Care to the dependent older person: motivations of caregivers in Brazil and Portugal / O cuidado ao idoso dependente: motivações de cuidadores do Brasil e Portugal / Cuidando a los dependientes mayores: motivaciones de cuidadores en Brasil y Portugal

In an attempt to fulfill care needs to the elderly, the family usually assumes this function. In order to understand the social representations of informal caregivers of Brazilian and Portuguese elderly people about the motivations for care, a qualitative, exploratory-descriptive research was carried out, based on the Social Representations Theory, in which 21 informal Brazilian caregivers and 11 informal Portuguese caregivers of elderly dependents were interviewed. Thematic Content Analysis and QSR NVivo® software were used in the treatment of the data, and the results showed care as the main motivation: family relationships, in which marriage, parenting, and the affections resulting from these relationships led to the function; the negative representation of Portuguese caregivers on the home, as a place of abandonment and action contrary to the cultural norm; and the representation of the elderly as frail and dependent, who, like children, constantly need care and attention.

Na tentativa de suprir as necessidades de cuidado destinado ao idoso, a família comumente é a instituição que assume tal função. Com o objetivo de compreender as representações sociais dos cuidadores informais de idosos brasileiros e portugueses acerca das motivações para o cuidado, realizou-se uma pesquisa qualitativa, exploratória e descritiva, fundamentada na Teoria das Representações Sociais, em que foram entrevistados 21 cuidadores informais brasileiros e 11 cuidadores informais portugueses de idosos dependentes. Utilizaram-se a análise de conteúdo temática e o software QSR NVivo® no tratamento dos dados, e os resultados evidenciaram como principais motivações o cuidado: as relações familiares, em que o matrimônio, a parentalidade e os afetos decorrentes dessas relações conduziram a função; a representação negativa dos cuidadores portugueses sobre o lar como local de abandono e ação contrária à norma cultural; e a representação da pessoa idosa como frágil e dependente, que, assim como as crianças, precisa constantemente de cuidados e atenção.

En un intento por atender las necesidades de cuidado de las personas mayores, la familia suele ser la institución que asume esta función. Para comprender las representaciones sociales de los cuidadores informales de ancianos brasileños y portugueses sobre las motivaciones del cuidado, se realizó una investigación cualitativa, exploratoria-descriptiva, basada en la Teoría de las Representaciones Sociales, en la que 21 cuidadores informales brasileños y 11 informales portugueses Se entrevistó a los cuidadores de ancianos dependientes. En el tratamiento de los datos se utilizó el software de Análisis de Contenido Temático y QSR NVivo® y los resultados se mostraron como las principales motivaciones: las relaciones familiares, en las que el matrimonio, la paternidad y los afectos resultantes de estas relaciones condujeron a la función; la representación negativa de los cuidadores portugueses en el hogar, como lugar de abandono y acción contraria a la norma cultural; y la representación de los ancianos como frágiles y dependientes, quienes, como los niños, necesitan cuidados y atenciones constantes.

A green method for determination of ethanol in homeopathic medicines using thermal infrared enthalpimetry.

In this work, a simple and fast method is proposed for the determination of ethanol in homeopathic medicines using thermal infrared enthalpimetry (TIE). Samples containing alcohol in a wide concentration range (from 5% to 95% v/v) were used. Purified water or absolute ethanol was added directly into homeopathic medicine and increase of temperature was monitored using an infrared camera. Total volume, stirring speed and dispensing rate of solutions were the most significant parameters studied for method optimization. A response surface methodology (RSM) was used for optimization of the experimental conditions. The method was validated in the following parameters: selectivity, linearity, linear range, precision (repeatability and intermediate precision), limit of detection and quantification, accuracy and robustness. Linear range was obtained from 4% to 55% (ethanol, v/v). The proposed method showed accuracy in agreement with the conventional one. The proposed method it was demonstrated a good alternative for determination of ethanol in homeopathic medicines, presenting low cost, fast analysis and agreement with the principles of green analytical chemistry.

Green and fast determination of the alcoholic content of wines using thermal infrared enthalpimetry.

An innovative use of thermal infrared enthalpimetry (TIE) is proposed for the determination of alcoholic content of red and white wines. Notwithstanding the presence of ethanol in beverages, absolute ethanol was added directly to wines, and the temperature rise caused by the heat of dilution was monitored using an infrared camera. Analytical signals were obtained in only 10 s for four samples simultaneously, and a calibration curve was constructed with hydroalcoholic reference solutions. A linear calibration curve was obtained from 3.0 to 18.0% (v/v) ethanol (R2 = 0.9987). The results showed agreement ranging from 98.2 to 104.0% with 942.06 and 969.12 methods of AOAC. Organic compounds (e.g., sugar) did not interfere in the determinations. The proposed method provided fast results, with a throughput of 480 samples per hour and negligible energy consumption (0.001 kWh). In addition, the consumption of reagents was reduced when compared with conventional method fulfilling green analytical chemistry requirements.

One-Shot, reagent-free determination of the alcoholic content of distilled beverages by thermal infrared enthalpimetry.

A simple and fast method is proposed for determining the alcoholic content of distilled beverages by thermal infrared enthalpimetry (TIE), in which purified water is added directly and the temperature rise caused by the heat of dilution is monitored using an infrared camera. A calibration curve was constructed with hydroalcoholic reference solutions to determine the alcoholic content of vodka, whisky, and cachaça. The influence of the total volume of solutions in the reactor, the stirring speed, the dispensing rate, and the ratio between hydroalcoholic samples and water were evaluated to reach an optimum mixture and provide low variation among measurements. Optimized conditions for those respective parameters were 2.4mL, 200rpm, 0.57mLs-1, and 1:1. To evaluate the accuracy, alcoholic content was also determined by a conventional method (AOAC method 942.06, pycnometry), with agreement ranging from 99.4% to 100.9%. No sample preparation (e.g., dilution or distillation) was required with the proposed method, decreasing the time required for analysis by at least one order of magnitude. The proposed method required less energy consumption by a factor of about three thousand in comparison with the conventional method. The proposed TIE method was robust, able to determine the alcoholic content of diverse distilled beverages. Due to these features and the high sample throughput (up to 480 samples per hour), the proposed method could be considered suitable for routine analysis and agrees with the principles of green analytical chemistry.

Physical violence between intimate partners during pregnancy and postpartum: a prediction model for use in primary health care facilities.

This article offers a simple predictive model of physical intimate partner violence (PIPV) to be used by primary health care (PHC) professionals. The sample comprised 811 mothers of children <5 months old attending PHC facilities in Rio de Janeiro, Brazil. A multinomial logit model was used. Measured by the Revised Conflict Tactics Scales, PIPV was classified in three levels (absence, at least one episode during pregnancy or postpartum, and presence in both periods). Socio-economic, demographic and life style variables were considered as potential predictors. Maternal age <20 years, an education of <8 years of schooling, raising >2 children under 5, tobacco smoking, alcohol misuse and illicit drug use by the mother and/or partner, and perception of baby's ill-health were identified as predictors of PIPV. The model-projected prevalence of PIPV for pregnancy and/or postpartum was just 10.1% in the absence of these characteristics, whereas this increased to 96.4% when all the seven characteristics were present. Child, maternal and family characteristics greatly increase the likelihood of PIPV and could be used together as screening indicators.

Severe physical violence between intimate partners during pregnancy: a risk factor for early cessation of exclusive breast-feeding.

OBJECTIVE: To investigate the role of severe physical violence during pregnancy (SPVP) between intimate partners in early cessation of exclusive breast-feeding (EBF). DESIGN: A health services survey. The revised Conflict Tactics Scale was used to characterize SPVP; premature breast-feeding cessation was identified using a current status data approach, which was based on the information reported from food recall during the preceding 7 d. The cumulative hazard function was estimated by complementary log-log transformation models, which allowed the ensuing estimation of early breast-feeding cessation rates in different age groups and the ratio of rates of weaning between women exposed and not exposed to violence. SETTING: Five large public primary health-care facilities of Rio de Janeiro, Brazil. SUBJECTS: The sample comprised 811 randomly selected mothers of children under 5 months of age who were waiting to be consulted. RESULTS: SPVP is an independent risk factor of cessation of EBF since, after controlling for socio-economic, demographic, reproductive and lifestyle variables, women exposed to violence presented an incidence density that was 31% higher than those who were not exposed (hazard ratio = 1·30, 95% CI 1·01, 1·69). CONCLUSIONS: The findings corroborate the hypothesis that SPVP is an important risk factor for EBF. This indicates the need for incentives to adequately train health-care personnel in dealing with lactating women in order to gain a broader view of breast-feeding beyond the biological aspects of lactation, including the maternal psychological dimension.

Revisiting the dimensional structure of the Edinburgh Postnatal Depression Scale (EPDS): empirical evidence for a general factor.

BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS) has been proposed as a one-dimensional instrument and used as a single 10-item scale. This might be considered questionable since repeated psychometric studies have shown multi-dimensionality, which would entail using separate component subscales. This study reappraised the dimensional structure of the EPDS, with a focus on the extent of factor correlations and related factor-based discriminant validity as a foundation for deciding how to effectively scale the component items. METHODS: The sample comprised 811 randomly selected mothers of children up to 5 months attending primary health services of Rio de Janeiro, Brazil. Strict Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis modeled within a CFA framework (E/CFA) were sequentially used to identify best fitting and parsimonious model(s), including a bifactor analysis to evaluate the existence of a general factor. Properties concerning the related 10-item raw-score scale were also investigated using non-parametric items response theory methods (scalability and monotonicity). RESULTS: An initial CFA rejected the one-dimensional structure, while an E/CFA subscribed a three-dimensional solution. Yet, factors were highly correlated (0.66, 0.75 and 0.82). The ensuing CFA showed poor discriminant validity (some square-roots of average variance extracted below the factor correlations). A general bifactor CFA was then fit. Results suggested that, although still weakly encompassing three specific factors, the EPDS might be better described by a model encompassing a general factor (loadings ranging from 0.51 to 0.81). The related 10-item raw score showed adequate scalability (Loevinger's H coefficient = 0.4208), monotonicity e partial double monotonicity (nonintersections of Item Step Response Functions). CONCLUSION: Although the EPDS indicated the presence of specific factors, they do not qualify as independent dimensions if used separately and should therefore not be used empirically as sub-scales (raw scores). An all-encompassing scale seems better suited and continuing its use in clinical practice and applied research should be encouraged.