Exploring the osteogenic potential of semisynthetic triterpenes from Combretum leprosum: An in vitro and in silico study.

Combretum leprosum Mart. is a plant of the Combretaceae family, widely distributed in the Northeast region of Brazil, popularly used as an anti-inflammatory agent, and rich in triterpenes. This study evaluated in vitro and in silico potential osteogenic of two semisynthetic triterpenes (CL-P2 and CL-P2A) obtained from the pentacyclic triterpene 3ß,6ß,16ß-trihydroxylup-20(29)-ene (CL-1) isolated from C. leprosum. Assays were carried out in cultured murine osteoblasts (OFCOL II), first investigating the possible toxicity of the compounds on these cells through viability assays (MTT). Cell proliferation and activation were investigated by immunohistochemical evaluation of Ki-67, bone alkaline phosphatase (ALP) activity, and mineralization test by Von Kossa. Molecular docking analysis was performed to predict the binding affinity of CL-P2 and CL-P2A to target proteins involved in the regulation of osteogenesis, including: bone morphogenetic protein 2 (BMP-2), proteins related to Wingless-related integration (WNT) pathway (Low-density lipoprotein receptor-related protein 6-LRP6 and sclerostin-SOST), and receptor activator of nuclear factor (NF)-kB-ligand (RANK-L). Next, Western Blot and immunofluorescence investigated BMP-2, WNT, RANK-L, and OPG protein expressions in cultured murine osteoblasts (OFCOL II). None of the CL-P2 and CL-P2A concentrations were toxic to osteoblasts. Increased cell proliferation, ALP activity, and bone mineralization were observed. Molecular docking assays demonstrated interactions with BMP-2, LRP6, SOST, and RANK-L/OPG. There was observed increased expression of BMP-2, WNT, and RANK-L/OPG proteins. These results suggest, for the first time, the osteogenic potential of CL-P2 and CL-P2A.

Polysacharide of Agaricus blazei gel mitigates bone necrosis in model of the jaws related to bisphosphonate via Wnt signaling.

To investigate de effect of PAb gel on the bone tissue of rats submitted to Bisphosphonate-related osteonecrosis of the jaws (BRONJ). Initially, 54 animals were submitted to BRONJ model by Zoledronic Acid (ZA) (0.1 mg/kg 3x/wk for 9 wk, ip), followed by the 1st upper left molar extraction at the 8th wk. After tooth removal, the animals were divided into 3 groups, ZA that received placebo gel or PAb gel that received 1% PAb gel, inside the dental alveolus. The control Group (CONTROL) received 0.1 mg/kg of 0.9% saline and then placebo gel. Three weeks after tooth extraction, the animals were euthanized, and maxillae were colleted for macroscopic, radiographic, histological and Raman spectomery assays. Additionally, GSK3b, beta-catenin, and Runx2 mRNA expressions were determined. Blood samples were collected for the analysis of Bone-specific alkaline phosphatase (BALP) levels. PAb gel improved mucosal healing, increased the number of viable osteocytes, while it reduced the number of empty lacunae, as well as the amount of bone sequestration. Furthermore, PAb gel positively influenced the number and functionality of osteoblasts by stimulating Wnt signaling, thereby inducing bone remodeling. Additionally, PAb gel contributed to improved bone quality, as evidenced by an increase in bone mineral content, a decrease in bone solubility, and an enhancement in the quality of collagen, particularly type I collagen. PAb gel mitigated bone necrosis by stimulating of bone remodeling through Wnt signaling and concurrently improved bone quality. PAb gel emerges as a promising pharmacological tool for aiding in BRONJ therapy or potentially preventing the development of BRONJ.

The Neonatal Palliative Care Attitude Scale: Psychometric properties for Portuguese neonatal nurses.

BACKGROUND: This study is aimed to perform the translation and cultural adaptation of the Neonatal Palliative Care Attitude Scale (NiPCAS) and evaluation of its psychometric properties with Portuguese neonatal nurses. METHODS: The research started with a scoping review that allowed the identification of the NiPCAS. It was a methodological study with a quantitative approach. The semantic equivalence of the items was adjusted with the participation of 20 neonatal nurse experts. They performed facial and quantitative content validation. Psychometric validation of the NiPCAS was performed on a nonprobability nurses sample (n = 283) in 13 level 3 neonatal units between July 2021 and February 2022. Confirmatory factor analysis using the polychoric correlation matrix was performed to estimate factor validity using the "lavaan" package for R statistical software. Internal consistency was estimated using Cronbach's alpha coefficient, and item sensitivity was assessed using the asymmetry and kurtosis coefficients. Empirical indices were considered: chi-square over degrees of freedom; comparative fit index; normed fit index; Tucker-Lewis index, and root mean square error of approximation; average extracted variance and composite reliability were used to assess convergent validity. RESULTS: Asymmetry and kurtosis were <|3| and <|7|, respectively, suggesting psychometric sensitivity. The convergent validity of the factors was: F1, FCF1 = 0.90 and for F2, FCF2 = 0.80, and a lower value for F3, FCF3 = 0.40. According to the squared correlation criterion average variance extracted (AVE) between the factors, there was no discriminant validity for F1 and F2, but there was discriminant validity for F1, F3, F2, and F3. SIGNIFICANCE OF RESULTS: This instrument has implications for providing end-of-life care to newborns and their families. The use of this instrument reveals several barriers and facilitating elements inherent in the organization and culture of the facility and nursing education.

Tidal variability of water quality parameters in a mesotidal estuary (Sado Estuary, Portugal).

To establish effective water quality monitoring strategies in estuaries, it is imperative to identify and understand the main drivers for the variation of water quality parameters. The tidal effect is an important factor of the daily and fortnightly variability in several estuaries. However, the extent of that influence on the different physicochemical and biological parameters is still overlooked in some estuarine systems, such as the Sado Estuary, a mesotidal estuary located on the west coast of Portugal. The main objective of this study was to determine how the water quality parameters of the Sado Estuary varied with the fortnightly and the semidiurnal tidal variation. To achieve this goal, sampling campaigns were conducted in May/18, Nov/18 and Jun/19, under neap and spring tidal conditions, with data collection over the tidal cycle. Results were observed to be significantly influenced by the tidal variation, in a large area of the estuary. Flood seemed to mitigate possible effects of nutrient enrichment in the water column. Additionally, significant differences were also observed when considering the different sampling stations. Temperature, Suspended Particulate Matter (SPM) and nutrients showed the highest values at low water. Lastly, the implications of the tidal variability in the evaluation of the water quality according to Water Framework Directive were also discussed, highlighting the importance of studying short-time scale variations and the worst-case scenario to ensure water quality is maintained. These findings are relevant for the implementation of regional management plans and to promote sustainable development.

Escala de evaluación del estrés parental en la Unidad de Neonatología: validación estadística para la población portuguesa / Parental stress scale in the neonatology unit: Statistical validation for the portuguese population

Objetivo: Realizar la traducción, adaptación cultural y lingüística y la valoración de las cualidades psicométricas de la Escala de Evaluación de Estrés Parental en la Unidad de Neonatología - versión modificada. Método: Estudio metodológico con enfoque cuantitativo, para validar la Escala de Evaluación de Estrés Parental en la Unidad de Neonatología. Los padres fueron seleccionados por muestreo no aleatorio (n= 406 padres). En la estimación de la sensibilidad, validez y confiabilidad de la Escala de Evaluación de Estrés Parental en Neonatología se utilizó estadística descriptiva, alfa de Cronbach estandarizado y análisis factorial confirmatorio (índices de calidad del ajuste del modelo χ2 / df, CFI, TLI, RMSEA, P (RMSEA). Resultados: Los índices empíricos de la calidad del ajuste del modelo factorial EASPUN-VM, presentan una calidad acepTable (χ2 / gl = 3.3; CFI = 0.8; GFI = 0.8; TLI = 0.8 y PRMSEA = 0,07). Conclusión: La Escala de Evaluación de Estrés Parental en la Unidad de Neonatología - versión modificada es un instrumento psicométricamente sensible, válido y confiable que permitirá la evaluación sistemática del estrés parental, cuando los niños ingresan en las unidades de Neonatología, facilita la toma de decisiones de enfermeras en el seguimiento de los padres y derivación a otros profesionales de la salud. (AU)

Quality of life and therapeutic regimen management in onychomycosis patients and in vitro study of antiseptic solutions.

Onychomycosis or tinea unguium (EE12.1) and Onychomycosis due to non-dermatophyte moulds (1F2D.5) (OM) is a fungal infection of the nail plates with a high prevalence that often affects vulnerable people with co-existing health problems. Gold standard pharmacological treatments for onychomycosis have been associated with low success rates and increasing antifungal resistance, suggesting that treatment outcome is dependent on multiple variables. Here, the prevalence of OM and quality of life were characterized in two vulnerable populations-Hospital patients and Homeless people. Comparing both groups, the most prevalent fungal species were identified in Hospital patients. Then, the in vitro fungicidal properties of the antiseptics povidone-iodine, polyhexamethylene biguanide-betaine, octenidine dihydrochloride, and a super-oxidized solution against two ATCC strains (Candida albicans and Aspergillus niger) and three clinical fungal isolates from Hospital patients (Candida parapsilosis, Trichophyton interdigitale, and Trichophyton rubrum) were tested. OM prevalence was high in both patient groups studied, who also reported a reduction in quality of life and concerns about the state of their feet. In addition, Hospital patients had a non-negligent therapeutic regimen management style. Antiseptics tested in vitro revealed antifungal properties. As antiseptics are low-cost and easy to apply and have few iatrogenic effects, the demonstration of fungicidal properties of these solutions suggests that they may constitute potential supportive therapeutics for OM.

The effect of high concentration of zoledronic acid on tooth induced movement and its repercussion on root, periodontal ligament and alveolar bone tissues in rats.

Zoledronic acid (ZA) is often prescribed for osteoporosis or resorptive metabolic bone disease. This study aims to evaluate the effect of ZA on orthodontic tooth movement (OTM) and root and bone resorption and its repercussion on root, periodontal ligament and alveolar bone tissues. The experimental group consisted of 72 Wistar rats divided in four subgroups: Naive, Saline and Zoledronic Acid groups at the concentration of 0.2 mg/kg [ZA (0.2)] or 1.0 mg/kg [ZA (1.0)]. The animals were subjected to i.v (dorsal penile vein) administrations of ZA or saline solution, on days 0, 7, 14 and 42. Under anesthesia, NiTi springs were installed in the first left maxillary molar with 50gf allowing the OTM, except for the negative control group (N) for mesial movement of the left first maxillary teeth. The animals were sacrificed and maxillae were removed for macroscopic and histopathological analyzes, scanning electron microscopy, computerized microtomography and confocal microscopy. Treatment with ZA decreased the OTM and the number of osteoclasts and loss of alveolar bone when compared to the naive and saline groups. Reduction of radicular resorption, increased necrotic areas and reduced vascularization in the periodontal ligament were observed in the ZA groups. ZA interferes with OTM and presents anti-resorptive effects on bone and dental tissues associated with a decreased vascularization, without osteonecrosis.

Bisphosphonate-related osteonecrosis induced change in alveolar bone architecture in rats with participation of Wnt signaling.

OBJECTIVE: This work aimed to study the role of inflammation in medication-related osteonecrosis of the jaw (MRONJ) in rats with focus on Wnt signaling. METHODS: A total of 36 female Wistar rats (12 weeks ± 200 g) were divided into 2 groups (n = 6) in 3 experiments: saline (SAL) and zoledronic acid (ZOL). For MRONJ induction, rats received 0.1 mg/kg of ZOL (ip) 3×/week for 9 weeks. Animals from the SAL group received 0.1 mg/kg of 0.9% SAL, ip 3×/week for 9 weeks. On the 8th week, 3 left upper molars were extracted, and on the 11th week, they were euthanized. Maxillae were evaluated by macroscopic and histopathological analyses; scanning electron microscopy (SEM); immunohistochemistry for DKK-1, Wnt 10b, and caspase-3; and Raman spectrometry. Gingiva was also collected for TNF-α e IL-1ß quantification. RESULTS: Bone necrosis was confirmed by healing impairment, reduced number of viable osteocytes, increased caspase-3 immunoexpression, and increased number of empty lacunae (p < 0.05). ZOL enhanced inflammation and increased gingival levels of IL-1ß and TNF-α (p < 0.05). Irregular indentations were seen on bone after ZOL administration. Bone necrosis was marked by reduced amount of total and type I collagen. ZOL reduced the mineral/matrix ratio and increased carbonate/phosphate ratio. It was observed a significant reduction on Wnt10b and beta-catenin immunolabeling in the bone tissue of ZOL group. CONCLUSION: In summary, MRONJ model caused bone necrosis due to intense inflammation. Wnt signaling seems to play an important role in this process. CLINICAL RELEVANCE: New therapeutic strategies focusing on Wnt pathway can provide an interesting approach for future treatments.

DISABKIDS® in Brazil: advances and future perspectives for the production of scientific knowledge.

OBJECTIVE: to map the Brazilian scientific production related to the stages of the methodological process for the use of DISABKIDS® instruments and/or forms adapted to Brazil. METHOD: scoping review, with searches conducted on10 electronic databases, plus Google Scholar and contacts with researchers, without restriction of period or language. RESULTS: the mapping identified 90 scientific studies involving 46 instruments. Of these, 11 (23.9%) included the elaboration and/or cultural adaptation of the DISABKIDS® instruments to measure the Quality of Life of children or adolescents with chronic conditions and 35 (76.1%) used the Generic Measures and/or Specific Modules for the semantic validation of other instruments. CONCLUSION: this scoping review allowed a comprehensive evaluation of the use of the DISABKIDS® instrument and forms, in relation to the validation of the instrument adapted to Brazil, presenting a positive advance in the scenario with the development of academic/scientific projects in the country, incorporating the method recommended by the literature for the elaboration, cultural adaptation and validation of instruments and for the systematized and standardized recording of the perception and understanding of the target population about the measure of interest, using DISABKIDS® forms adapted for this purpose.

Domínios ético e espiritual da Dor do existir no contexto familiar de crianças com câncer: uma revisão integrativa / Ethical and spiritual domains of pain of existing in the family context of children with cancer: an integrative review / Domínios ético e espiritual da Dor do existir no contexto familiar de crianças com câncer: uma revisão integrativa Ethical and spirituDominios éticos y espirituales del dolor existente en el contexto familiar de niños con cáncer: una revisión integradora

Objetivou-se investigar as dimensões da dor da morte em famílias de crianças com câncer. Utilizou-se o método da revisão integrativa a partir da consulta, limitada ao período de 2005 a 2019, nas bases de dados LILACS, MEDLINE, PSYCINFO, SocINDEX, Academic Search Premier e CINAHL com os DeCS ou MeSH: "morte"/"atitude frente à morte", "neoplasia"/"câncer, "criança" e "família". Foram selecionados 06 artigos na íntegra não replicados, os quais correspondiam à questão pesquisada. De acordo com leitura e análise dos artigos foram encontradas as seguintes dimensões associadas à dor frente à morte/luto por câncer infantil: éticas e espirituais. Os estudos revisados evidenciaram que, a dor \da morte pode levar a refletirmos sobre a qualidade do adoecer e morrer com câncer na família, bem como, ensinar-nos caminhos metafísicos como recursos para suportarmos a dor da perda e seguirmos em frente. Portanto, esta revisão abre espaço para as necessidades destas dimensões serem mais exploradas, principalmente em comunicação do diagnóstico terminal; o espaço de espiritualidade nos locais de saúde e qualificação do manejo da dor de morte no luto, pois, tais conhecimentos poderiam ser ferramenta para facilitar o manejo da dor frente a perda de um ente querido pelo câncer infantil.(AU)

This study aimed to investigate the dimensions of pain of death in families of children with cancer. The integrative review method from the consultation, limited to the period from 2005 to 2019, was used in the LILACS, MEDLINE, PSYCINFO, SocINDEX, Academic Search Premier and CINAHL databases with DeCS or MeSH: "death" / "attitude death "," neoplasia"/" cancer, "child" and "family". We selected 06 unreplicated full articles, which corresponded to the researched question. According to reading and analysis of the articles, the following dimensions associated with pain in the face of death / grief for childhood cancer were found ethical and spiritual. The reviewed studies have shown that the pain of death can lead us to reflect on the quality of falling ill and dying with cancer in the family, as well as to teach us metaphysical ways as resources to support the pain of loss and move on. Therefore, this review makes room for the needs of these dimensions to be further explored, especially in terminal diagnosis communication; the space of spirituality in health care and the qualification of the management of pain of death in mourning, as such knowledge could be a tool to facilitate the management of pain in the face of the loss of a loved one by childhood cancer.(AU)

Este estudio tuvo como objetivo investigar las dimensiones del dolor de la muerte en familias de niños con cáncer. El método de revisión integral de la consulta, limitado al período de 2005 a 2019, se utilizó en las bases de datos LILACS, MEDLINE, PSYCINFO, SocINDEX, Academic Search Premier y CINAHL con DeCS o MeSH: actitud de "muerte"/ " muerte "," neoplasia"/" cáncer "," niño "y" familia ". Seleccionamos 06 artículos completos no replicados, que correspondían a la pregunta investigada. De acuerdo con la lectura y el análisis de los artículos, se encontraron las siguientes dimensiones asociadas con el dolor frente a la muerte/ dolor por cáncer infantil: ético y espiritual. Los estudios revisados han demostrado que el dolor de la muerte puede llevarnos a reflexionar sobre la calidad de enfermar y morir de cáncer en la familia, así como a enseñarnos formas metafísicas como recursos para soportar el dolor de la pérdida y seguir adelante. Por lo tanto, esta revisión deja espacio para explorar más a fondo las necesidades de estas dimensiones, especialmente en la comunicación de diagnóstico terminal; El espacio de la espiritualidad en el cuidado de la salud y la calificación del manejo del dolor de la muerte en el duelo, como tal conocimiento podría ser una herramienta para facilitar el manejo del dolor frente a la pérdida de un ser querido por cáncer infantil.(AU)

Experiências de parentalidade: as respostas dos pais ao stress na unidade de cuidados neonatais / Parenting experiences: parents' responses to stress in the neonatal care unit

O internamento do recém-nascido na Unidade de Cuidados Neonatais é uma fonte de stress para os pais devido ao ambiente agressivo e à fragilidade do seu filho, mas também devido à dificuldade em estabelecer e desenvolver processos de vinculação. Sabendo que os pais desempenham um papel decisivo no desenvolvimento do seu filho e que necessitam de apoio para compreender este papel, é importante que os profissionais de saúde, nomeadamente os enfermeiros, reconheçam os fatores protetores e stressors associados às experiências vividas pelos pais, de modo a prestar cuidados holísticos, não-traumáticos, promotores do desenvolvimento e centrados na família. Este Relatório é o produto da aprendizagem experiencial e formação reflexiva obtida com as experiências nos diversos contextos de estágio, onde, através das atividades desenvolvidas e da concretização dos objetivos delineados, se adquiriram contributos para o desenvolvimento das competências que compõem o perfil do Enfermeiro Especialista, do Enfermeiro Especialista em Enfermagem de Saúde Infantil e Pediátrica e de Mestre em Enfermagem. Sustenta-se na filosofia dos Cuidados Centrados na Família e, na perspetiva de compreender como os stressors influenciam o equilíbrio do Sistema-Família, apoia-se no Modelo dos Sistemas de Neuman. A realização do estudo de investigação denominado Experiências de Parentalidade. As respostas dos pais ao stress na Unidade de Cuidados Neonatais, começou com a tradução, validação e adaptação da escala Neonatal Parental Stress (NUPS) para a população portuguesa, no sentido de uniformizar a avaliação do stress parental, as intervenções promotoras da parentalidade e, assim, dar uma maior consistência aos cuidados de enfermagem e uma maior visibilidade dos mesmos. Estas atividades contribuíram para a disseminação do conhecimento e a sua translação para a prática, promovendo o desenvolvimento de competências e a mobilização de recursos para resolver novas situações no contexto de trabalho através da capacidade para analisar, tomar decisões e agir.

The newborns' hospitalization in the Neonatal Care Unit can be a source of stress for their parents. These face a multitude of stressful experiences due to the aggressive environment and the fragility of the newborn, but also due to their difficulty in making the transition to parenting. Knowing that parents play a decisive role in the baby's development and that they need support to understand this role, it is important that health professionals, namely nurses, recognize the protective factors and stressors associated with the parents' experiences to provide holistic, non-traumatic, developmental and family-centered care.This Report is the product of experiential learning and reflective training, obtained through experiences in the different internship contexts, where, through the activities developed and the achievement of the objectives outlined, contributions were acquired for the development of the skills that make up the profile of the Specialist Nurse, and the Specialist Nurse in Child and Pediatric Health Nursing, and the profile of Master in Nursing. It was built following the philosophy Family Centered Care and the Neuman Systems Model was selected in the perspective of understanding how stressors influence the Family-System balance. The research study called Parenting Experiences. Parents' responses to stress in the Neonatal Care Unit began with the translation, validation and adaptation of the Neonatal Parental Stress scale (NUPS) for the Portuguese population, in order to standardize the assessment of parental stress, interventions that promote parenting and, thus, giving greater consistency to nursing care and greater visibility of them. These activities contributed to the dissemination of knowledge and its translation into practice, promoting the development of skills and the mobilization of resources to solve new situations in the work context through the ability to analyze, make decisions and take action.

DISABKIDS® in Brazil: advances and future perspectives for the production of scientific knowledge / DISABKIDS® no Brasil: avanços e perspectivas futuras na produção do conhecimento científico / DISABKIDS® en Brasil: avances y perspectivas futuras en la producción del conocimiento científico

Objective: to map the Brazilian scientific production related to the stages of the methodological process for the use of DISABKIDS® instruments and/or forms adapted to Brazil. Method: scoping review, with searches conducted on10 electronic databases, plus Google Scholar and contacts with researchers, without restriction of period or language. Results: the mapping identified 90 scientific studies involving 46 instruments. Of these, 11 (23.9%) included the elaboration and/or cultural adaptation of the DISABKIDS® instruments to measure the Quality of Life of children or adolescents with chronic conditions and 35 (76.1%) used the Generic Measures and/or Specific Modules for the semantic validation of other instruments. Conclusion: this scoping review allowed a comprehensive evaluation of the use of the DISABKIDS® instrument and forms, in relation to the validation of the instrument adapted to Brazil, presenting a positive advance in the scenario with the development of academic/scientific projects in the country, incorporating the method recommended by the literature for the elaboration, cultural adaptation and validation of instruments and for the systematized and standardized recording of the perception and understanding of the target population about the measure of interest, using DISABKIDS® forms adapted for this purpose.

Objetivo: mapear a produção científica brasileira que versa sobre as fases do processo metodológico para a utilização dos instrumentos e/ou formulários DISABKIDS® adaptados para o Brasil. Método: scoping review realizada através da busca em 10 bases de dados eletrônicas, no Google Scholar e por meio de consulta à pesquisadores, sem restrição de período ou idioma. Resultados: o mapeamento identificou 90 estudos científicos que envolveram 46 instrumentos, dos quais 11 (23,9%) foram realizados os processos de elaboração e/ou adaptação cultural dos instrumentos DISABKIDS® para mensuração da Qualidade de Vida de crianças ou adolescentes com condições crônicas e em 35 (76,1%) foram utilizados o Formulários de Impressões Gerais e/ou Folhas Específicas para realizar a validação semântica de outros instrumentos. Conclusão: constatou-se que essa scoping review permitiu avaliação abrangente do uso do instrumento e dos documentos DISABKIDS®. Em relação à validação do instrumento adaptado ao Brasil apresenta avanço positivo do cenário junto ao desenvolvimento de projetos acadêmicos/científicos no país, a partir da incorporação ao método preconizado pela literatura para elaboração, adaptação cultural e validação de instrumentos, do registro sistematizado e padronizado da percepção, bem como do entendimento da população alvo sobre a medida de interesse, ao lançar mão de formulários DISABKIDS® adaptados para esse fim.

Objetivo: mapear la producción científica que se ocupa de las etapas del proceso metodológico para el uso de los instrumentos y/o formularios adaptados DISABKIDS® a Brasil. Método: scoping review, búsqueda realizada en 10 bases de datos electrónicas, en el Google Scholar y por intermedio de consulta a investigadores, sin restricción de período o idioma. Resultados: el mapeo identificó 90 estudios científicos que involucraron 46 instrumentos, de los cuales 11 (23,9%) la elaboración y/o adaptación cultural de los instrumentos DISABKIDS® se realizaron para medir la Calidad de Vida de niños o adolescentes con afecciones crónicas y en 35 (76,1%) utilizaron los Formularios de Impresiones Generales y/o Hojas Específicas para realizar la validación semántica de otros instrumentos. Conclusión: se encontró que esta revisión de alcance permitió una evaluación exhaustiva del uso del instrumento y los documentos DISABKIDS®. En cuanto a la validación del instrumento adaptado a Brasil presenta un avance positivo del escenario en conjunto al desarrollo de proyectos académicos/científicos en el país, desde la incorporación al método recomendado por la literatura para la elaboración, adaptación cultural y validación de instrumentos, desde el registro sistematizado y estandarizado de la percepción, así como la comprensión de la población objetivo sobre la medida de interés mediante el uso de formularios DISABKIDS® adaptados con esta finalidad.

Adaptation of the Multidimensional Pain Evaluation Scale: A Cross-Cultural Study.

BACKGROUND AND PURPOSE: Instruments to measure pain must be cross-culturally adapted through rigorous processes, so they can provide equivalence of measure regardless of the context in which they are applied. The study aim was to perform a cross-cultural adaptation of Multidimensional Pain Evaluation Scale (MPES) for use in the United States. METHODS: Cross-cultural adaptation study entailed translation, back translation, and review by a committee, face and content validity and pilot testing with 90 participants with acute or chronic pain from United States. The Cronbach's alpha coefficient was calculated. RESULTS: Some items of MPES was changed to maintain the highest level of similarity between the original scales in Portuguese and adapted to English. CONCLUSION: The Cronbach's alpha was high showed this scale has internal consistency and reliability.

Pain from the life cycle perspective: Evaluation and Measurement through psychophysical methods of category estimation and magnitude estimation.

OBJECTIVE: to describe acute and chronic pain from the perspective of the life cycle. METHODS: participants: 861 people in pain. The Multidimensional Pain Evaluation Scale (MPES) was used. RESULTS: in the category estimation method the highest descriptors of chronic pain for children/ adolescents were "Annoying" and for adults "Uncomfortable". The highest descriptors of acute pain for children/adolescents was "Complicated"; and for adults was "Unbearable". In magnitude estimation method, the highest descriptors of chronic pain was "Desperate" and for descriptors of acute pain was "Terrible". CONCLUSIONS: the MPES is a reliable scale it can be applied during different stages of development. OBJETIVO: descrever a dor aguda e a crônica na perspectiva do ciclo vital. Métodos: participaram 861 pessoas com dor. Foi utilizada a Escala Multidimensional de Avaliação da Dor (EMADOR). Resultados: no método da estimação de categoria o descritor da dor crônica de maior atribuição para crianças e adolescentes foi "Chata" e para adultos foi "Desconfortável". Os descritores de maior atribuição para dor aguda em crianças e adolescentes foram "Complicada" e em adultos "Insuportável". No método de estimação de magnitude, o descritor de maior atribuição na dor crônica foi "Atormentadora" e na dor aguda foi "Terrível". CONCLUSÕES: a EMADOR é uma escala confiável e pode ser utilizada nas diferentes etapas do desenvolvimento humano. OBJETIVO: la descripción del dolor agudo y crónico desde las perspectiva del ciclo de vida. MÉTODOS: participaron 861 personas con dolor. Se utilizó la Escala Multidimensional de Evaluación del Dolor (EMEDOR). RESULTADOS: en el método de estimación de categoría el descriptor de dolor crónico más alto para niños y adolescentes fue de Molesto y para adultos fue Incómodo. Los descriptores mayores de dolor agudo para niños y adolescentes fueron Complejo y para adultos Insoportable. En el método de estimación de magnitud, el mayor descriptor de dolor crónico fueron Atormentador y el mayor de dolor agudo fue Terrible. CONCLUSIONES: la EMEDOR es una escala confiable y puede ser utilizada en diferentes etapas de desarrollo.

Pain from the life cycle perspective: Evaluation and Measurement through psychophysical methods of category estimation and magnitude estimation / A dor desde a perspectiva do ciclo de vida: avaliação e medição através de métodos psicofísicos de estimação de categoria e magnitude / El dolor desde la perspectiva del ciclo de vida: evaluación y medición a través de métodos psicofísicos de estimación de categoría y de magnitud

Abstract Objective: to describe acute and chronic pain from the perspective of the life cycle. Methods: participants: 861 people in pain. The Multidimensional Pain Evaluation Scale (MPES) was used. Results: in the category estimation method the highest descriptors of chronic pain for children/ adolescents were "Annoying" and for adults "Uncomfortable". The highest descriptors of acute pain for children/adolescents was "Complicated"; and for adults was "Unbearable". In magnitude estimation method, the highest descriptors of chronic pain was "Desperate" and for descriptors of acute pain was "Terrible". Conclusions: the MPES is a reliable scale it can be applied during different stages of development.

Resumo Objetivo: descrever a dor aguda e a crônica na perspectiva do ciclo vital. Métodos: participaram 861 pessoas com dor. Foi utilizada a Escala Multidimensional de Avaliação da Dor (EMADOR). Resultados: no método da estimação de categoria o descritor da dor crônica de maior atribuição para crianças e adolescentes foi "Chata" e para adultos foi "Desconfortável". Os descritores de maior atribuição para dor aguda em crianças e adolescentes foram "Complicada" e em adultos "Insuportável". No método de estimação de magnitude, o descritor de maior atribuição na dor crônica foi "Atormentadora" e na dor aguda foi "Terrível". Conclusões: a EMADOR é uma escala confiável e pode ser utilizada nas diferentes etapas do desenvolvimento humano.

Resumen Objetivo: la descripción del dolor agudo y crónico desde las perspectiva del ciclo de vida. Métodos: participaron 861 personas con dolor. Se utilizó la Escala Multidimensional de Evaluación del Dolor (EMEDOR). Resultados: en el método de estimación de categoría el descriptor de dolor crónico más alto para niños y adolescentes fue de Molesto y para adultos fue Incómodo. Los descriptores mayores de dolor agudo para niños y adolescentes fueron Complejo y para adultos Insoportable. En el método de estimación de magnitud, el mayor descriptor de dolor crónico fueron Atormentador y el mayor de dolor agudo fue Terrible. Conclusiones: la EMEDOR es una escala confiable y puede ser utilizada en diferentes etapas de desarrollo.

Expressão da dor na criança com câncer: uma compreensão fenomenológica / Pain expression in children with cancer: A phenomenological comprehension

A abordagem fenomenológica, descritiva e exploratória, foi utilizada para compreender a experiência de dor em crianças com câncer. Participaram do estudo 17 crianças, tratadas no serviço de oncologia pediátrica do Hospital das Clínicas de Ribeirão Preto, da Universidade de São Paulo, entre janeiro e dezembro de 2010. Foi aplicada entrevista fenomenológica com o consentimento dos pais ou familiares. A análise e a discussão foram realizadas pelo modelo proposto por Martins e Bicudo e referencial fenomenológico de Merleau-Ponty, respectivamente. A experiência dolorosa mostrou as dimensões: dor e paradoxo da vida e da morte, apegando-se à espiritualidade na vivência da dor, percebendo a dor emocional da família, experimentando a dor na temporalidade da hospitalização e compreendendo a dor corporal positiva e negativamente. As crianças foram capazes de entender a dor multidimensionalmente, comunicando-a de modo sofisticado. Tal compreensão pode ser influenciada pela intersubjetividade, história de vida, aspectos psicossociais e, especialmente, pelo entendimento adquirido durante o adoecimento.(AU)

A descriptive, exploratory, and phenomenological approach was used to understand pain experience in children with cancer. Seventeen children that were being treated at the pediatric oncology service of the "Clinics Hospital ofRibeirão Preto of the University ofSão Paulo" (University hospital) participated in this study between January and December 2010. A phenomenological interview was conducted with parental, legal guardian, or responsible relative consent. Analysis and discussion were carried out according to the model proposed by Martins and Bicudo and the Merleau-Ponty's conceptions of phenomenology, respectively. The experience of pain evidenced the dimensions: pain and paradox of life and death, turning to spirituality when dealing with pain, realizing the emotional pain of the family, experiencing pain in the during the hospitalization period, and understanding the body pain positively and negatively. These children were able to understand their pain through a multidimensional approach, communicating their understanding in a sophisticated way. Such understanding can be influenced by intersubjectivity, life history, psychosocial aspects, and, especially, by the understanding achieved while dealing with the disease.(AU)

Expressão da dor na criança com câncer: uma compreensão fenomenológica / Pain expression in children with cancer: a phenomenological comprehension

A abordagem fenomenológica, descritiva e exploratória, foi utilizada para compreender a experiência de dor em crianças com câncer. Participaram do estudo 17 crianças, tratadas no serviço de oncologia pediátrica do Hospital das Clínicas de Ribeirão Preto, da Universidade de São Paulo, entre janeiro e dezembro de 2010. Foi aplicada entrevista fenomenológica com o consentimento dos pais ou familiares. A análise e a discussão foram realizadas pelo modelo proposto por Martins e Bicudo e referencial fenomenológico de Merleau-Ponty, respectivamente. A experiência dolorosa mostrou as dimensões: dor e paradoxo da vida e da morte, apegando-se à espiritualidade na vivência da dor, percebendo a dor emocional da família, experimentando a dor na temporalidade da hospitalização e compreendendo a dor corporal positiva e negativamente. As crianças foram capazes de entender a dor multidimensionalmente, comunicando-a de modo sofisticado. Tal compreensão pode ser influenciada pela intersubjetividade, história de vida, aspectos psicossociais e, especialmente, pelo entendimento adquirido durante o adoecimento.

A descriptive, exploratory, and phenomenological approach was used to understand pain experience in children with cancer. Seventeen children that were being treated at the pediatric oncology service of the "Clinics Hospital ofRibeirão Preto of the University ofSão Paulo" (University hospital) participated in this study between January and December 2010. A phenomenological interview was conducted with parental, legal guardian, or responsible relative consent. Analysis and discussion were carried out according to the model proposed by Martins and Bicudo and the Merleau-Ponty's conceptions of phenomenology, respectively. The experience of pain evidenced the dimensions: pain and paradox of life and death, turning to spirituality when dealing with pain, realizing the emotional pain of the family, experiencing pain in the during the hospitalization period, and understanding the body pain positively and negatively. These children were able to understand their pain through a multidimensional approach, communicating their understanding in a sophisticated way. Such understanding can be influenced by intersubjectivity, life history, psychosocial aspects, and, especially, by the understanding achieved while dealing with the disease.