Pediatric Asthma Control and Communication Instrument: translation into Portuguese and cross-cultural adaptation for use in Brazil.

OBJECTIVE: To translate the Pediatric Asthma Control and Communication Instrument (PACCI) to Portuguese and adapt it for use in Brazil, ensuring the cultural validity of the content and semantic equivalence of the target version. METHODS: The Brazilian Portuguese-language version of the PACCI was developed according to the most commonly used methodology, which included the following steps: translation; synthesis of the translation; review by the author of the original questionnaire; back-translation; synthesis of the back-translation; review by a native external researcher who is a native speaker of English; approval of the author of the original questionnaire; review by a specialist in Portuguese; review by a multidisciplinary committee of experts to determine the agreement of the items, considering the clarity of each and its appropriateness in the cultural context; cognitive debriefing; and development of the final version. The cognitive debriefing involved 31 parents/legal guardians of children 1-21 years of age with a clinical diagnosis of asthma, as defined by the Global Initiative for Asthma, with the objective of determining the comprehensibility and clarity of the items for the target population. RESULTS: The multidisciplinary committee of experts indicated that the items on the questionnaire were clear and comprehensible, with kappa values above 0.61, indicating substantial agreement. In the cognitive debriefing, the parents/legal guardians presented no difficulties in understanding any of the items (agreement > 0.90); therefore, no further changes were needed. CONCLUSIONS: The translation and cross-cultural adaptation of the PACCI for use in Brazil were successful.

Examining Childhood Obesity From Infancy: The Relationship Between Tummy Time, Infant BMI-z, Weight Gain, and Motor Development-An Exploratory Study.

INTRODUCTION: This exploratory study investigated the infant time spent in tummy time (TT) in relation to body mass index z score (BMI-z), weight gain, and motor development in infants from birth to 4 months. METHOD: Mothers and their infants were telephone surveyed at 2 and 4 months. Mother demographics; TT; feeding practices; and infant length, and height, and development were collected each time. RESULTS: Results from Cochran-Mantel-Haenszel and single logistic regression showed a significant association between development, level of BMI-z, and time spent in TT at 2 months of age (p < .0001). The threshold model showed there was a decline in BMI-z at 4 months as daily time in TT increases past the threshold value of approximately 12 minutes per day. Mother education and TT at 2 months were significant predictors of BMI-z at 4 months. DISCUSSION: Study outcomes suggest that infant positioning and time in TT promote infant motor development and may moderate rapid infant weight gain.

Pediatric Asthma Control and Communication Instrument: translation into Portuguese and cross-cultural adaptation for use in Brazil / Pediatric Asthma Control and Communication Instrument: tradução e adaptação transcultural para a língua portuguesa falada no Brasil

ABSTRACT Objective: To translate the Pediatric Asthma Control and Communication Instrument (PACCI) to Portuguese and adapt it for use in Brazil, ensuring the cultural validity of the content and semantic equivalence of the target version. Methods: The Brazilian Portuguese-language version of the PACCI was developed according to the most commonly used methodology, which included the following steps: translation; synthesis of the translation; review by the author of the original questionnaire; back-translation; synthesis of the back-translation; review by a native external researcher who is a native speaker of English; approval of the author of the original questionnaire; review by a specialist in Portuguese; review by a multidisciplinary committee of experts to determine the agreement of the items, considering the clarity of each and its appropriateness in the cultural context; cognitive debriefing; and development of the final version. The cognitive debriefing involved 31 parents/legal guardians of children 1-21 years of age with a clinical diagnosis of asthma, as defined by the Global Initiative for Asthma, with the objective of determining the comprehensibility and clarity of the items for the target population. Results: The multidisciplinary committee of experts indicated that the items on the questionnaire were clear and comprehensible, with kappa values above 0.61, indicating substantial agreement. In the cognitive debriefing, the parents/legal guardians presented no difficulties in understanding any of the items (agreement > 0.90); therefore, no further changes were needed. Conclusions: The translation and cross-cultural adaptation of the PACCI for use in Brazil were successful.

RESUMO Objetivo: Realizar a tradução e a adaptação transcultural do Pediatric Asthma Control and Communication Instrument (PACCI) para o contexto da população brasileira, e assegurar a validade de conteúdo e equivalência semântica da versão adaptada. Métodos: A versão do PACCI para a língua portuguesa falada no Brasil foi desenvolvida de acordo com a metodologia mais comumente utilizada, que incluiu as seguintes etapas: tradução; síntese da tradução; revisão de um pesquisador nativo de língua inglesa; tradução reversa; síntese da tradução reversa; revisão de um pesquisador nativo de língua inglesa; apreciação do autor do questionário original; revisão por especialista em língua portuguesa; revisão do comitê multiprofissional de especialistas para verificar a concordância dos itens, considerando a clareza e a adequação dos itens ao contexto cultural; desdobramento cognitivo; e desenvolvimento da versão final. O desdobramento cognitivo foi realizado com 31 pais/responsáveis por crianças e adolescentes de 1-21 anos, com diagnóstico clínico de asma de acordo com a Global Initiative for Asthma, com o objetivo de verificar a compreensão e a clareza dos itens na população-alvo. Resultados: O comitê multiprofissional de especialistas indicou que os itens do questionário se apresentaram claros e compreensíveis, com valores de kappa superiores a 0,61, indicando concordância substancial. Considerando o procedimento de desdobramento cognitivo, os pais/responsáveis não apresentaram dificuldades de compreensão (concordância > 0,90) não havendo necessidade de modificações da versão final em português. Conclusões: O PACCI apresenta-se adequadamente traduzido e transculturalmente adaptado para uso na população brasileira.

Parental information and behaviors and provider practices related to tummy time and back to sleep.

INTRODUCTION: This exploratory study aimed to discern parental understanding and behaviors, provider practices, and available online information related to infant positioning including "Back to Sleep" and "Tummy Time" (TT) during early infancy. METHOD: The study employed three methods of exploration: surveys of 119 mothers of newborns, a focus group of nine health care providers, and an analysis of popular parental Web sites. RESULTS: Ninety percent of the mothers reported receiving information about positioning the infant while asleep. However, only 55% mothers postpartum and 26% at 2 months after birth received information regarding infant positioning during awake time. Providers reported barriers such as lack of time and confusing guidelines to TT education. Parenting Web sites were inconsistent regarding TT initiation and duration information. DISCUSSION: Study outcomes suggest that, with the implementation of "Back to Sleep" guidelines, there has been a need for parental education about positioning infants during sleep and awake times.

The effect of hippotherapy on functional outcomes for children with disabilities: a pilot study.

PURPOSE: The purpose of this study was to measure the effect of hippotherapy on functional outcomes using the Goal Attainment Scale (GAS) for children with physical disabilities. METHODS: Participants included 4 children aged 5 to 9 years with physical impairments and/or documented motor delays. Individual measurable objectives were developed using the GAS for each child. Data were collected on each child every other week throughout the baseline and intervention phase over 1 year using a multiple single case experimental A-B design. RESULTS: Three of the 4 children had a significant improvement in functional outcomes based on a standardized T-score formula from the GAS. Two of the 4 children had statistically significant results on the nonparametric binomial test following 6 months of intervention. CONCLUSION: This study represents an initial attempt to use the GAS in a single-case design with a variety of pediatric diagnoses.