Sucrose preference test: A systematic review of protocols for the assessment of anhedonia in rodents.

Anhedonia is described as a decreased ability to experience rewarding and enjoyable activities, a core symptom of major depressive disorder. The sucrose preference test (SPT) is a widely used and reliable behavioural test to assess anhedonia in rodents, based on a two-bottle choice paradigm. To date, different protocols are in use, inducing variability between researchers and hampering comparisons between studies. We performed a systematic review of the SPT protocols used in 2021 to identify the parameters in which they differ and their potential impact. We searched a total of four databases (PubMed, Scopus, Web of Science and Science Direct), from 1st January 2021 to 31st December 2021, and screened a total of 1066 articles. After screening by title and abstract, a total of 415 articles were included in this review. We extracted and analysed the different procedures used, the type of sweet solution and the habituation, deprivation, and testing protocols. The overall quality of the studies was considered very good, however, SPT protocols were extremely variable between studies with a total of 65 different habituation protocols and 104 combinations of food/water deprivation and preference testing duration. As the SPT is one of the most used tests to assess anhedonia in rodents, this work raises awareness of the great variability in SPT protocols being currently used. Furthermore, we call for standardization in the protocol used, and overall improvement of data reporting of methodologies and results, to increase the consistency between studies and allow a better comparison of results between different labs.

The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review.

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

Effect of Helicobacter pylori Infection on Macromineral and Trace Element Status-Systematic Review and Meta-Analysis.

OBJECTIVES: To explore the effect of Helicobacter pylori (Hp ) infection on zinc, copper, calcium, magnesium, phosphorus, and iodine status in the pediatric population. METHODS: A protocol was registered on PROSPERO. A literature search was conducted on Embase, PubMed MEDLINE, and Web of Science, from inception to September 2020, including all studies in English, Spanish, and Portuguese languages. Reference lists were manually searched. Primary studies describing at least one micronutrient status in Hp -positive and Hp -negative or control children were included. PRISMA recommendations were applied. Pooled mean differences (MDs) and 95% confidence intervals were estimated using a random-effects model. A total of 1011 citations were screened. Six cross- sectional studies were included. No publications regarding phosphorus and iodine were identified. RESULTS: Included studies in meta-analyses comprised an overall age range of 4-18 years, with Hp positivity ranging between 29.5% and 72.3%. These meta-analyses demonstrated a lack of evidence of an association between Hp -positive and Hp -negative or control children regarding serum zinc (vs Hp -negative: MD -1.36 µg/dL; vs control: MD 326.22 µg/dL), copper (MD -0.83 µg/dL), and calcium (MD 0.09 mg/dL) status. Considerable heterogeneity was recognized, except for calcium analysis (I 2 = 0%). Meta-analysis for magnesium was not performed. Five studies presented a low risk of bias. CONCLUSIONS: The study demonstrated a lack of evidence of an effect of Hp infection on serum zinc, copper, and calcium status. Studies concerning magnesium, phosphorus, and iodine status are warranted. Furthermore, larger and well-controlled studies are recommended.

Characteristics of Reliever Inhaler Users and Asthma Control: A Cross-Sectional Multicenter Study in Portuguese Community Pharmacies.

PURPOSE: SABA overuse might indicate poorly managed or uncontrolled asthma and be responsible for poor health outcomes. The aim of this study integrated in new fourth multi-design SABINA+ pillar was to characterize the population using short-acting ß2-agonists for asthma and examine the patterns of its use among community pharmacy customers in Portugal, as well as identify characteristics associated with disease control and explore potential differences between GINA treatment steps. PATIENTS AND METHODS: This cross-sectional multicenter study was conducted in Portuguese community pharmacies between 29 May 2018 and 15 August 2018. Participants were adults (age ≥18 years) self-reporting asthma diagnosis recruited in the context of a short-acting ß2-agonist dispense. A two-part questionnaire (pharmacist interview and self-administered) was used to collect information about sociodemographic characteristics, comorbidities, reliever inhaler use, healthcare resource consumption and self-reported disease control (assessed by the Control of Allergic Rhinitis and Asthma Test - CARAT®). Descriptive statistics was done to characterize the study sample. After categorizing patients according to GINA steps, based on their therapeutic regimen, we performed an exploratory subgroup analysis to evaluate if there were any differences between such groups in terms of the variables collected. A logistic regression was used to identify the potential determinants of overall disease control. RESULTS: Around 50.8% of patients were male, and the average age was 52 years old. Half of the patients never smoked, and 51.9% were employed. More than half of the patients report inhaler overreliance - purchasing more than 1 pack in 3 months (65.0%) or using the inhaler on more than 8 days over the previous 4 weeks (50.2%). Of the total number of patients in the study, 79.1% had poorly controlled asthma symptoms, and 78.7% had overall poorly controlled respiratory symptoms. We found statistically significant differences between GINA treatment steps in all sociodemographic characteristics (sex, mean age, education level, employment status); maximum number of SABA uses in 24h, CARAT score (total an asthma sub-score); history of exacerbations requiring ED visits or treatment with OCS for at least 3 days in the previous 12 months. Logistic regression revealed that patients reporting SABA use in more than 8 days in the previous 4 weeks and patients with at least 1 exacerbation requiring treatment with OCS for at least 3 days in the previous 12 months have greater odds of poor disease control [adjusted OR (95% CI): 2.6 (1.3-5.2) and 3.0 (1.3-6.6)]. CONCLUSION: Based on the results of this study, it can be inferred that the asthma population using SABA is largely uncontrolled and uses reliever inhalers excessively.

Useful Ultrasonographic Parameters to Predict Difficult Laryngoscopy and Difficult Tracheal Intubation-A Systematic Review and Meta-Analysis.

Unexpected difficult airway management can cause significant morbidity and mortality in patients admitted for elective procedures. Ultrasonography is a promising tool for perioperative airway assessment, nevertheless it is still unclear which sonographic parameters are useful predictors of difficult laryngoscopy and tracheal intubation. To determine the ultrasonographic predictors of a difficult airway that could be applied for routine practice, a systematic review and meta-analysis was conducted. Literature search was performed on PubMED, Web of Science and Embase using the selected keywords. Human primary studies, published in English with the use of ultrasonography to prediction of difficult laryngoscopy or tracheal intubation were included. A total of 19 articles (4,570 patients) were analyzed for the systematic review and 12 articles (1,141 patients) for the meta-analysis. Standardized mean differences between easy and difficult laryngoscopy groups were calculated and the parameter effect size quantified. A PRISMA methodology was used and the critical appraisal tool from Joanna Briggs Institute was applied. Twenty-six sonographic parameters were studied. The overall effect of the distance from skin to hyoid bone (p = 0.02); skin to epiglottis (p = 0.02); skin to the anterior commissure of vocal cords (p = 0.02), pre-epiglottis space to distance between epiglottis and midpoint between vocal cords (p = 0.01), hyomental distance in neutral (p < 0.0001), and extended (p = 0.0002) positions and ratio of hyomental distance in neutral to extended (p = 0.001) was significant. This study shows that hyomental distance in the neutral position is the most reliable parameter for pre-operative airway ultrasound assessment. The main limitations of the study are the small sample size, heterogeneity of studies, and absence of a standardized ultrasonographic evaluation method [Registered at International prospective register of systematic reviews (PROSPERO): number 167931].

Individual and clinical variables associated with the risk of Buruli ulcer acquisition: A systematic review and meta-analysis.

BACKGROUND: Buruli ulcer (BU) is a necrotizing skin disease, caused by Mycobacterium ulcerans, with poorly understood acquisition risk factors. This review aims at evaluating the importance of individual-sex, age, family ties with history of BU, gene variants-and clinical-Bacillus Calmette-Guérin (BCG) immunization, Human Immunodeficiency Virus (HIV) infection-variables in this process. METHODS: A systematic review was performed considering the following databases: ClinicalTrials.gov, Cochrane Controlled Register of Trials (CENTRAL), Current Contents Connect, Embase, MEDLINE, SciELO, Scopus and Web of Science. Eligible studies were critically appraised with The Joanna Briggs Institute checklists and heterogeneity was assessed with Cochran Q-test and I2 statistic. Published demographic data was descriptively analysed and clinical data pooled within random-effects modelling for meta-analysis. RESULTS: A total of 29 studies were included in the systematic review. Two randomized controlled trials (RCTs) and 21 case-control studies were selected for meta-analysis. Studies show that BU mainly affects age extremes, more preponderately males among children. Data pooled from RCTs do not reveal BCG to be protective against BU (odds ratio (OR) = 0.63; 95% CI = 0.38-1.05; I2 = 56%), a finding case-control studies appear to corroborate. HIV infection (OR = 6.80; 95% CI = 2.33-19.85; I2 = 0%) and SLC11A1 rs17235409 A allele (OR = 1.86; 95% CI = 1.25-2.77; I2 = 0%) are associated with increased prevalence of the disease. No definite conclusions can be drawn regarding the influence of previous family history of BU. DISCUSSION: While available evidence warrants further robustness, these results have direct implications on current interventions and future research programs, and foster the development of more cost-effective preventive and screening measures. REGISTRATION: The study was registered at PROSPERO with number CRD42019123611.

The modified patient enablement instrument: a Portuguese cross-cultural adaptation, validity and reliability study.

Enabling patients with asthma to obtain the knowledge, confidence and skills they need in order to assume a major role in the management of their disease is cost effective. It should be an integral part of any plan for long-term control of asthma. The modified Patient Enablement Instrument (mPEI) is an easily administered questionnaire that was adapted in the United Kingdom to measure patient enablement in asthma, but its applicability in Portugal is not known. Validity and reliability of questionnaires should be tested before use in settings different from those of the original version. The purpose of this study was to test the applicability of the mPEI to Portuguese asthma patients after translation and cross-cultural adaptation, and to verify the structural validity, internal consistency and reproducibility of the instrument. The mPEI was translated to Portuguese and back translated to English. Its content validity was assessed by a debriefing interview with 10 asthma patients. The translated instrument was then administered to a random sample of 142 patients with persistent asthma. Structural validity and internal consistency were assessed. For reproducibility analysis, 86 patients completed the instrument again 7 days later. Item-scale correlations and exploratory factor analysis were used to assess structural validity. Cronbach's alpha was used to test internal consistency, and the intra-class correlation coefficient was used for the analysis of reproducibility. All items of the Portuguese version of the mPEI were found to be equivalent to the original English version. There were strong item-scale correlations that confirmed construct validity, with a one component structure and good internal consistency (Cronbach's alpha >0.8) as well as high test-retest reliability (ICC=0.85). The mPEI showed sound psychometric properties for the evaluation of enablement in patients with asthma making it a reliable instrument for use in research and clinical practice in Portugal. Further studies are needed to confirm its responsiveness.

The respiratory research agenda in primary care in Portugal: a Delphi study.

BACKGROUND: A research agenda can help to stimulate and guide research. The International Primary Care Respiratory Group (IPCRG) published a Research Needs Statement (RNS) in 2010 in which 145 research questions were identified. In 2012, priorities for respiratory research were established, based on these questions. To date, there has been no statement on primary care respiratory research needs in Portugal. The aim of the study was to develop a national consensus on research priorities in respiratory diseases in primary care in Portugal and to assess the applicability of the priorities for respiratory research set by the IPCRG. METHOD: We conducted a Delphi study by electronic mail with a panel of experts on respiratory disease from primary and secondary care in Portugal. In the first round, the research needs in respiratory disease in Portugal were identified. In the second round, 196 research questions in six disease areas, derived from the first round and from the IPCRG Respiratory needs statement, were prioritised on a five-point Likert-type scale. In the third round, the questions were prioritized again with feed-back provided on the median scores for each item in the second round. Consensus was considered to have been reached when 80 % of the participants gave a score of 4 or 5 out of five on a given item. RESULTS: The 40 experts identified 121 respiratory research questions in Round 1 and expressed their views on 196 questions in Rounds 2 and 3. Twelve research questions (6 %) reached consensus. There were five questions in the asthma domain on early diagnosis, pulmonary function tests, the use of inhalers, and adherence to treatment. There were four questions in the chronic obstructive pulmonary disease domain on vaccinations, on routine monitoring and evaluation of treatment, on diagnosis, and on adherence to treatments. There was one question in the smoking domain on the effects of brief counselling. There were two questions on respiratory tract infections on the treatment of children and on the prescription of antibiotics. An additional 23 research questions (12 %) achieved consensus between 75 and 79 %. CONCLUSION: The results reflect the Portuguese reality in response the international agenda for research on respiratory diseases published by the IPCRG. They can support the development of future respiratory disease research in Portugal.

The Effects of Workplace Physical Activity Programs on Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

This article reviews the effectiveness of physical activity (PA) interventions at the workplace to reduce musculoskeletal pain among employees and assesses the effect size of these programs using meta-analysis. Four databases (i.e., PubMed, EBSCO, Web of Science, and Cochrane) were searched for research trials, which included comparison groups of employees that assessed PA programs, musculoskeletal pain, and health-related behaviors, published between January 1990 and March 2013. The meta-analysis estimates of standardized mean differences (Hedges' g) present significant evidence of less general pain (g = -.40 with a 95% confidence interval [CI] = [-0.78, -0.02]) and neck and shoulder pain (g = -.37 with a 95% CI = [-0.63, -0.12]) in intervention groups. The few studies of low back pain and arm, elbow, wrist, hand, or finger pain did not present sufficient statistically significant evidence. Consistent evidence demonstrates that workplace PA interventions significantly reduce general musculoskeletal pain and neck and shoulder pain. More studies are needed to determine the effectiveness of work-related PA interventions for arm, elbow, wrist, hand or finger, and low back pain.

Linking Learning Contexts: The Relationship between Students' Civic and Political Experiences and Their Self-Regulation in School.

This paper considers the relationship between self-regulation strategies and youth civic and political experiences, assuming that out-of-school learning can foster metacognition. The study is based on a sample of 732 Portuguese students from grades 8 and 11. Results show that the quality of civic and political participation experiences, together with academic self-efficacy, are significant predictors of young people's self-regulation, particularly regarding cognitive and metacognitive strategies (elaboration and critical thinking). Such effects surpass even the weight of family cultural and school variables, such as the sense of school belonging. Therefore, we argue that the pedagogical value of non-formal civic and political experiences is related to learning in formal pedagogical contexts. This is because civic and political participation with high developmental quality can stimulate higher-order cognitive engagement and, thus, contribute to the development of learning strategies that promote academic success.

Stress, Cognitive Appraisal and Psychological Health: Testing Instruments for Health Professionals.

The job of health professionals, including nurses, is considered inherently stressful, and thus, it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP), the Cognitive Appraisal Scale (CAS) and the General Health Questionnaire-12 (GHQ-12). Validity and reliability issues were considered with statistical analysis (i.e., confirmatory factor analysis, convergent validity and composite reliability) that revealed adequate values for all of the instruments, namely a six-factor structure for the SQHP, a five-factor structure for the CAS and a two-factor structure for the GHQ-12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses' adaptation to work contexts.

Propriedades psicométricas da Escala de Percepção do Funcionamento Parental – Mãe e Pai / Psychometric properties of the Parental Functioning Perception Scale – Mother and Father / Propriedades psicométricas de la Escala de Percepción del Funcionamiento Parental – Madre y Padre

Este estudo tem como objetivo validar, em uma população portuguesa jovem, a Escala de Percepção de Funcionamento Parental (EPFP) desenvolvida com base na versão espanhola Estilos Educativos Materno y Paterno. Seiscentos e cinco participantes, equitativamente divididos pelos dois sexos, responderam à EPFP. A estrutura fatorial original composta por seis dimensões foi adaptada, com a remoção de alguns itens, tendo apresentado bons índices de ajustamento (análise fatorial confirmatória) e valores de consistência variando entre α=0,81 e 0,95. Apesar de significativamente correlacionadas, verificaram-se diferenças importantes entre as percepções relativas às dimensões do funcionamento materno e paterno. As mães são consideradas mais afetuosas e comunicativas, promotoras da autonomia, confidentes, bem-humoradas e menos controladoras. A EPFP se revelou um instrumento válido e fidedigno na avaliação do funcionamento parental, através da percepção dos filhos.(AU)

This study aimed to validate the Parental Functioning Perception Scale – Mother and Father (EPFP), as the Portuguese language version of the Spanish scale Estilos Educativos Materno y Paterno (Maternal and Paternal Educational Styles). A sample of 605 college students participated, equally divided by gender, who responded to the EPFP regarding the two parental figures. The original factorial structure (which was composed of six dimensions, adapted, with some items removed), showed good adjustment indexes (confirmatory factor analysis) and acceptable internal consistency values ranging from α=0.81 to 0.95. Despite being significantly correlated, statistically significant differences were found between the perceptions of the dimensions of maternal and paternal parental functioning. Mothers were considered to be more affectionate, communicative, good-humored and trustworthy, while encouraging autonomy, and less controlling than fathers. The EPFP proved to be a valid and reliable instrument in the assessment of the adolescents’ perception of maternal and paternal parental functioning.(AU)

Este estudio tuvo como objetivo validar la Escala de Percepción del Funcionamiento Parental (EPFP) en una populación portuguesa joven, desarrollada a partir de la versión española de Estilos Educativos Materno y Paterno. Participaron en el estudio 605 jóvenes, de los dos sexos, que contestaron a la EFPF para las dos figuras parentales. La estructura factorial original (seis dimensiones) fue adaptada con la retirada de algunos ítems, habiendo presentado buenos índices de ajustamiento (análisis fatorial confirmatória), con apropiados valores de consistencia interna (α=0,81 α=0,95). A pesar de significativamente correlacionadas, se han comprobado diferencias significativas entre las percepciones relativas a las dimensiones del funcionamiento materno y paterno. Las madres fueran consideradas más afectuosas y comunicativas, promotoras de autonomía, confidentes, de buen humor y menos controladoras. La EPFP se mostró un instrumento válido y confiable en la evaluación de la percepción que los adolescentes tienen del funcionamiento parental.(AU)

Propriedades psicométricas da Escala de Percepção do Funcionamento Parental – Mãe e Pai / Psychometric properties of the Parental Functioning Perception Scale – Mother and Father / Propriedades psicométricas de la Escala de Percepción del Funcionamiento Parental – Madre y Padre

Este estudo tem como objetivo validar, em uma população portuguesa jovem, a Escala de Percepção de Funcionamento Parental (EPFP) desenvolvida com base na versão espanhola Estilos Educativos Materno y Paterno. Seiscentos e cinco participantes, equitativamente divididos pelos dois sexos, responderam à EPFP. A estrutura fatorial original composta por seis dimensões foi adaptada, com a remoção de alguns itens, tendo apresentado bons índices de ajustamento (análise fatorial confirmatória) e valores de consistência variando entre α=0,81 e 0,95. Apesar de significativamente correlacionadas, verificaram-se diferenças importantes entre as percepções relativas às dimensões do funcionamento materno e paterno. As mães são consideradas mais afetuosas e comunicativas, promotoras da autonomia, confidentes, bem-humoradas e menos controladoras. A EPFP se revelou um instrumento válido e fidedigno na avaliação do funcionamento parental, através da percepção dos filhos...

This study aimed to validate the Parental Functioning Perception Scale – Mother and Father (EPFP), as the Portuguese language version of the Spanish scale Estilos Educativos Materno y Paterno (Maternal and Paternal Educational Styles). A sample of 605 college students participated, equally divided by gender, who responded to the EPFP regarding the two parental figures. The original factorial structure (which was composed of six dimensions, adapted, with some items removed), showed good adjustment indexes (confirmatory factor analysis) and acceptable internal consistency values ranging from α=0.81 to 0.95. Despite being significantly correlated, statistically significant differences were found between the perceptions of the dimensions of maternal and paternal parental functioning. Mothers were considered to be more affectionate, communicative, good-humored and trustworthy, while encouraging autonomy, and less controlling than fathers. The EPFP proved to be a valid and reliable instrument in the assessment of the adolescents’ perception of maternal and paternal parental functioning...

Este estudio tuvo como objetivo validar la Escala de Percepción del Funcionamiento Parental (EPFP) en una populación portuguesa joven, desarrollada a partir de la versión española de Estilos Educativos Materno y Paterno. Participaron en el estudio 605 jóvenes, de los dos sexos, que contestaron a la EFPF para las dos figuras parentales. La estructura factorial original (seis dimensiones) fue adaptada con la retirada de algunos ítems, habiendo presentado buenos índices de ajustamiento (análisis fatorial confirmatória), con apropiados valores de consistencia interna (α=0,81 α=0,95). A pesar de significativamente correlacionadas, se han comprobado diferencias significativas entre las percepciones relativas a las dimensiones del funcionamiento materno y paterno. Las madres fueran consideradas más afectuosas y comunicativas, promotoras de autonomía, confidentes, de buen humor y menos controladoras. La EPFP se mostró un instrumento válido y confiable en la evaluación de la percepción que los adolescentes tienen del funcionamiento parental...