Development and cross-cultural validation of the Goal Content for Weight Maintenance Scale (GCWMS).

PURPOSE: Long-term weight management requires sustained engagement with energy-balance-related behaviours. According to self-determination theory, behaviour goals can support or undermine motivation depending on the quality of their content (i.e., extrinsic and intrinsic motivation). This study aimed to develop and validate the goal content for weight loss maintenance scale (GCWMS). METHODS: The GCWMS was administered to 1511 participants who had achieved clinically significant weight losses and were taking part in a large weight loss maintenance study: the NoHoW Trial (ISRCTN88405328). The scale derived from two well-established questionnaires regarding exercise goals. Construct validity was examined for 4 theory-driven domains: Health Management, Challenge, Image, and Social Recognition. Split-sample confirmatory factor analysis was conducted to test the factorial validity and multi-group measurement invariance (configural, metric, scalar, and residual invariance). The reliability estimates were also assessed, and discriminant validity was evaluated using 2 conceptually related questionnaires. RESULTS: The first analysis showed a poor fit of the original factorial structure. Subsequent investigation with a new specified model indicated close fit to the data after removal of 3 items χ2(58) = 599.982; p < .001; χ2/df = 10.345; CFI = 0.940; GFI = 0.941; SRMR = 0.063; RMSEA = 0.079 (LL = 0.073; UL = .084). Good internal consistency was achieved in all subscales (α > .775), convergent and divergent validity were verified through associations with other theoretical related constructs. Findings from multi-group invariance test demonstrated that the specified model of GCWMS achieved full measurement invariance for gender but did not support residual invariance across countries. CONCLUSION: Findings support the hypothesised four-dimension structure of the GCWMS, confirming reliability and multi-group invariance in factor structure. Analysis also supports valid group means comparisons on latent factors at gender and at cross-cultural level. Ways to improve the quality of the scale are discussed. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive.

The role of estradiol metabolism in urogenital schistosomiasis-induced bladder cancer.

Urogenital schistosomiasis is a neglected tropical disease that can lead to bladder cancer. How urogenital schistosomiasis induces carcinogenesis remains unclear, although there is evidence that the human blood fluke Schistosoma haematobium, the infectious agent of urogenital schistosomiasis, releases estradiol-like metabolites. These kind of compounds have been implicated in other cancers. Aiming for enhanced understanding of the pathogenesis of the urogenital schistosomiasis-induced bladder cancer, here we review, interpret, and discuss findings of estradiol-like metabolites detected in both the parasite and in the human urine during urogenital schistosomiasis. Moreover, we predict pathways and enzymes that are involved in the production of these metabolites emphasizing their potential effects on the dysregulation of the tumor suppressor gene p53 expression during urogenital schistosomiasis. Enhanced understanding of these potential carcinogens may not only shed light on urogenital schistosomiasis-induced neoplasia of the bladder, but would also facilitate development of interventions and biomarkers for this and other infection-associated cancers at large.

A Donabedian Model of the Quality of Nursing Care From Nurses' Perspectives in a Portuguese Hospital: A Pilot Study.

BACKGROUND AND PURPOSE: To test a Donabedian model in a pilot study of nurses' perceptions of the quality of nursing care. METHODS: Four methods for detecting the tridimensionality of perception are compared: Cronbach's alpha, Steenbergen's similarity coefficients, the box and whiskers plot (B&W), and the Friedman test. RESULTS: Low alphas suggested multidimensionality; the similarity coefficients indicated confounding between two factors but B&W and the Friedman test (p < .001) suggest nurses perceive more quality in outcome than in process. CONCLUSIONS: The similarity coefficients are preferable to Cronbach's alpha for estimating internal consistency and for detecting multidimensionality. B&W suggests the factors confounded using Steenbergen's method occupy different levels of perception, suggesting tridimensionality. The homogeneous social group is largely responsible for the apparently contradictory results obtained from statistical analysis.

Toxicodependência e maternidade: uma revisão de literatura / Drug addiction and maternity: a literature review / Drogodependencia y maternidad: una revisión de literatura

Pretende fazer-se uma revisão da literatura acerca da parentalidade de mães toxicodependentes, abordando as 1) consequências da toxicodependência na maternidade e 2) as condições ambientais e contextuais dos pais toxicodependentes, e suas famílias de origem. A literatura atual aponta para um comportamento parental perturbado das mães toxicodependentes, embora saliente a importância da gravidez e maternidade como fator predisponente ao início de um tratamento e recuperação. São referidos efeitos disruptivos na saúde, nascimento e desenvolvimento pós-natal das crianças, na qualidade do vínculo e da interação mãe-filho, bem como repercussões que se refletem na inadequação de cuidados maternais e risco aumentado de negligência e abuso. A investigação focaliza a atenção em algumas áreas específicas do comportamento parental, verificando-se lacunas e resultados nem sempre consistentes, falta de estudos contemplando a relação direta entre abuso de substâncias e disfunções familiares e da parentalidade, bem como a experiência e dificuldades inerentes à parentalidade nesta situação de risco. É feita uma análise da investigação atual e fornecidas algumas diretrizes para futuras investigações.

This article is a literature review on parenting of drug addicted mothers, addressing 1) the consequences of drug abuse in maternity and 2) the environmental conditions of drug addicted parents, and their families of origin. The current literature points to a disturbed parental behaviour of drug addicted mothers, although it stresses the importance of pregnancy and maternity as a predisposing factor to the beginning of a recovery treatment. Authors refer disruptive effects on health, birth and post-natal children development, on attachment quality and on mother-child interaction, as well as inadequate maternal care and high risk of abuse and negligence. The research focuses attention on specific areas of parental behavior, in which we can find gaps and incoeherences, characterized by the lack of studies covering the direct link between substance abuse and family dysfunction and parenting, as well as the experience and difficulties of parenting in the situation of risk that is drug addiction. We make an analysis of the current investigation and suggest some guidelines for future research.

El objetivo de la investigación es elaborar una revisión de la literatura sobre la parentalidad de las madres drogodependientes abordando las 1) consecuencias de la drogodependencia en la maternidad y 2) las condiciones ambientales y contextuales de los padres drogodependientes, y sus familias de origen. La literatura actual se orienta hacia un comportamiento parental perturbado de las madres drogodependientes, aunque realce la importancia del embarazo y maternidad como factor predisponente al inicio de un tratamiento y recuperación. Se refieren efectos disruptivos en la salud, nacimiento y desarrollo de los recién nacidos en el puerperio, en la calidad del vínculo e interacción madre-hijo, así como repercusiones que se reflejan en la inadecuación de los cuidados maternales y riesgo incrementado de negligencia y abuso. La investigación se focaliza en algunas áreas específicas del comportamiento parental, verificándose fallos y resultados que no son siempre consistentes, falta de estudios que reflejen la relación directa entre el abuso de substancias y disfunciones familiares y de la parentalidad, así como la experiencia y dificultades inherentes a la parentalidad en esta situación de riesgo. Se hace un análisis de la investigación actual y se facilitan algunas directrices para futuras investigaciones.

Schistosome and liver fluke derived catechol-estrogens and helminth associated cancers.

Infection with helminth parasites remains a persistent public health problem in developing countries. Three of these pathogens, the liver flukes Clonorchis sinensis, Opisthorchis viverrini and the blood fluke Schistosoma haematobium, are of particular concern due to their classification as Group 1 carcinogens: infection with these worms is carcinogenic. Using liquid chromatography-mass spectrometry (LC-MS/MS) approaches, we identified steroid hormone like (e.g., oxysterol-like, catechol estrogen quinone-like, etc.) metabolites and related DNA-adducts, apparently of parasite origin, in developmental stages including eggs of S. haematobium, in urine of people with urogenital schistosomiasis, and in the adult stage of O. viverrini. Since these kinds of sterol derivatives are metabolized to active quinones that can modify DNA, which in other contexts can lead to breast and other cancers, helminth parasite associated sterols might induce tumor-like phenotypes in the target cells susceptible to helminth parasite associated cancers, i.e., urothelial cells of the bladder in the case of urogenital schistosomiasis and the bile duct epithelia or cholangiocytes, in the case of O. viverrini and C. sinensis. Indeed we postulate that helminth induced cancers originate from parasite estrogen-host epithelial/urothelial cell chromosomal DNA adducts, and here we review recent findings that support this conjecture.