Temporal analysis of mortality from preventable causes in the first 24 hours of life, 2000-2021. / Análisis temporal de la mortalidad por causas evitables en las primeras 24 horas de vida, 2000-2021.

OBJECTIVE: to analyze the temporal pattern and estimate mortality rates in the first 24 hours of life and from preventable causes in the state of Pernambuco from 2000 to 2021. METHOD: an ecological study, using the quarter as the unit of analysis. The data source was made up of the Mortality Information System and the Live Birth Information System. The time series modeling was conducted according to the Autoregressive Integrated Moving Average Model. RESULTS: 14,462 deaths were recorded in the first 24 hours of life, 11,110 (76.8%) of which being preventable. It is observed from the forecasts that the mortality rate in the first 24 hours of life ranged from 3.3 to 2.4 per 1,000 live births, and the mortality rate from preventable causes ranged from 2.3 to 1.8 per 1,000 live births. CONCLUSION: the prediction suggested progress in reducing mortality in the first 24 hours of life in the state and from preventable causes. The ARIMA models presented satisfactory estimates for mortality rates and preventable causes in the first 24 hours of life.

Análisis temporal de la mortalidad por causas evitables en las primeras 24 horas de vida, 2000-2021 / Temporal analysis of mortality from preventable causes in the first 24 hours of life, 2000-2021 / Análise temporal da mortalidade por causas evitáveis nas primeiras 24 horas de vida, 2000-2021

Objetivo: analizar el patrón temporal y estimar las tasas de mortalidad en las primeras 24 horas de vida y por causas evitables en el estado de Pernambuco en el período de 2000 a 2021. Método: estudio ecológico, teniendo como unidad de análisis el trimestre. La fuente de datos se constituyó por el Sistema de Informaciones sobre Mortalidad y el Sistema de Informaciones sobre Nacidos Vivos. El modelado de series temporales se realizó según el Modelo Autorregresivo Integrado de Promedio Móvil. Resultados: se registraron 14.462 óbitos en las primeras 24 horas de vida, siendo 11.110 (el 76,8%) evitables. Se observa para los pronósticos ( forecasts) que la tasa de mortalidad en las primeras 24 horas de vida registro una variación de 3,3 a 2,4 por 1.000 nacidos vivos, y la tasa de mortalidad por causas evitables de 2,3 a 1,8 por 1.000 nacidos vivos. Conclusión: la predicción sugirió avances en la reducción de la mortalidad en las primeras 24 horas de vida en el estado y por causas evitables. Los modelos ARIMA presentaron estimaciones satisfactorias para las tasas de mortalidad y por causas evitables en las primeras 24 horas de vida.

Objective: to analyze the temporal pattern and estimate mortality rates in the first 24 hours of life and from preventable causes in the state of Pernambuco from 2000 to 2021. Method: an ecological study, using the quarter as the unit of analysis. The data source was made up of the Mortality Information System and the Live Birth Information System. The time series modeling was conducted according to the Autoregressive Integrated Moving Average Model. Results: 14,462 deaths were recorded in the first 24 hours of life, 11,110 (76.8%) of which being preventable. It is observed from the forecasts that the mortality rate in the first 24 hours of life ranged from 3.3 to 2.4 per 1,000 live births, and the mortality rate from preventable causes ranged from 2.3 to 1.8 per 1,000 live births. Conclusion: the prediction suggested progress in reducing mortality in the first 24 hours of life in the state and from preventable causes. The ARIMA models presented satisfactory estimates for mortality rates and preventable causes in the first 24 hours of life.

Objetivo: analisar o padrão temporal e estimar as taxas de mortalidade nas primeiras 24 horas de vida e por causas evitáveis no estado de Pernambuco no período de 2000 a 2021. Método: estudo ecológico, tendo como unidade de análise o trimestre. A fonte de dados foi constituída pelo Sistema de Informações sobre Mortalidade e pelo Sistema de Informações sobre Nascidos Vivos. A modelagem da série temporal foi conduzida segundo o Modelo Autorregressivo Integrado de Médias Móveis. Resultados: foram registrados 14.462 óbitos nas primeiras 24 horas de vida, sendo 11.110 (76,8%) evitáveis. Observa-se para os forecasts que a taxa de mortalidade nas primeiras 24 horas de vida variou de 3,3 a 2,4 por 1.000 nascidos vivos, e a taxa de mortalidade por causas evitáveis variou de 2,3 a 1,8 por 1.000 nascidos vivos. Conclusão: a previsão sugeriu avanços na redução da mortalidade nas primeiras 24 horas de vida no estado e por causas evitáveis. Os modelos ARIMA apresentaram estimativas satisfatórias para as taxas de mortalidade e por causas evitáveis nas primeiras 24 horas de vida.

Perfil do consumo de álcool entre estudantes universitários* / Alcohol consumption between students / Perfil del consumo de alcohol entre estudiantes universitarios

O objetivo foi avaliar o perfil de consumo de bebidas alcoólicas entre estudantes de uma universidade brasileira. Quanto ao consumo de álcool, 76,6% foram classificados com baixo risco e 23,4% de risco/uso abusivo. Os estudantes que faziam uso de tabaco e drogas ilícitas apresentaram riscos potencialmente elevados de consumo de álcool (RPbruta=3,69, IC95%: 2,01 - 6,79; RPbruta=2,44, IC95%: 1,32 - 4,50, respectivamente). Os estudantes apresentaram baixo risco de dependência, no entanto, os escores se mostraram diferenciados quando avaliado com características sociodemográficas e hábitos de vida.

The aim of this study is to evaluate the profile of alcohol consumption among students of a Brazilian university. Regarding alcohol consumption, 76.6% are in the low risk of dependence and 23.4% in the risk/ harmful use. Students who used tobacco and illicit drugs presented potentially high risks of alcohol consumption (PR =3.69, 95% CI: 2.01 to 6.79; PR =2.44, 95% CI: 1.32 to 4.50, respectively). The students presented a low risk of alcohol dependence, however, scores consumption showed different when a comparison is made with sociodemographic characteristics and lifestyle habits.

El estudio tiene por objetivo evaluar el perfil de consumo de bebidas alcohólicas entre los estudiantes de una universidad brasileña. En relación con el patrón de consumo de alcohol, el 76,6% fue clasificado con bajo riesgo y el 23,4% en el riesgo/ abuso. Los estudiantes que hacían uso de tabaco y drogas ilícitas presentaron riesgos potencialmente elevados de consumo de alcohol (RPbruta= 3,69; IC del 95%: 2,01 a la 6,79; RPbruta = 2.44, IC del 95%: 1.32 a la 4.50, respectivamente). Los estudiantes presentaron bajo riesgo de dependencia del alcohol, sin embargo, las puntuaciones de consumo se mostraron diferenciado cuando se evaluó con características sociodemográficas y hábitos vida.

Clinical study of the caries-preventive effect of resin-modified glass ionomer restorations: aging versus the influence of fluoride dentifrice.

AIM: The use of fluoride-releasing materials could be compromised due to aging and might also be influenced by other ordinary sources of fluoride. The aim of the present study was to investigate the aging effect on caries development around resin-modified glass ionomer cement (RMGIC) restorations and the influence of fluoride dentifrice use in this process under the oral environment. METHODS: A clinical study was performed in two phases of 14 days each. A total of 16 volunteers wore palatal devices containing dental slabs restored with either a composite resin or RMGIC, either aged or unaged by thermocycling. To simulate a clinical situation of high caries risk, the slabs were exposed to a 20% sucrose solution 10 times per day via the in situ model, where non-fluoride or a fluoride dentifrice was used. Integrated demineralization was determined by cross-sectional microhardness at both margins of the restoration: enamel and dentin. RESULTS: For enamel, higher demineralization around the composite restorations was observed, regardless of dentifrice or aging. For dentin, higher demineralization was observed around the aged composite restorations regardless of the dentifrice type used. CONCLUSIONS: The RMGIC restorations provided more enhanced protection against secondary caries for dentin under aging, and the fluoride dentifrice used in this condition had either no clinically relevance or only a minimal effect.

Dental health knowledge and attitudes of primary school teachers toward dental health education in Maceió, Brazil

Objective:To evaluate the levels of knowledge and attitudes toward oral health of preschool teachers of Maceió, Alagoas. Material and Methods:Cross-sectional study using a pretested structured questionnaire (32 teachersequivalent to 20% of the sample) applied to 140 teachers of Child Day Care Centers of Maceió. To assess the level of information of survey participants (dependent variable), frequency from 0 to 49.99% of correct answers of questions proposed was considered unsatisfactory knowledge; 50 to 70% as reasonable knowledge and above 70% as satisfactory knowledge. Independent variables were age, sex, educational level, marital status and children. Data analysis was performed using SPSS software 17.0 and presented as descriptive statistics and Logistic Regression (p < 0.05%). Results:The level of knowledge of teachers on the etiology of caries was unsatisfactory, because although 90% reported that sugar is responsible for the decay process, only 3.6% reported that its excessive consumption is the responsible for the emergence of the disease; the level of knowledge for periodontal disease was unsatisfactory, since only 32.1% correctly answered the meaning of plaque. Teachers over 40 years and with children are more likely to have satisfactory knowledge regarding oral health and 88.6% of these professionals have already conducted some activity related to the theme. Conclusion:Although most teachers have done oral health activities, the level of knowledge of teachers about the etiology of caries and periodontal disease was considered unsatisfactory, therefore further clarification in oral health is need so that teachers could act as agents in oral health promotion

Stunkard Figure Rating Scale for Brazilian men.

PURPOSE: To evaluate psychometric assessment of Stunkard Figure Rating Scale (FRS) for Brazilian male population. METHODS: The sample was composed of a control group (94 students) and a clinical group (20 eating disordered patients). Two questionnaires were applied: the FRS and the Eating Attitudes Questionnaire-26. Weight, height, and body mass index (BMI) were collected in the control group (self-reported) and clinical group (measured). Body dissatisfaction (BD) was calculated by subtraction of ideal body (IB) from the current body (CB) score. The concurrent validity was assessed through the analysis of the correlation between the CB and BD scores and the BMI and the body weight. The discriminant validity was achieved by measurements of association between the groups studied and the scales CB, IB and BD. Reliability was assessed by the comparison of the score averages at two moments and by the intraclass coefficient correlation. RESULTS: The questionnaire had a correlation higher than 0.67 for the measures of weight and BMI. Regarding the CB, IB and BD scores, a significant difference was not observed between the clinical and the control group. There was no difference between the scores for BD at the two moments analyzed. CONCLUSIONS: The FRS is stable and capable of correlating with anthropometric measures. Nevertheless, for this population the questionnaire was unable to distinguish between the two groups analyzed.

Avaliação psicométrica da Escala de Influência dos Três Fatores (EITF) / Psychometric evaluation of the Tripartite Influence Scale

Objetivou-se avaliar as qualidades psicométricas da Escala de Influência dos Três Fatores (EITF) entre jovens brasileiros, de ambos os sexos. A amostra foi composta por 475 universitários com idade entre 18 e 29 anos (Média = 20,8 anos, DP = 2,0 anos). Avaliou-se sua validade de construto (análise fatorial exploratória), validade convergente (correlação entre os escores da EITF e medidas de satisfação corporal), confiabilidade (alfa de Cronbach) e reprodutibilidade (teste-reteste). O instrumento apresentou estrutura fatorial composta por três fatores, replicando os da escala original, correlações negativas e significativas para as medidas de satisfação corporal (> -0,21, p < 0,001) e não demonstrou diferença entre os escores no teste-reteste. A EITF confirmou suas propriedades psicométricas, sendo indicada sua utilização para jovens.(AU)

The objective of the present study was the psychometric evaluation of the Tripartite Influence Scale (TIS) among Brazilian youths of both sexes. The sample consisted of 475 undergraduate students aged between 18 and 29 years old (M = 20.8, SD = 2.0). We evaluated the construct validity (exploratory factor analysis), convergent validity (correlation between the scores of the TIS and measures of body satisfaction), reliability (Cronbach's alpha) and reproducibility (test-retest). The instrument presented factorial structure composed of three factors replicating the original scale factors, significant negative correlation for measures of body satisfaction (> -.21, p <.001), and showed no difference between the scores on test-retest reproducibility. It was confirmed TIS's psychometric properties, and its use is indicated for young Brazilian people.(AU)

Avaliação psicométrica da Escala de Influência dos Três Fatores (EITF) / Psychometric evaluation of the Tripartite Influence Scale

Objetivou-se avaliar as qualidades psicométricas da Escala de Influência dos Três Fatores (EITF) entre jovens brasileiros, de ambos os sexos. A amostra foi composta por 475 universitários com idade entre 18 e 29 anos (Média = 20,8 anos, DP = 2,0 anos). Avaliou-se sua validade de construto (análise fatorial exploratória), validade convergente (correlação entre os escores da EITF e medidas de satisfação corporal), confiabilidade (alfa de Cronbach) e reprodutibilidade (teste-reteste). O instrumento apresentou estrutura fatorial composta por três fatores, replicando os da escala original, correlações negativas e significativas para as medidas de satisfação corporal (> -0,21, p < 0,001) e não demonstrou diferença entre os escores no teste-reteste. A EITF confirmou suas propriedades psicométricas, sendo indicada sua utilização para jovens...

The objective of the present study was the psychometric evaluation of the Tripartite Influence Scale (TIS) among Brazilian youths of both sexes. The sample consisted of 475 undergraduate students aged between 18 and 29 years old (M = 20.8, SD = 2.0). We evaluated the construct validity (exploratory factor analysis), convergent validity (correlation between the scores of the TIS and measures of body satisfaction), reliability (Cronbach's alpha) and reproducibility (test-retest). The instrument presented factorial structure composed of three factors replicating the original scale factors, significant negative correlation for measures of body satisfaction (> -.21, p <.001), and showed no difference between the scores on test-retest reproducibility. It was confirmed TIS's psychometric properties, and its use is indicated for young Brazilian people...

Immunogenicity of a meningococcal serogroup C conjugate vaccine in HIV-infected children, adolescents, and young adults.

Children and adolescents infected with HIV typically have a lower response to immunization than do those in the general population. In most developed countries, meningococcal serogroup C conjugate vaccine is one of the recommended vaccines for such individuals. However, there have been no studies evaluating the antibody response to this vaccine in HIV-infected children, adolescents or young adults. In this study, we evaluated that response using serum bactericidal antibody (SBA) and enzyme-linked immunosorbent assay, comparing HIV-infected with non-HIV-infected patients, as well as analysing the occurrence of side effects. In non-responders, we assessed the antibody response to revaccination. This clinical trial involved 92 patients between 10 and 20 years of age: 43 HIV-infected patients (HIV+ group) and 49 non-HIV-infected patients (HIV- group). After one dose of the vaccine, 72.1% of the HIV+ group patients and 100% of the HIV- group patients were considered protected. Of the HIV+ group patients who received a second dose of the vaccine, only 40% acquired protection. Overall, 81.4% of the HIV+ group patients acquired protection (after one or two doses of the vaccine). Side effects occurred in 16.3% and 44% of the HIV+ group and HIV- group patients, respectively. Therefore, the meningococcal serogroup C conjugate vaccine proved to be safe and effective for use in HIV-infected children, adolescents, and young adults, although their antibody response was weaker than that shown by non-HIV-infected patients. This indicates the need to discuss changes to the immunization schedule for children, adolescents, and young adults infected with HIV, in order to ensure more effective protection against meningococcal disease.

Behavior and progression of early carious lesions in early childhood: a 1-year follow-up study.

PURPOSE: The purpose of this 1-year follow-up study was to evaluate the behavior/progression of early carious lesions (active noncavitated carious lesions) by surface and type of tooth in early childhood. METHODS: A total of 179 3-and 4-year-old preschoolers took part in this study. Clinical examinations were conducted by a calibrated examiner using a mirror, ball-ended probe, gauze for cleaning and drying of teeth, and artificial light. The World Health Organization criteria, with an added measurement of early carious lesions (ECLs), were employed for the caries examinations. Descriptive statistics and logistic regression were used in the statistical analysis. RESULTS: After a 1-year follow-up, the study population developed 1.60 ± 1.64 new carious lesions. Children with caries activity at baseline showed much higher risks of developing new lesions than caries-free children (odds ratio=17.3 for ECL development, OR=24.5 for cavitations/fillings). Most ECLs remained active/unchanged after 1 year, whereas approximately 36% were arrested. Approximately 10% of the ECLs became cavitated, were filled, or were missing due to caries at follow-up. ECLs turned into cavities or fillings more frequently in the posterior region. CONCLUSION: This study's findings support the conservative management of ECLs since, after 1 year, the majority of lesions were active/unchanged or were arrested on the smooth surfaces of primary teeth.

Health Related Quality of Life Assessment questionnaire for children aged 5 to 11 years with HIV/AIDS: cross-cultural adaptation for the Portuguese language.

The objective of this study is to describe preliminary results from the cross-cultural adaptation of the Quality of Life Assessment Questionnaire, used to measure health related quality of life (HRQL) in Brazilian children aged between 5 and 11 with HIV/AIDS. The cross-cultural model evaluated the Concept, Item, Semantic and Measurement Equivalences (internal consistency and intra-observer reliability). Evaluation of the conceptual, item, semantic equivalences showed that the Portuguese version is pertinent for the Brazilian context. Four of seven domains showed internal consistency above 0.70 (α: 0.76-0.90) and five of seven revealed intra-observer reliability (ricc: 0.41-0.70). This first Portuguese version of the HRQL questionnaire can be understood as a valuable tool for assessing children's HRQL, but further studies with large samples and more robust analyses are recommended before use in the Brazilian context.

Health Related Quality of Life Assessment questionnaire for children aged 5 to 11 years with HIV/AIDS: cross-cultural adaptation for the Portuguese language / Questionário de Avaliação da Qualidade de Vida para crianças de 5 a 11 anos com HIV/AIDS: adaptação transcultural para a língua portuguesa

The objective of this study is to describe preliminary results from the cross-cultural adaptation of the Quality of Life Assessment Questionnaire, used to measure health related quality of life (HRQL) in Brazilian children aged between 5 and 11 with HIV/AIDS. The cross-cultural model evaluated the Concept, Item, Semantic and Measurement Equivalences (internal consistency and intra-observer reliability). Evaluation of the conceptual, item, semantic equivalences showed that the Portuguese version is pertinent for the Brazilian context. Four of seven domains showed internal consistency above 0.70 (α: 0.76-0.90) and five of seven revealed intra-observer reliability (ricc: 0.41-0.70). This first Portuguese version of the HRQL questionnaire can be understood as a valuable tool for assessing children's HRQL, but further studies with large samples and more robust analyses are recommended before use in the Brazilian context.

O objetivo deste estudo é descrever os resultados preliminares da adaptação, para o uso no Brasil, do questionário Quality of Life Assessment, usado para mensurar qualidade de vida relacionada à saúde (HRQL) em crianças com HIV/AIDS. O modelo de adaptação cultural considerou as avaliações de equivalência Conceitual, Itens, Semântica e de Mensuração (consistência interna e reprodutibilidade). As avaliações da equivalência conceitual, itens e semântica, mostraram que a versão para o Português é pertinente para o contexto brasileiro. Quatro de sete domínios apresentaram consistência interna acima de 0,70 (α: 0.76-0.90) e cinco de sete apresentaram reprodutibilidade (ricc: 0.41-0.70). Esta primeira versão em Português do questionário de HRQL pode ser entendida como uma valiosa ferramenta para mensurar HRQL em crianças, porém outros estudos com amostras maiores e análises mais robustas, são recomendados antes do uso no contexto brasileiro.

Time trend of the male proportion at birth in Brazil, 1979-2004.

Several studies suggest that exposure to environmental endocrine disrupters can reduce the number of male births, and therefore, the male proportion at birth (also denominated birth ratio or sex ratio at birth) can be used as a sentinel health indicator. This work aimed to analyze the trend of male births in Brazil, according to their distribution by states and capitals. An ecological descriptive time series was carried out using polynomial regression, showing a declining trend for male proportion at birth in Brazil (1979-1994), followed by an upward trend until 2004. A decline on the proportion of male births was observed in Brazil between 1979 and 1993, followed by a subsequent rise of this ratio between 1995 and 2004, wherein the mean proportion of male births in Brazil rose from 51.05 to 51.18, representing a relative increase of 0.25%. The states of São Paulo (Southwest region) and Acre (Western Amazon), as well as some capitals-Cuiabá (Western Region), Palmas (Amazon) and Rio Branco (Amazon)-showed increasing trends, which suggests the influence of socio-demographic changes. In contrast, a declining trend in the State of Ceará State (Northeast region), with a 0.35% yearly decrease was observed. As a whole, these results suggest the influence of different environmental factors (demographic changes, public health services distribution, and population exposure to endocrine disruptor substances) influencing the time trend of birth ratio in the Brazilian population during the last decades.

A insatisfação corporal de jovens: um estudo exploratório / The body dissatisfaction of adolescents: an exploratory research

A presente pesquisa objetivou avaliar a satisfação corporal de um grupo de adolescentes e as possíveis diferenças entre os sexos. Participaram do estudo 121 jovens, de ambos os sexos, matriculados numa instituição particular de ensino no ABC Paulista. Aplicaram-se entrevistas coletivas e individuais, com os dados analisados por meio da estatística descritiva e os depoimentos por meio da técnica do Discurso do Sujeito Coletivo, embasada na teoria das representações sociais. Entre as meninas, destacaram-se a idealização do corpo magro e os discursos vinculados às ideias do desejo de diminuir ou aumentar áreas corporais. Entre os meninos, foi observada a idealização do corpo eutrófico, além do desejo de diminuir áreas corporais e ganhar massa muscular. As ideias centrais de satisfação corporal foram verificadas em 1,8 por cento e 23,3 por cento dos discursos de meninas e meninos, respectivamente. Os dados indicam que a insatisfação corporal está presente na vivência destes jovens, com variações relacionadas aos prováveis mecanismos e reações atrelados ao gênero.

This paper aimed to evaluate body satisfaction in a group of adolescents and the possible differences between sexes; 121 teenagers of both sexes, enrolled in a private high school in ABC Paulista, were studied. Collective and individual interviews were conducted and data base was analyzed through the descriptive analysis and the statements of the Collective Subject Discourse technique, based on the social representation theory. Girls evinced the idealization of the skinny body and the speeches rolled to the wish of decrease and increase body areas. Among boys it was observed the idealization of eutrophic body, as well as the wishes to reduce body's areas and increase muscle size The central body satisfaction ideas were verified in 1.8 percent and 23.3 percent of speeches among girls and boys, respectively. Data confirm that body dissatisfaction is present in the adolescent's reality, with variation connected with the probable mechanisms and reactions connected with gender.

Validity and reliability of a self-efficacy expectancy scale for adherence to antiretroviral therapy for parents and carers of children and adolescents with HIV/AIDS.

OBJECTIVE: To validate and evaluate the reproducibility of a self-efficacy (SE) scale for adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/guardians. METHODS: The study was carried out at the Hospital-Dia, Centro de Referência e Treinamento em DST/AIDS (CRT/SP), in São Paulo, Brazil. The parents/guardians of 54 children and adolescents aged 6 months to 20 years were interviewed during routine consultations at our service. Data on SE were collected using the Self-Efficacy for Following Anti-Retroviral Prescription Scale, and SE scores were calculated in two different ways: factor analysis and a predefined formula. The scale's internal consistency was verified using Cronbach's alpha coefficient. Validity was tested by comparing the mean scores of a group of patients who did adhere to antiretroviral treatment with those of a group that did not (Mann-Whitney test) and by calculating the Spearman correlation coefficient for agreement between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, intraclass correlation coefficients (r(icc)) and Bland-Altman plots. RESULTS: The SE scale demonstrated good internal consistency (alpha = 0.87) and good reproducibility (r(icc) = 0.69 and r(icc) = 0.75). In terms of validity, the SE scale was capable of differentiating adherent patients from those who did not adhere to their antiretroviral treatment (p = 0.002) and exhibited a significant correlation with CD4 counts (r = 0.28; p = 0.04). CONCLUSIONS: The SE scale can be used to assess adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/carers.

Validação e reprodutibilidade de uma escala de auto-eficácia para adesão ao tratamento anti-retroviral em pais ou cuidadores de crianças e adolescentes vivendo com HIV/AIDS / Validity and reliability of a self-efficacy expectancy scale for adherence to antiretroviral therapy for parents and carers of children and adolescents with HIV/AIDS

OBJETIVO: Validar uma escala de auto-eficácia para adesão ao tratamento anti-retroviral em crianças e adolescentes com HIV/AIDS, levando em consideração a perspectiva dos pais/responsáveis, e avaliar a sua reprodutibilidade. MÉTODOS: O estudo foi realizado no Hospital-Dia do Centro de Referência e Treinamento em DST/AIDS de São Paulo. Foram entrevistados os pais/responsáveis de 54 crianças e adolescentes de 6 meses a 20 anos que passaram em consulta de rotina pelo serviço. Os dados de auto-eficácia foram levantados pela escala de auto-eficácia para seguir prescrição anti-retroviral (AE), que foi calculada de duas maneiras: análise fatorial e fórmula já definida. A consistência interna da escala foi verificada pelo coeficiente ade Cronbach. A validade foi avaliada pela comparação das médias dos escores entre grupos de pacientes aderentes e não aderentes ao tratamento anti-retroviral (teste de Mann-Whitney) e cálculo do coeficiente de correlação de Spearman entre os escores e parâmetros clínicos. A reprodutibilidade foi verificada por meio do teste de Wilcoxon, pelo coeficiente de correlação intraclasse (CCI) e pelo gráfico de Bland-Altman. RESULTADOS: A escala de AE apresentou boa consistência interna (a= 0,87) e boa reprodutibilidade (CCI = 0,69 e CCI = 0,75). Quanto à validade, a escala de AE conseguiu discriminar pacientes aderentes e não aderentes ao tratamento anti-retroviral (p = 0,002) e apresentou correlação significativa com a contagem de CD4 (r = 0,28; p = 0,04). CONCLUSÕES: A escala de AE pode ser utilizada para avaliar a adesão à terapia anti-retroviral em crianças e adolescentes com HIV/AIDS, levando em consideração a perspectiva dos pais/cuidadores.

OBJECTIVE: To validate and evaluate the reproducibility of a self-efficacy (SE) scale for adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/guardians. METHODS: The study was carried out at the Hospital-Dia, Centro de Referência e Treinamento em DST/AIDS (CRT/SP), in São Paulo, Brazil. The parents/guardians of 54 children and adolescents aged 6 months to 20 years were interviewed during routine consultations at our service. Data on SE were collected using the Self-Efficacy for Following Anti-Retroviral Prescription Scale, and SE scores were calculated in two different ways: factor analysis and a predefined formula. The scale's internal consistency was verified using Cronbach's acoefficient. Validity was tested by comparing the mean scores of a group of patients who did adhere to antiretroviral treatment with those of a group that did not (Mann-Whitney test) and by calculating the Spearman correlation coefficient for agreement between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, intraclass correlation coefficients (r icc) and Bland-Altman plots. RESULTS: The SE scale demonstrated good internal consistency (a= 0.87) and good reproducibility (r icc = 0.69 and r icc = 0.75). In terms of validity, the SE scale was capable of differentiating adherent patients from those who did not adhere to their antiretroviral treatment (p = 0.002) and exhibited a significant correlation with CD4 counts (r = 0.28; p = 0.04). CONCLUSIONS: The SE scale can be used to assess adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/carers.

Falha terapeutica em crianças com AIDS / Therapeutic failure in children with AIDS

A falha terapeutica em criancas com aids é hoje uma das principais responsaveis pela necessidade de troca de esquemas terapeuticos. O teste de genotipagem do HIV pode ser um importante auxiliar na escolha de um novo esquema. O objetivo do trabalho foi traçar o perfil dos pacientes acompanhados no CRT-DST/AIDS/PESP apresentado falha terapeutica, além de avaliar os beneficios da genotipagem na orientação das trocas de esquemas terapêuticos de 29 pacientes avaliados. Todas as genotipagens analisadas apresentaram algum padrão de resistência aos antiretrovirais (ARV), sendo 92,8 porcento aos ITRNs, 64,2 porcento aos ITRNNs, 64,2 porcento aos IPs, 60,7 porcento aos ITRNts. Com base nos resultados das genotipagens foram feitas mudanças de esquemas ARVs, observando-se a resposta de elevação de CD4 e queda de carga viral 6 meses após as trocas, sendo que cerca de 25 porcento evoluiram com nova falha terapeutica durante a evolucao, definida com falha terapeutica posterior (nos meses subsequentes). Foi observado que os pacientes que nao apresentaram boa resposta (apos o periodo de 6 meses de observação) eram aqueles sem adesão prévia, adolescentes, classificação C3 e com uso de maior número de esquemas terapeuticos anteriores. Concluimos que a genotipagem foi um importante instrumento diagnostico para orientação de troca de ARV em pacientes com falha terapeutica, sendo a adesão, o tempo de evolução da doença, assim como a classificação e o historico prévio de uso de grande número de drogas fatores limitantes para o sucesso terapeutico.

Qualidade de vida em crianças e adolescentes com HIV/AIDS: validação e reprodutibilidade de instrumentos / Quality of life in children and adolescents with HIV/Aids: instrument's validity and reability

Introdução: Qualidade de vida relacionada à saúde e adesão ao uso de medicamentos em crianças/adolescentes são questões importantes que têm sido estudadas em países desenvolvidos, utilizando, fundamentalmente, questionários que ainda não foram traduzidos e/ou validados no Brasil. Objetivos: 1) Traduzir e validar o questionário Quality of Life Assessment (QLA), específico para crianças e adolescentes com HIV/Aids e avaliar a sua reprodutibilidade. 2) Validar um questionário sobre expectativa de auto-eficácia para seguir prescrição anti-retroviral em crianças e adolescentes com HIV/Aids e avaliar a sua reprodutibilidade. Métodos: O estudo foi realizado no Centro de Referência e Treinamento em DST/AIDS de São Paulo (CRT/SP). Participaram do estudo 90 crianças e adolescentes de 6 meses a 20 anos que passaram em consulta de rotina pelo serviço. Os dados de qualidade de vida foram coletados por meio dos questionários de Avaliação da Qualidade de Vida (AQV) com 3 versões para 3 faixas etárias específicas (6 meses a 4 anos, 5 a 11 e12 a 20 anos) e, os de auto-eficácia, pela Escala de Auto-Eficácia para seguir Prescrição Anti-Retroviral (AE). Foi realizada a avaliação de equivalência transcultural do QLA. A consistência interna dos questionários foi verificada pelo cálculo do coeficiente alfa de Cronbach. Foi realizada análise fatorial confirmatória para o questionário AQV e exploratória para o de AE. A validade de constructo foi avaliada pela comparação das médias dos escores entre grupos do Center for Disease Control (teste de Mann-whitney) para o AQV, e entre grupos aderentes e não aderentes ao tratamento anti-retroviral para a escala AE e, também, pela análise da correlação entre os escorres de AQV e de AE e marcadores clínicos e de utilização dos serviços de saúde. A reprodutibilidade foi verificada por meio de testes de comparação de médias entre escores em dois momentos (pareado), pelo coeficiente de correlação intra-classe (ricc) e pelo método de Bland-Altman....