Serum Occludin and Zonulin Levels in Children With Attention-Deficit/Hyperactivity Disorder and Healthy Controls

Objective: To evaluate zonulin and occludin levels, potentially associated with immunological pathways in the gut-brain axis, in children with attention-deficit/hyperactivity disorder (ADHD). Method: We examined the association between serum levels of zonulin and occluding, and behavioral/emotional problems in children with ADHD. 40 medicationnaïve children meeting Diagnostic and statistical (DSM-5) criteria for ADHD (11 females; mean (SD) age 9.4 (1.6) years) and 39 healthy comparisons (12 females; mean (SD) age 9.3 (1.9) years) were studied. Serum zonulin and occludin levels were measured by (ELISA). Result: We found higher mean (SD) serum zonulin levels [37.1 (28.2) vs 8.1 (4.5) ng/mL; P<0.001) and occludin levels [2.4 (1.6) vs 0.6 (0.4) ng/mL; P<0.001] in the ADHD group compared to control group. Serum zonulin levels had a positive correlation with weight (r=0.452; P=0.003) and BMI (r=0.401; P=0.01) among children with ADHD. Serum zonulin and occludin levels also had a positive correlation with Conners parent rating scale scores (r=0.58; P<0.001), and Strengths and difficulties questionnaire scores (r=0.49; P<0.001). Multiple linear regression analysis revealed that age, sex, weight, conduct problems and oppositional sub-scores were significant predictors of increased serum zonulin levels. Conclusion: These data confirm an association between ADHD, and serum zonulin and occludin levels. Pathophysiological and clinical significance of these findings needs to be elucidated.

Item analysis of the Teacher's Gifted Rating Screening Scale / Análise dos itens da Triagem de Indicadores de Altas Habilidades / Superdotação

Objective: The present study aimed to add new evidence of construct validity of the Teacher's Rating Giftedness Screening Scale. The analysis of its items, in relation to the adjustment indices to the Graduated Response Model, as well as to interpret the sense of the scales formed by the items. Method: The sample was composed of 666 students (64.7% males). The instrument consisted of 42 items that assess five areas (general intellectual abilities, leadership, creativity, specific academic abilities, and artistic talent), being answered by 224 teachers. Results: The results indicated that all items had infit/outfit adjustment indexes within the expected value, between 0.5 and 1.5. The factor accuracy, estimated by the graduated response model, varied between 0.74 to 0.85. Conclusion: The results allowed the elaboration of an interpretation proposal referenced in the item, as well as the identification of the most effective items in discriminating individuals with above average ability level.

Objetivo: O presente estudo visou ampliar as evidências de validade de construto do instrumento Triagem de Indicadores de Altas Habilidades/Superdotação, por meio da análise dos seus itens, em relação aos índices de ajuste ao Modelo de Resposta Graduada, bem como interpretar o sentido das escalas formadas pelos itens. Método: A amostra foi composta por 666 estudantes (64,7% meninos). O instrumento, composto por 42 itens que avaliam cinco dimensões (capacidade intelectual geral, liderança, criatividade, habilidades acadêmicas especificas e talento artístico), foi respondido por 224 professores. Resultados: Os resultados indicaram que todos os itens apresentaram índices de ajuste infit/outfit dentro do valor esperado, entre 0,5 e 1,5. A precisão dos fatores, estimada pelo modelo de resposta graduada, variou entre 0,74 e 0,85. Conclusão: Os resultados permitiram a elaboração de uma proposta de interpretação referenciada no item, bem como a identificação dos itens que se mostram mais eficazes em discriminar indivíduos com habilidade acima da média.

Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children / Consistência interna do Questionário de Capacidades e Dificuldades em crianças amazônicas

ABSTRACT OBJECTIVE: To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. METHODS: Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. RESULTS: According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). CONCLUSIONS: Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.

RESUMO OBJETIVO: Descrever a frequência de problemas de comportamento e a consistência interna da versão para os pais do Questionário de Capacidades e Dificuldades (SDQ-P) em crianças pré-escolares da Amazônia durante a pandemia de covid-19. MÉTODOS: Foram utilizados dados do estudo de saúde e nutrição Materno-Infantil no Acre (MINA-Brasil), uma coorte de nascimentos de base populacional na Amazônia Ocidental Brasileira. O SDQ-P foi aplicado aos pais e cuidadores em 2021 na visita de acompanhamento de cinco anos de 695 crianças (49,4% das quais eram meninas). Esse instrumento é um breve questionário de rastreamento comportamental composto por 25 itens reorganizados em cinco subescalas: sintomas emocionais, problemas de conduta, hiperatividade/desatenção, problemas de relacionamento com colegas e comportamento pró-social. Os casos de problemas de comportamento foram definidos de acordo com os pontos de corte originais do SDQ, baseados nas normas do Reino Unido. Além disso, os pontos de corte foram estimados com base nos percentis dos resultados do SDQ-P da amostra do nosso estudo. A consistência interna foi avaliada pelo cálculo do coeficiente alfa de Cronbach e ômega de McDonald para cada escala. RESULTADOS: De acordo com os pontos de corte baseados na distribuição da população estudada, 10% de todas as crianças apresentaram escores totais de dificuldade elevados ou muito elevados, o que quase dobrou quando os pontos de corte originais do SDQ, baseados nas normas do Reino Unido, foram utilizados (18%). Este estudo também encontrou diferenças nas demais escalas. Comparados às meninas, os meninos apresentaram maiores médias de problemas de externalização e menores médias de comportamento pró-social. O modelo de cinco fatores apresentou consistência interna dos itens moderada para todas as escalas (0,60 ≤ α ≤ 0,40), exceto para a escala de pontuação total de dificuldades, a qual foi considerada substancial (α > 0,61). CONCLUSÕES: Nossos resultados apoiam a utilidade do SDQ em nossa população de estudo e reforçam a necessidade de estratégias e desenvolvimento de políticas para o cuidado em saúde mental no início da vida na Amazônia.

Electroacupuncture for acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of electroacupuncture (EA) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction.@*METHODS@#A total of 100 patients with AECOPD complicated with gastrointestinal dysfunction were randomly divided into an EA group (50 cases, 2 cases dropped off, 1 case excluded) and a medication group (50 cases). Both groups were treated with symptomatic and supportive treatment such as low flow oxygen, nebulized inhalation of short-acting β2 agonist (SABA) or short-acting muscarinic antagonist (SAMA) combined with inhaled corticosteroid (ICS). The EA group was treated with EA at Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Shuifen (CV 9), Tianshu (ST 25), Chize (LU 5) and Lieque (LU 7), with discontinuous wave, 2 Hz in frequency, 30 min each time, once a day. In the medication group, oral mosapride citrate tablets were given, 3 times a day, 5 mg each time. Both groups were treated for 5 d. Before and after treatment, the gastrointestinal symptom rating scale (GSRS) score was observe, serum procalcitonin (PCT), C-reactive protein (CRP), and plasma oxygenation index (PaO2/FiO2) were detected, and patient satisfaction degree was evaluated in the two groups.@*RESULTS@#Compared with before treatment, except for diarrhea dimension in the medication group, the total scores and each dimension scores of GSRS were decreased (P<0.05), serum PCT and CRP were decreased (P<0.05), plasma PaO2/FiO2 was increased (P<0.05) in the two groups after treatment. After treatment, in the EA group, the total score and abdominal pain, dyspepsia, constipation and diarrhea scores of GSRS were lower than those in the medication group (P<0.05), meanwhile serum PCT and CRP were lower and plasma PaO2/FiO2 was higher than those in the medication group (P<0.05). The improvement of gastrointestinal symptoms, life quality and overall satisfaction degree in the EA group were superior to those in the medication group (P<0.05).@*CONCLUSION@#EA could improve the symptoms of patients with AECOPD complicated with gastrointestinal dysfunction, reduce inflammatory response, improve oxygenation and patient satisfaction degree.

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

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

Research progress in evaluating severity and prognosis of children with community acquired pneumonia by scales and biomarkers / 中国小儿急救医学

Community acquired pneumonia(CAP)has a high morbidity and mortality rate, and can bring a heavy social and economic burden.Its etiology is complex.How to identify high-risk children, early diagnosis, prognosis prediction are the focus of clinical research.Early identification and active intervention of high-risk children who need hospitalization or admission to pediatric intensive care unit by using score scales and biomarkers are crucial to improve the survival rate.This review summarized the assessment of severity and prognosis of CAP in children by different score scales and biomarkers.

Governor vessel moxibustion combined with western medication for mild to moderate depression with kidney-yang deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the therapeutic efficacy of governor vessel moxibustion combined with fluoxetine hydrochloride capsule, simple fluoxetine hydrochloride capsule and placebo moxibustion combined with fluoxetine hydrochloride capsule for mild to moderate depression with kidney-yang deficiency.@*METHODS@#A total of 126 patients with mild to moderate depression with kidney-yang deficiency were randomized into a governor vessel moxibustion group (42 cases, 2 cases dropped off), a western medication group (42 cases, 1 case dropped off) and a placebo moxibustion group (42 cases, 1 case dropped off). The western medication group was given fluoxetine hydrochloride capsule orally, 20 mg a time, once a day. On the basis of the treatment in the western medication group, governor vessel moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) in the governor vessel moxibustion group, once a week; placebo moxibustion was applied in the placebo moxibustion group, once a week. Treatment of 8 weeks was required in the 3 groups. Before and after treatment, the scores of Hamilton depression scale-17 (HAMD-17), Asberg's rating scale for side effects (SERS) and TCM clinical symptom were compared, and the clinical efficacy was evaluated.@*RESULTS@#After treatment, the scores of HAMD-17, SERS and TCM clinical symptom were decreased compared before treatment in the 3 groups (P<0.05), the decrease ranges of above scores in the governor vessel moxibustion group were larger than those in the western medication group and the placebo moxibustion group (P<0.05). The total effective rate was 92.5% (37/40) in the governor vessel moxibustion group, which was higher than 75.6% (31/41) in the western medication group and 80.5% (33/41) in the placebo moxibustion group (P<0.05).@*CONCLUSION@#Governor vessel moxibustion combined with fluoxetine hydrochloride capsule can improve the degree of depression and relieve the clinical symptoms in mild to moderate depression patients with kidney-yang deficiency, the efficacy is superior to simple fluoxetine hydrochloride capsule, and can reduce the fluoxetine hydrochloride capsule-induced adverse effect to a certain extent.

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

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

A cross-sectional study on the prevalence and severity of suicidal ideations and behaviors of senior high school students using the Columbia-Suicide Severity Rating Scale (C-SSRS)

Objectives@#In the light of increased suicide risk among adolescents, this research aimed at determining the prevalence and severity of suicidal ideations and behaviors of senior high school students in a public secondary school in Metro Manila using the Columbia-Suicide Severity Rating Scale (C-SSRS).@*Methodology@#This is a descriptive cross-sectional school-based study, conducted on 236 senior high school students, 18 years old and above, in San Juan National High School (SJNHS) in San Juan, Metro Manila. The study employed convenience sampling. Upon selection, the C-SSRS was administered. Data on four constructs of suicide were gathered: 1) suicidal ideation severity; 2) intensity, which was quantified in terms of frequency, duration, control, deterrents and reasons for suicidal ideation; 3) suicidal behavior rated on a nominal subscale as actual, aborted, interrupted, preparatory behavior and non-suicidal injurious behavior; and lastly 4) lethality of actual suicide attempts on a 6-point ordinal scale, and if actual lethality was zero, potential lethality was further rated on a 3-point ordinal scale.@*Results@#The majority (67.8%) had mild suicidal ideations; 37.71% had active suicidal ideations with intent but not necessarily a specific plan and only 13.98% had active suicidal ideation with intent to act and a specific plan. The intensity of suicidal ideation was not that frequent in 35.59% of the respondents i.e.18.64% 1x/ week and 16.95% less than 1x/ week. About a third (30.07%) had very short duration of suicidal ideations i.e. fleetingly (19.92%) or less than an hour/ day (11.02%). A third (32.62%) were able to easily control (18.64%) or control with minimal difficulty (13.98%). Reason for suicidal ideation were either to get attention (10.59%) or to end the emotional pain (11.02%). A third (30.93%) had actual attempts (15.25%) and Non -Suicidal Self Injury (NSSI) (15.68%); while another 35.06 % had interrupted (16.53%) or aborted (19.07%) attempts. Those who had actual attempts, 41.67% had no physical injury while 50 % incurred minor injuries. Thirty- two (88.89%) had suicidal attempt that was likely to result in injury but not likely to cause death.@*Conclusion@#In light of these relatively high prevalence rates for suicidal ideation and behaviors, schoolwide intervention on education or awareness programs, gatekeeper training, peer leadership, skills training and screening or assessment may have to be instituted to curb the increased suicide risk of the senior high school students and further prevent suicide attempts.

Pattern of analgesic use for post-operative pain relief among adult surgical patients in a tertiary care hospital

Background: Post-operative pain is an acute pain which if not adequately managed may lead to morbidity and complications. It can be controlled effectively by analgesics. It is essential to choose an analgesic with good efficacy and safety profile to avoid drug-related complications. Aims and Objectives: This study aims (i) to study the pattern of analgesic use for postoperative pain; (ii) to study the efficacy of the analgesic prescribed for post-operative pain; and (iii) to study the safety of the analgesics used for post-operative pain. Materials and Methods: A prospective observational study was conducted for 3 months period. The pattern of analgesic use for post-operative pain was studied in 110 patients. The influence of sociodemographic factors, surgery related factors on pain assessment score, and patient satisfaction score was assessed. The safety profile of analgesics used was studied. Results: Post-operative was seen equally in both the genders and mean age of patients was 41 years. Diclofenac was the most common analgesic prescribed and intramuscular route was most commonly used. About 64% of patients were satisfied with their treatment and 94.55% of patients did not encounter any adverse effects. However, there was no association between various factors and pain assessment score and patient satisfaction score. Conclusion: Post-operative pain can be effectively managed by non-opioid analgesics like diclofenac which provide cost-effective treatment. Analgesic for post-operative pain should be chosen judiciously by considering patient-related and surgery-related factors for better post-operative pain management and to prevent post-operative complications.

An interprofessional interventional approach to improve the mental well-being of medical students for better academic performances

Background: Medical students are the future doctors who are the primary caregivers for the society. High level of stress can obstruct the learning of medical students by impairing their concentration, problem solving, and decision-making skills. Improving mental well-being of medical students will ensure community safety. The stakeholders need to realize positive role of mental well-being on academic performance of students. This will not only benefit the students as well as the society as a whole. Aim and Objective: The present study was innovatively planned to determine the impact of the motivational sessions on relieving perceived stress and anxiety of the students along-with impact of such sessions on motivation for learning. Materials and Methods: An interventional cross-sectional study was designed for 2nd year MBBS students. A module comprising of eight sessions for improving mental well-being of undergraduate students was designed by an interprofessional team comprising a medical teacher, clinical phycologist, psychiatrist, and medical students. The pre-validated scales used were Hamilton Anxiety Rating Scale (HAM-A) to assess anxiety level, Perceived Stress Scale to assess perceived stress, and Motivated Strategies for Learning Questionnaire to measure the types of learning strategies and academic motivation of college students. Results: About 64% (n = 46) of the participants were male and 36% (n = 26) were female students. The present study showed no significant association between the gender and stress. It was seen that number of students with high perceived stress before the session were reduced by as much as 72.41% and that of students with highest motivation for learning strategies doubled from 18 to 36 (100% improvement).The difference in means of HAM-A scores in post-test and pre-tests is highly significant (P = 0.01). The students were very much satisfied with the mode and content of the module. They expressed that these sessions made them feel thought of and cared for. Conclusion: It is strongly recommended to apply this interprofessional interventional approach to improve the mental well-being of medical students for better academic performances.

White matter hyperintensities on magnetic resonance imaging among elderly depressed patients and its association with the severity of depression and cognition

Introduction: Depression in the elderly can have a different pathophysiology and clinical profile, and studies have shown pathological changes in the brain on radio imaging. The present study aimed to find out the association of white matter hyperintensities (WMH) on magnetic resonance imaging (MRI) with the severity of illness and cognition in elderly depressed patients. Methodology: This cross-sectional study included 68 elderly (>60 years of age) depressed patients who had undergone MRI at a tertiary care center, and based on the severity of WMH, they were divided into two groups: no or slight WMH group and moderate or severe WMH group. The severity of depression was assessed using the Hamilton Depression Rating Scale (HAM-D) scale, and neuropsychological assessments were made for testing attention, concentration and executive function. Results: HAM?D scores were found significantly higher in patients with moderate?to?severe WMH groups (22.6 ± 5.2) compared to those with no or slight WMH (16.3 ± 4.2). The cognitive performance evaluated by backward digit span test, Trail making Test A and B, and Color Stroop test was significantly poor in the moderate?to?severe WMH group. Conclusion: Elderly depressed patients having a greater WMH had more severe depression and poor cognitive performance, especially psychomotor and executive functioning. WMH could be a potential marker for the severity of illness and cognition in depression in elderly persons.

Association between ocular trauma and attention-deficit/hyperactivity disorder in adult patients

Purpose: To investigate the potential relationship between ocular trauma and attention?deficit/hyperactivity disorder (ADHD)?related clinical outcomes in adults. Methods: This prospective case?control study included 108 ocular trauma patients and 90 age?sex?matched healthy control. The ocular trauma group was separated into the subgroups home accident, outdoor activity, and work related in terms of the reasons for ocular trauma, and as ocular surface problems, blunt trauma?related, and open globe injury in terms of the clinical findings. The ADHD?related clinical outcomes were evaluated using the Wender?Utah Rating Scale (WURS). The outcomes were compared between ocular trauma and control groups, and ocular trauma subgroups. Results: The demographic characteristics of ocular trauma groups and controls were similar (P > 0.05, for all). In comparison to the control group, the ocular trauma group had higher total WURS score and WURS subscale scores, but not significantly (P > 0.05, for all). According to comparisons of the subgroups separated by the reasons, there was significant difference in the mean behavioral problems/impulsivity scores in favor of outdoor activities (P = 0.015). On the other hand, the mean scores for WURS subscales of the subgroups separated by the clinical findings were similar (P > 0.05, for all). Conclusion: WURS scores in ocular trauma patients are similar to control; however, the score in behavioral problems/impulsivity subscales is higher for ocular trauma caused by outdoor activities

Adaptação transcultural do teacher's rating scale of student's actual behavior: versão brasileira / Cross-cultural adaptation of teacher's rating scale of student's actual behavior: brazilian version / Adaptación transcultural de la teacher's rating scale of student's actual behavior: versión brasileña

Este estudo objetivou realizar a adaptação transcultural do Teacher's Rating Scale of Student's Actual Behavior (TRS) para o contexto brasileiro. O TRS é uma escala utilizada para avaliar a percepção que pais e/ou professores apresentam sobre as competências de crianças entre 8 a 12 anos. Foram realizadas cinco etapas metodológicas: tradução, síntese das traduções, tradução reversa (back-translation), análise de comitê e pré-teste. Após todas as avaliações, a escala mostrou-se de fácil aplicação, bons níveis de aceitação e compreensão pela população-alvo, composta por 10 pais de crianças em um centro de referência à saúde da criança. O TRS-versão brasileira foi adaptado no que se refere às equivalências semânticas, idiomáticas, conceituais e culturais. (AU)

This study aimed to carry out the cross-cultural adaptation of the Teacher's Rating Scale of Student's Actual Behavior (TRS) to the Brazilian context. The TRS is a scale used to evaluate the perception that parents and/or teachers present regarding the competencies of children between 8 and 12 years of age. Five methodological steps were executed: translation, translation synthesis, back-translation, committee analysis and pre-testing. After all evaluations, the scale was easy to apply and presented good levels of acceptance and understanding by the target population, represented by 10 parents of children in a reference center for children's health in Brazil. The TRS-Brazilian version was adapted with regard to semantic, idiomatic, conceptual and cultural equivalences. (AU)

Este estudio tuvo como objetivo realizar la adaptación transcultural de la Teacher's Rating Scale of Student's Actual Behavior (TRS) para el contexto brasileño. El TRS es una escala utilizada para evaluar la percepción que padres y/o profesores presentan sobre las competencias de niños entre 8 a 12 años. Se ejecutaron cinco etapas metodológicas: traducción, síntesis de las traducciones, retrotraducción (back-translation), análisis de comité y pre-test. Después de todas las evaluaciones, la escala se mostró de fácil aplicación, buenos niveles de aceptación y comprensión por la población objetivo, compuesta por 10 padres de niños en un centro de referencia a la salud infantil en Brasil. El TRS-versión brasileña fue adaptado en lo que se refiere a las equivalencias semánticas, idiomáticas, conceptuales y culturales. (AU)

Lilalva Scale: soft-hard technology to measure clinical competencies in emergencies of nurses / Escala Lilalva: tecnología blanda-dura para medir competencias clínicas en urgencias de enfermeras y enfermeros / Escala Lilalva: tecnologia leve-dura para medir competências clínicas em emergências de enfermeiras e enfermeiros

ABSTRACT Objectives: to present the visual identity of a soft-hard technology; to describe its technical characteristics, standardization and norms of criteria for the interpretation of results, in order to measure clinical competencies in emergencies of nurses. Methods: article developed as a methodological study for the creation of the graphic image of the scale and standardization based on previous studies of validity and reliability evidence. Results: the designed technology was named "Lilalva Scale for Measuring Clinical Competencies in Emergencies of Nurses". The graphic image text is organized by title, instructions on how to fill it out, description of the quality of delivery, and behavioral actions with respective degrees of response. The Scale has 22 items with characterization data. The standardization of the measurement instrument included: instructions for use, calculation protocol, and hypothetical example to calculate scores, the sum of the resulting scores metric for each clinical competence and diagnostic classification. Conclusions: the visual identity and the standardization instrumentalize the use of the Scale for those interested in the theme.

RESUMEN Objetivos: presentar la identidad visual de una tecnología blanda-dura; describir sus características técnicas, estandarización en la aplicación y normalización de criterios para la interpretación de los resultados, a fin de mensurar competencias clínicas en urgencias de enfermeras y enfermeros. Métodos: artículo desarrollado como estudio metodológico de creación de la imagen gráfica de la escala y estandarización calcada en estudios anteriores de evidencias de validad y confiabilidad. Resultados: la tecnología diseñada fue denominada de "Escala Lilalva de Medida de las Competencias Clínicas en Urgencias de Enfermeras y Enfermeros". El texto de la imagen gráfica está organizado por título, instrucciones sobre la forma de relleno, descripción de la calidad de la entrega y acciones comportamentales con respectivos grados de respuesta. La Escala tiene 22 ítems con datos de caracterización. La estandarización del instrumento de medida contempló: instrucciones para uso, protocolo de averiguación, ejemplo hipotético para calcular escores, métrica de la sumatoria de los escores resultantes para cada competencia clínica y clasificación diagnóstica. Conclusiones: la identidad visual y la estandarización instrumentalizan el uso da Escala a los interesados en la temática.

RESUMO Objetivos: apresentar a identidade visual de uma tecnologia leve-dura; descrever suas características técnicas, padronização na aplicação e normatização de critérios para a interpretação dos resultados, a fim de mensurar competências clínicas em emergências de enfermeiras e enfermeiros. Métodos: artigo desenvolvido como estudo metodológico de criação da imagem gráfica da escala e estandardização calcada em estudos pregressos de evidências de validade e confiabilidade. Resultados: a tecnologia desenhada foi denominada de "Escala Lilalva de Medida das Competências Clínicas em Emergências de Enfermeiras e Enfermeiros". O texto da imagem gráfica está organizado por título, instruções sobre a forma de preenchimento, descrição da qualidade da entrega e ações comportamentais com respectivos graus de resposta. A Escala possui 22 itens com dados de caracterização. A estandardização do instrumento de medida contemplou: instruções para uso, protocolo de apuração, exemplo hipotético para calcular escores, métrica da somatória dos escores resultantes para cada competência clínica e classificação diagnóstica. Conclusões: a identidade visual e a estandardização instrumentalizam o uso da Escala aos interessados na temática.

Neurological deficit and neurobehavioral evaluation of non-human primate ischemic stroke model / 国际脑血管病杂志

Because the clinical studies of neuroprotective drugs ended in failure, the Stroke Treatment Academy Industry Roundtable recommended the use of non-human primates for preclinical research on stroke. Non-human primates are the bridge between basic experiment and clinical research, and the experimental results are of great reference value. However, non-human primate stroke models have a variety of neurological deficits and behavioral evaluation methods, and the scoring methods also have their own emphases. It is easy to have differences in the evaluation, or there are deficiencies in the scale itself, resulting in inaccurate scoring, which directly affects the experimental results and the implementation of subsequent research. This article summarizes the neurological deficits and behavioral evaluation methods of non-human primate stroke model.

Development of a rating scale for measuring resistance to persuasive health messages

BACKGROUND@#Pretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages.@*METHODS@#Six candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score.@*RESULTS@#Explanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score.@*CONCLUSION@#The 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience.@*TRIAL REGISTRATION@#Not applicable; this is not a report of intervention trial.

Clinical diagnosis and treatment of 9 childhood opsoclonus-myoclonus syndrome patients and application of standard rating scale / 中华神经科杂志

Objective:To summarize the clinical features of childhood opsoclonus-myoclonus syndrome (OMS), evaluate severity degree and prognosis using OMS Symptom Severity Standard Rating Scale.Methods:The clinical features,diagnosis, therapeutic regimen and follow-up of 9 children with OMS in Department of Neurology and Oncology Department of Children's Hospital of Fudan University between 2011 and 2019 were retrospectively reviewed. Severity degree and prognosis were evaluated using OMS Symptom Severity Standard Rating Scale.Results:Among the 9 children with OMS, 4 were males and 5 were females. The onset age ranged from 14 months to 5 years, with a median of 17 months. Main symptoms were opsoclonus, myoclonus, ataxia, motor function regression, behavior and mood changes and sleep disorders. Eghit patients were combined with tumor. Seven of them with neuroblastoma were confirmed by surgical pathology, the other one showed spontaneous regression and symptom remission without treatment. Eight patients received hormone combined with intravenous immunoglobulin, of which 3 cases received adrenocorticotropic hormone, while 5 cases received methylprednisolone pulse therapy, with prednisone sequential therapy, decreasing dose gradually. Rituximab was administrated in 3 patients whose annual recurrent time was≥2. Nine patients were divided into 3 groups according to OMS Symptom Severity Standard Rating Scale, 1 of mild degree, 3 of moderate degree, 5 of severe degree. There was no recurrence and sequelae in the mild-degree patient after 3 years follow-up. There was no recurrence and sequelae in 2 of the moderate-degree patients after 1-2 years follow-up. Different degrees of motor, cognitive sequelae were found in 1 of moderate-degree patients and all of severe-degree patients after 1-8 years follow-up.Conclusions:Childhood OMS patients have early onset age. Bad symptom severity before treatment and multiphase course are associated with poor prognosis. OMS Symptom Severity Standard Rating Scale is suitable for estimations of long-term prognosis.

Comparison of the value of different scoring scales in predicting risk of stroke-associated pneumonia / 中国医师进修杂志

Objective:To explore the value of the age, atrial fibrillation, dysphagia, sex, stroke severity (A2DS2) score, the prestroke independence, sex, age, National Institutes of Health stroke scale (ISAN) score, acute ischemic stroke-associated pneumonia score (AIS-APS), and intracerebral hemorrhage associated pneumonia score without hematoma volume included (ICH-APS-A) in predicting risk of stroke-associated pneumonia (SAP).Methods:From January to June 2019, 304 patients with acute stroke who were hospitalized in the Lianyungang Hospital Affiliated to Xuzhou Medical University were analyzed retrospectively. There were 164 patients with acute ischemic stroke (AIS), including 82 patients with SAP. And there were 140 patients with intracerebral hemorrhage (ICH), including 70 patients with SAP. They were divided into SAP group (152 cases) and non-SAP group (152 cases) depending on whether they had SAP. The area under the receiver operating characteristic curve (AUC) was used to compare the predictive value of the four scores.Results:When predicting risk of SAP in patients with the stroke, the A2DS2 score had the largest AUC compared to the ISAN score, AIS-APS score, and ICH-APS-A score. When predicting risk of SAP in patients with AIS, the AUC (0.875, 95% CI 0.815 to 0.922) of the A2DS2 score was greater than the AIS-APS score and the ISAN score. When predicting risk of SAP in patients with ICH, the AUC (0.950, 95% CI 0.900 to 0.980) of the A2DS2 score was greater than the ICH-APS-A score and the ISAN score. When predicting risk of SAP in patients with AIS and ICH: 0.911 (95% CI 0.873 to 0.94) vs. 0.882 (95% CI 0.840 to 0.916), Z = 2.319, P = 0.020, the A2DS2 score was significantly better than the ISAN score ( P<0.05). When predicting risk of SAP in patients with AIS, the A2DS2 score, ISAN score, and AIS-APS score all have good predictive value ( P>0.05). When predicting SAP in patients with ICH, the A2DS2 score, ISAN score, and ICH-APS-A score all have good predictive value ( P>0.05). Conclusions:When predicting risk of SAP in patients, the A2DS2 score is a reliable prediction tool, with good predictive value.

Construct validity of the Individual Lifestyle Profile scale in times of social distancing / Validade de constructo da escala Perfil do Estilo de Vida Individual em tempos de distanciamento social

The aims of the study were to estimate the level of reliability and factorial validity of the "Individual Lifestyle Profile" scale in times of social distancing, through confirmatory factor analysis (CFA). Therefore, the "Individual Lifestyle Profile" scale in times of social distancing was used in a study carried out with samples of students and employees of higher education institutions from different Brazilian regions. The final sample consisted of 4,694 adults who have answered the online form. For construct evaluation, internal consistency analysis was performed using Cronbach's Alpha (a) and Spearman's correlation. The CFA was used to test the hypothetical factor structure of the scale. Overall internal consistency was a = 0.778 and there were significant correlations, however, less than ± 0.799 for items from the same constructs and ± 0.499 among items from different constructs. In the CFA, after adjustments to the model structure, all indicators were adequate (Goodness-of-fit Index: 0.976; Comparative Fit Index: 0.937; Normalized Fit Indices: 0.932; Tucker-Lewis Indi-ces: 0.914; Root Mean Square Error of Approximation: 0.047; Root Mean-Square Residual: 0.031; Standardized Root Mean-Square Residual: 0.0337), with the exception for chi-square p values and the ratio between chi-square and degrees of freedom. It is concluded that the "Individual Lifestyle Profile" scale in times of social distancing has shown satisfactory internal consistency and factor structure to guide the assessment of lifestyle (individual or groups) and interventions to promote healthy lifestyles

Os objetivos do estudo foram estimar o nível de confiabilidade e validade fatorial da escala "Perfil do Estilo de Vida Individual " em tempos de distanciamento social, por meio da análise fatorial confirmatória (AFC). Para tanto, a escala "Perfil do Estilo de Vida Individual " em tempos de distanciamento social foi empregada em um estudo realizado com amostras de estudantes e servidores de instituições de ensino superior de diferen-tes regiões brasileiras. A amostra final correspondeu a 4.694 adultos que responderam o formulário on-line. Para a avaliação de constructo foi realizada a análise de consistência interna via Alfa de Cronbach's (a) e correlação de Spearman. Empregou-se a AFC para testar a estrutura fatorial hipotética da escala. A con-sistência interna geral foi de a de 0,778 e houve correlações significativas, porém, inferiores a ± 0,799 para os itens dos mesmos constructos e ± 0,499 entre os itens de constructos diferentes. Na AFC, após ajustes na estrutura do modelo, ocorreu a adequação para todos os indicadores (Goodness-of-fit Index: 0,976; Compa-rative Fit Index: 0,937; Normalized Fit Indices: 0,932; Tucker-Lewis Indices: 0,914; Root Mean Square Error of Approximation: 0,047; Root Mean-Square Residual: 0,031; Standardized Root Mean-Square Residual: 0,0337), com a exceção para os valores de p do Qui-quadrado e razão entre Qui-quadrado e graus de liberdade. Conclui-se que a escala "Perfil do Estilo de Vida Individual " em tempos de distanciamento social, mostrou consistência interna e estrutura fatorial satisfatórias para orientar a avaliação do estilo de vida (individual ou de grupos) e as intervenções para promover estilos de vida saudáveis