció un predominio de casos del sexo masculino y en el grupo de edad de los 20 a 29 años, las lesiones encontradas, en la mayoría de los casos, fueron producidas con un objeto contundente. El tipo de perjuicio estético más encontrado fueron las cicatrices, en más de la mitad de los casos no se indicó si las cicatrices producían alteración de la armonía facial o si eran retráctiles y en una tercera parte tampoco se mencionaba si producían alteración de la mímica facial. La mayoría de las cicatrices se describieron como hipocrómicas y planas. En cuanto a la visibilidad más de la tercera parte de los casos presentaban lesiones descritas como visibles a distancia de conversación y un 20% se describieron como visibles a distancia social. Solamente la quinta parte de los casos valorados, se catalogaron como con marca indeleble. En cerca de un 70% de los casos no se estableció porcentaje de incapacidad permanente. El presente estudio refleja la importancia de la valoración del perjuicio estético en la actualidad así como la necesidad de contar con criterios estandarizados para realizar este tipo de valoraciones así como para determinar la presencia de marca indeleble en el rostro.

The present study aims to answer the need to have an up to date study related to facial aesthetic damage assessment in the field of legal medicine in Costa Rica. For this study it was used a population of 239 cases evaluated for facial injury sequels extracted from the files of the Clinical Forensic Medicine Section of the Legal Medicine Department in Costa Rica during the year 2011. Variables used include socio demographic and others used in characterization and evaluation of facial aesthetic damage. Among the most relevant results of this study it was evidenced a predominance of masculine cases and in the group of 20 to 29 years, the injuries, in the majority of cases, were produced by a blunt object. The most frequent type of aesthetic damage encountered were the scars, in more than half of the cases it was not indicated if the scars produced alteration of the facial harmony or if they were retractable and in a third of cases it was not mention if there was facial mimic alteration. The majority of the scars were described as hipocromic and flat. In regard to visibility, in more than a third of the cases the alterations were described as visible in conversation distance and 20% as visible in social distance. Only a fifth part of the cases were cataloged as indelible mark. In nearly a 70% of the cases no percentage of permanent impairment were established The present study reflects the importance of the evaluation of the aesthetic damage nowadays and also the need to have standardized criteria to perform this kind of assessment and to determine the presence of facial indelible mark.

Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice

BACKGROUND Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. OBJECTIVE Perform psychometric analysis of a functional impairment scale (FIE). METHODS A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. RESULTS Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. DISCUSSION Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups. .

Disfagia orofaríngea em pacientes com esclerose múltipla: as escalas de classificação da doença refletem a gravidade da disfagia? / Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity?

A esclerose múltipla é uma afecção neurológica que envolve distúrbios da deglutição. Muitos estudos têm mostrado associação entre o comprometimento neurológico e o desempenho da deglutição, porém, os resultados têm sido conflitantes. OBJETIVO: Identificar a frequência de disfagia nos pacientes com esclerose múltipla e os indicadores neurológicos que podem representar o desempenho da deglutição. MÉTODO: Neste estudo (estudo transversal), 120 pacientes com esclerose múltipla foram submetidos à avaliação funcional da deglutição por fibronasofaringolaringoscopia, cujos resultados foram comparados com a pontuação das escalas de classificação (Formas Clínicas Evolutivas da Doença, Escala de Incapacidade Funcional por Sistemas e Escala Ampliada de Incapacidade Funcional [Kurtzke Expanded Disability Status Scale]). RESULTADOS: A disfagia foi identificada em 90% dos pacientes. Dentre as formas clínicas, as formas progressivas (primária progressiva e secundária progressiva) apresentaram com maior frequência disfagia grave, enquanto a forma remitente-recorrente apresentou mais frequentemente disfagia leve e moderada. Em relação à Escala de Incapacidade Funcional por Sistemas, as funções cerebelares, do tronco encefálico e mental tiveram associação com a disfagia, especialmente na forma grave. Quanto à Escala Ampliada de Incapacidade Funcional, pontuações mais altas se associaram aos quadros graves de disfagia. CONCLUSÃO: A disfagia é frequente em pacientes com esclerose múltipla, especialmente naqueles com maior comprometimento das funções neurológicas.

Multiple sclerosis is a neurological disease that involves swallowing disorders. Many studies have shown an association between neurological and swallowing performance, but results have been conflicting. OBJECTIVE: To identify the frequency of dysphagia in patients with multiple sclerosis and neurological indicators that can represent the performance of swallowing. METHOD: In this study (cross-sectional) 120 Multiple Sclerosis patients underwent Functional Assessment of Swallowing by flexible nasal-pharyngo-laryngoscopy and the results were compared with the scores of the rating scales: (Clinical Evolving Forms of Disease, Functional Disability Scale for and Scale Systems Extended Functional Disability [Kurtzke Expanded Disability Status Scale]). RESULTS: Dysphagia was found in 90% of patients. Among the clinical forms of the disease, the progressive forms (primary progressive and secondary progressive) were more frequently associated with severe dysphagia, while the relapsing-remitting form presented more often mild and moderate dysphagia. Regarding the Disability Scale for Functional Systems, cerebellar function, brainstem function and mental health were associated with dysphagia, especially in the severe form. Regarding the Extended Functional Disability Scale, higher scores were associated with severe dysphagia. CONCLUSION: Dysphagia is common in MS patients, especially in those with greater impairment of neurological functions.