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Assistive technologies have allowed people with disabilities to perform daily tasks with greater independence and autonomy, especially for visually impaired people. Using smart home solutions allows these users to control their homes with less cognitive and physical demand. However, making such applications accessible to meet the needs of visually impaired users, especially in developing countries, remains a challenge. This paper investigates the perceptions of these users about home automation technologies through semi-structured interviews. A total of 20 visually impaired people participated in the interviews. A thematic analysis revealed results concerning the following themes: (1) how people go about their lives at home and around, how people interact with current appliances, objects and environments, (3) how people perceive their attitude to technologies, (4) the Brazilian context of smart homes, (5) what people think smart homes should do and (6) envisaging ways of interacting with smart home systems. The results obtained provide significant insight into the needs of visually-impaired people in Brazil, with analysis of issues that are common with previous studies in more developed countries and specific issues that have important particularities and implications in Brazil and other developing countries. [ABSTRACT FROM AUTHOR]

A wide range of portable and wearable electronic travel aids have been developed to enable visually impaired people to move around public spaces without a sighted guide. However, few of them have gone beyond the prototype stage and the long cane and guide dog are still the main mobility aids. Despite the importance of evaluation to determine, for instance, effective functioning and end-user satisfaction, a standard approach has not yet been developed for mobility aids. The paper reports the evaluation of a low-cost electronic long cane, developed by the authors and colleagues in Brazil. It used a two-part methodology involving an experimental investigation of performance of the electronic long cane and a questionnaire to explore user satisfaction. The results of the experiments and questionnaire demonstrated both the cane’s usefulness and the need for modifications to improve its functioning. This work is also important for the development of methodologies for effective evaluation, as this is the first evaluation of a mobility device developed and carried out in Brazil. In addition, it is one of only a small number of evaluations in real locations with real obstacles. Finally, a series of recommendations for evaluating mobility devices is presented. What this paper adds? A standard approach to evaluating electronic travel for visually impaired people has not yet been developed and the most appropriate approach may depend on the objectives of the evaluation. Existing approaches generally use participants with no previous experience of using the device being evaluated and is carried out indoors with artificial obstacles. The training or device familiarisation period usually provided might be insufficient for participants to obtain optimal device performance or an effective comparison to be made of different devices. The approach to evaluating an electronic long cane reported in this paper has three main advantages over previous methods. The participants were experienced users of the electronic long cane who had been using it to support their daily mobility for at least a month. The evaluation was carried out in two different real urban environments with real obstacles. This has the advantages of being close to real-life cane use and participants being able to make informed comments and suggestions for improvements as a result of their experience. A questionnaire included questions on user satisfaction with and evaluation of a number of different cane features based on their experiences of cane use over a period. The work is also significant as the first detailed mobility device evaluation carried out in Brazil and in the presentation of a series of recommendations divided into themes for effective evaluation of mobility devices. [ABSTRACT FROM AUTHOR]

Information on occupational health and safety practices in Brazilian aquaculture is limited. This paper reports preliminary results from an online survey based on research questions to identify occupational hazards, risk assessment practices, and prevention measures adopted in Brazilian aquaculture. Data were collected through an online questionnaire, comprising 25 questions, on a voluntary and anonymous basis. Aquaculture stakeholders were invited to participate in the study through email and social media channels. The demographic data demonstrated that the majority of respondents were men (72%) and having a higher education (95%). Most respondents employed administrative controls and personal protective equipment (PPE) rather than substitution and other risk elimination measures to reduce exposure. The most commonly adopted measures were PPE use (87%), adequate handling of chemicals (86%), and imparting knowledge of risks (90%). However, only 12% of participants reported the presence of safety protocols at their workplace, and 17% had some form of immunization of workers. In this study, it was possible to identify a lack of hazard signage in the workplace and lack of occupational health and safety training. The results further indicate that risk management in aquaculture continues to be a challenge in low-income countries. Aquaculture farmers should be encouraged and supported in adopting measures and appropriate technologies to eliminate risks in Brazilian aquaculture. [ABSTRACT FROM AUTHOR]

Background: Data on disability are regularly collected by different institutions or ministries using specific tools for different purposes, for instance to estimate the prevalence of disability or eligibility of specific populations for social benefits. The interoperability of disability data collected in countries is essential for policy making and to monitor the implementation of the Convention on the Rights of Persons with Disabilities. The first objective of this paper is to map and compare tools that collect data on disability for different purposes, more specifically the Brazilian National Health Survey and the Brazilian Functioning Index to the World Health Organization (WHO) and the World Bank Model Disability Survey (MDS), currently recommended as a standard tool for disability measurement. The second objective is to demonstrate the usefulness and value of the International Classification of Functioning, Disability and Health Linking Rules to map and compare population-based surveys and other content-related tools collecting data on disability, even when these have already been developed based on the International Classification of Functioning, Disability and Health. Methods: Disability information collected with the three different tools was mapped and compared using the International Classification of Functioning, Disability and Health Linking Rules. Results: Although the disability module in the Brazilian National Health Survey is fundamentally different from the MDS, the mapping disclosed that several modules of the Brazilian National Health Survey already cover many aspects necessary to estimate prevalence and understand disability as currently recommended by the WHO and the World Bank. The Brazilian Functioning Index and the MDS are both based on the International Classification of Functioning, Disability and Health and are very similar in the approach and content of their questions on functioning. Specific information on environmental factors is essential to identify needs and barriers, as well as to devise procedures to reduce injustice and inequalities. This information is still not targeted broadly enough in both the Brazilian National Health Survey and the Brazilian Functioning Index. Conclusions: Overall, this mapping exercise showed that applying the International Classification of Functioning, Disability and Health linking rules to population-based data coming from different sources provides researchers and stakeholders involved in decision-making with standardized and straightforward information about overlaps and gaps. Implications for Rehabilitation: Data on functioning and disability regularly collected with different purposes and by different institutions or ministries within a country can be compared using the International Classification of Functioning, Disability and Health as a reference framework and the International Classification of Functioning, Disability and Health linking rules. The recently published refinements of the International Classification of Functioning, Disability and Health Linking Rules go beyond the sole linking to International Classification of Functioning, Disability and Health categories and provide standardized procedures to document the perspective of linked questions or the categorization of response options. They are therefore useful to compared tools that have been developed based on the International Classification of Functioning, Disability and Health. The current disability module of the Brazilian Health Survey needs a revision to be suitable to collect data on disability that is Convention on the Rights of Persons with Disabilities conform and guarantees interoperability with disability data from other sources in Brazil, especially from disability assessment for social benefits and implementation of policies. [ABSTRACT FROM AUTHOR]

Introduction: Medical education provides students with abundant learning opportunities, each of which is embodied with messages concerning what is expected from students. This paper analyses students? exposure to instances of unprofessional behavior, investigating whether they judge such behavior to be unprofessional and whether they also participate in unprofessional behavior. Methods: The survey developed in the Pritzker School of Medicine at the University of Chicago was the basis of this questionnaire that was answered by 276 students from two medical schools in Brazil and Portugal. Results: Unprofessional behavior was observed frequently by students in both universities, and the mean participation rates were similar (26% and 27%). Forty-five percent of students? participation in unprofessional behavior was explained by academic year, prior observation, and judgment. Discussion: The results indicate that once students have observed, participated in or misjudged unprofessional behavior, they tend to participate in and misjudge such behavior. The frequency with which students judged behaviors they had observed or participated in as ?borderline? or unprofessional could mean that they are experiencing moral distress. Conclusion: Proper discussion of unprofessional behavior should foster a broad debate to encourage empowered students, faculties, and physicians to co-create a more professional environment for patient care. [ABSTRACT FROM AUTHOR]

Data on cannabis use patterns and health outcome indicators for Brazil are limited. We undertook a cross-sectional internet-based survey assessing socio-demographics, cannabis use frequency, other drug use, quality-of-life (QOL), affective states (i.e. anxiety and depression), and cannabis use disorder among adult respondents in Brazil. A multinomial logistic regression was conducted using cannabis frequency status as the dependent variable. A total of 6876 responders were identified as people with occasional (n = 1088), regular (n = 1062), and frequent (n = 4726) cannabis use. Groups differed greatly on sociodemographic characteristics and other drug use rates. Cannabis use disorder (p < 0.001), early-onset of cannabis use (aOR:1.71), and other substance use (aOR: from 1.53 to 2.59) were associated with a higher frequency of cannabis use. We did not find major differences in psychosocial and mental health outcomes as related to the frequency of cannabis use. Our results suggest that early initiation of cannabis, high use frequency, and using cannabis with other substances may elevate the risk for cannabis use disorder. Given the generally liberalizing trends for cannabis use, it is timely and appropriate to further study cannabis use and related outcomes in Brazil, considering that available indicators for this country are limited. [ABSTRACT FROM AUTHOR]

The aim of this study was to present the construction process of the Coping Inventory for Paralympic Athletes in Competition Situations (ICAP) and, as well, evidence of its content validity. The ICAP was developed to evaluate coping strategies in Paralympic athletes aged 18 years and older, possessing physical and/or visual impairment. The instrument is self-reported and includes the dimensions of Self-Reliance, Support-Seeking, Problem-Solving, Information-Seeking, Accommodation, Negotiation, Delegation, Social Isolation, Helplessness, Escape, Submission, and Opposition. Development of the instrument involved: (1) theoretical foundation based on the motivational theory of coping; (2) construction of the preliminary version of the instrument; (3) items analysis by expert judges; (4) semantic analysis of the items; and (5) pilot study. These procedures enabled the creation and refinement of the instrument. Some items were deleted and modified, reaching a final version of 91 items. This exhaustive process is considered to have ensured the content validity of the instrument. It is hoped that the ICAP can contribute in the future to the areas of sports psychology and Paralympic sport, both in the context of research and in practice. [ABSTRACT FROM AUTHOR]

A quantitative descriptive study based on Brazilian Active Pharmacovigilance of Dolutegravir (DTG) Project was performed to describe the adverse drug reactions (ADRs) to DTG reported and to evaluate the noncompleteness of data from DTG active pharmacovigilance in Brazil. ADRs and clinical and individual data were obtained from information from the Pharmacovigilance Questionnaire from April 2017 to August 2019. The reported ADRs were classified using the Medical Dictionary for Regulatory Activities (MedDRA). In the evaluated period, 249,066 individuals using DTG participated in the active pharmacovigilance of DTG, with 3472 (1.39%) reporting ADRs at least once. A total of 6312 ADRs were reported, of which 57.56% were persistent and 81.46% were not serious according to the individuals' reports. Most of the reported ADRs were gastrointestinal, neurological and psychiatric. ADRs related to neural tube defects and serious neuropsychiatric ADRs have been reported. Completion of more than half of the fields in the Pharmacovigilance Questionnaire was excellent. The frequency of ADR was low in relation to the number of people living with HIV (PLHIV) using DTG in Brazil, which suggests good tolerability and safety of DTG. The DTG active pharmacovigilance database in Brazil showed good data completeness. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to discover whether experiences of sexual violence suffered by a sample of adolescents and young-adults at a Brazilian public health had been disclosed or detected, why or why not, and what happened after disclosure or detection. Seventy-one (8.3%) students were victims of sexual violence, and 52 (73.2%) were females. The researchers interviewed 22 participants to obtain an oral history of these abuse experiences. The 22 interviewees had experienced 29 episodes of violence. Acquaintances had perpetrated 26 of these attacks, and of these 26 only four (15.4%) occurrences were never disclosed. Twenty-two experiences were disclosed or detected, of which four (18.2%) were promptly revealed (days after the event), resulting in a discontinuation of the violence. Unfortunately, molestation continued without intervention in nine (41.0%) of the revealed situations, despite disclosure or detection. The authors find that children or adolescents disclosing their experiences of sexual violence cannot end the attacks. This study identifies an urgent need to educate society about how to respond appropriately to revelations of sexual violence. Children or adolescents must be oriented to disclose their abuse and seek help from as many people as necessary until they are heard, believed and the violence is ended. [ABSTRACT FROM AUTHOR]

Identifying existing care pathways is the first step for understanding how services can be improved to enable early diagnosis and effective follow-up care for non-communicable diseases (NCDs); however, evidence on how care pathways can and should be identified in low- and middle-income countries (LMICs) is lacking. To describe generalisability and lessons learned from recruitment and data collection for the quantitative component of a mixed methods study designed to determine the care pathway for atrial fibrillation (AF) in Brazil, China and Sri Lanka. Adults (≥18 years) that spoke the local language and with an AF diagnosis were eligible. We excluded anyone with a hearing or cognitive impairment or ineligible address. Eligible participants were identified using electronic records in Brazil and China; in Sri Lanka, researchers attended the outpatient clinics to identify eligible participants. Data were collected using two quantitative questionnaires administered at least 2-months apart. A minimum sample size of 238 was required for each country. The required sample size was met in Brazil (n = 267) and China (n = 298), but a large proportion of AF patients could not be contacted (47% and 27%, respectively) or refused to participate (36% and 38%, respectively). In Sri Lanka, recruitment was challenging, resulting in a reduced sample (n = 151). Mean age of participants from Brazil, China and Sri Lanka was 69 (SD = 11.3), 65 (SD = 12.8) and 58 (SD = 11.7), respectively. Females accounted for 49% of the Brazil sample, 62% in China and 70% in Sri Lanka. Generalisability was an issue in Brazil and China, as was selection bias. Recruitment bias was highlighted in Sri Lanka. Additional or alternative recruitment methods may be required to ensure generalisability and reduce bias in future studies aimed at identifying NCD care pathways in LMICs. [ABSTRACT FROM AUTHOR]

The role of universities in health promotion has been strengthened by institutional policies and the Health Promoting Universities movement. Together they seek to identify behaviours that are harmful to the health of university students and implement programs or interventions to promote the health of students within the physical environment of universities. However, the COVID-19 pandemic rapidly increased the number of students learning by distance. Under these circumstances, there is an increased need to assess the knowledge, attitudes and health practices of students in distance learning. To develop a KAP (knowledge, attitude and practice) questionnaire on the health of distance learning students. Development was carried out in four stages: 1) literature review to identify existing health programs in universities; 2) formulation of questions based on WHO theoretical frameworks, National Health Promotion Policy and the literature review; 3) selection of interdisciplinary expert judges and submission of the KAP-Health questionnaire for analysis of appearance, efficiency/consistency, clarity/understanding, pertinence of content and sequence of items; and 4) content validation by applying the content validity coefficient (CVC). The mean CVCs obtained were all equal to or greater than 0.96, 0.95 and 0.93 for the Knowledge, Attitudes and Practices domains, respectively; all comfortably above the cut-off score of 80% (CVCt = 0.80). At this stage of the study, the judges consider the content of the KAP-Health questionnaire adequate to identify issues related to the health of students in distance learning. However, it is important to note that the next step is to test the usefulness of this questionnaire. We believe that our KAP-Health instrument is both original and useful for planning institutional policies in order to implement assertive strategies to promote the health of remote-learning students in Brazil and in other parts of the world. [ABSTRACT FROM AUTHOR]

Although religiosity is a strong feature of Brazilian people, the integration of spirituality in palliative care (PC) has been a challenge for health care professionals. In order to evaluate the spiritual resources used by family members of patients in PC, this work presents the results of the research carried out with 50 family members. The Satisfaction with Life Scale, Centrality of Religiosity Scale, Spiritual/Religious Coping Scale, Religious and Spiritual Struggles Scale, and Attachment to God Inventory were applied. The prevalence of positive spiritual/religious coping was very high (76%) or high (6%). There was a strong correlation between positive spiritual/religious coping and centrality of religiosity (r = 0.805; SD = 0.87). There was a moderate negative correlation between the avoidant attachment to God and centrality of religiosity (r = −0.611; SD = 1.24) and positive spiritual/religious coping (r = −0.575; SD = 1.37). There was a moderate positive correlation between the anxious attachment to God and spiritual struggles (r = 0.515; SD = 0.76) and negative spiritual/religious coping (r = 0.555; SD = 0.616). These results suggest that spiritual/religious resources are present in family members of patients in PC. These resources have been mostly ignored by the multidisciplinary team. Findings provide an evidence base for training health care professionals to better integrate spirituality in PC settings. [ABSTRACT FROM AUTHOR]

In 2002, the Brazilian deaf communities' struggles against academic failure and deaf student dropout won a linguistic policy: the LIBRAS Federal Law. This official law, regulated by Decree N.5626 in 2005, recognises LIBRAS as a national language and requires inclusive educational practices in a bilingual model in order to promote meaningful learning, interaction and participation of deaf students in all educational domains. Nearly two decades later, the Law N. 14.191/2021 has been published, establishing bilingual education for deaf people as a teaching modality on Guidelines and Bases of National Education. Despite these political movements towards an effective inclusive education, the daily reality in Brazilian schools shows there are still challenges to adopting an additive bilingual and cultural approach using LIBRAS. There are also challenges in developing fluid communication between deaf and hearing class members that would enable inclusion, collaboration and understanding of cultural differences in the educational domain. Combining ethnographic perspectives and theoretical discussion of inclusive-bilingual education in Brazil, this article describes interactions in an intercultural dialogue between deaf trainee teachers, hearing children and their hearing teacher in a second-language learning context (LIBRAS). Focussing on the ways in which relationships and communication processes are re-constructed by the participants, this study reveals different ways of representing deaf people and the learning of LIBRAS, highlighting a deterritorialised perspective from the children which moves freely between the ideological boundaries and linguistic and cultural limitations of the deaf and hearing adults. [ABSTRACT FROM AUTHOR]

This study aim to evaluate the feasibility, based on six feasibility study criteria, of using a one-week intervention of interpersonal theory of nursing for anxiety management in people who are taking part in a substance use disorders (ITASUD). The study adopted a feasibility mixed methods approach. The ITASUD was implemented with 39 male users of cocaine/crack as their principal drug with high levels of anxiety. The outcome (anxiety) was assessed by the Beck anxiety inventory. To address the feasibility criteria, data were gathered during appointments. Additionally, qualitative open-ended interviews were conducted in the final appointment. The assessment of the six feasibility criteria indicated the following: (1) demand: there was high demand among eligible participants; (2) acceptability: the ITASUD had better acceptability until the 3rd appointment; (3) implementation: the ITASUD's complexity and design was acceptable for participants; (4) practicality: 61.54% of participants used strategies from the ITASUD to manage their anxiety; (5) adaptation: there was no contamination and cointervention; and (6) safety: the ITASUD was safe. The exploratory analysis showed a relation between the level of anxiety and ITASUD (p < 0.0001). The ITASUD appears to be feasible. The participants reported positive experiences with the implementation of the ITASUD. The findings support the design of a powered larger trial to evaluate the effectiveness of the ITASUD. [ABSTRACT FROM AUTHOR]

To verify the agreement between the Alberta Infant Motor Scale assessment and maternal perception of the motor development in full-term infants. This is a cross-sectional study involving 161 infants and mothers. Children were assessed with the Alberta Infant Motor Scale (AIMS) for motor developmental classification. Mothers completed questionnaires aiming to identify maternal profiles and impressions about their children's development. The kappa test was used to analyze the concordance between AIMS and mother perceptions. A total of 83.2% of the sample was classified as typically developing and 16.8% as suspected or delayed development. The maternal impression indicates that 77% of infants are developing typically, 19.9% perceived their infants' development as advanced, and 3.1% delayed development. There was low agreement between the mothers' perceptions and AIMS classifications (kappa = 0.153) Maternal perception of their infant's development was unsatisfactory for evaluation of motor development because their perceptions did not agree with the findings of the AIMS. [ABSTRACT FROM AUTHOR]

To evaluate the association between suicidal behaviors and binge drinking among Brazilian adolescents. A cross-sectional study was conducted with 2,476 students 14 to 19 years of age from 26 public high schools in the city of Olinda, Brazil. Data collection occurred between March and June 2018 through the self-administered Youth Risk Behavior Survey. Descriptive analysis and Poisson regression (p < 0.05, 95%CI) were performed. The prevalence of suicidal ideation, planning and attempt in the previous 12 months was 23.7%, 17.4% and 13.5%, respectively. Suicidal ideation was associated with binge drinking one to two days (PR:1.053, 95%CI:1.011-1.096) and ≥ three days in the previous 30 days (PR:1.069, 95%CI:1.016-1.125), sadness/hopelessness in the previous 12 months (PR:1.313, 95%CI:1.267-1.360), a report of family physical aggression in the previous 12 months (PR:1.111, 95%CI:1.068-1.155), the female sex (PR:1.082, 95%CI:1.049-1.115) and a non-nuclear family (PR:1.037, 95%CI:1.004-1.071). Suicidal planning was associated with sadness/hopelessness in the previous 12 months (PR:1.257, 95%CI:1.214-1.302), report of family physical aggression in the previous 12 months (PR:1.110, 95%CI:1.065-1.156) and the female sex (PR:1.072, 95%CI:1.041-1.104). Suicide attempt was associated with binge drinking ≥ three days in the previous 30 days (PR:1.062, 95%CI:1.008-1.119), sadness/hopelessness in the previous 12 months (PR:1.202, 95%CI:1.161-1.244), report of family physical aggression in the previous 12 months (PR:1.105, 95%CI:1.060-1.153) and the female sex (PR:1.064, 95%CI:1.034-1.095). The Catholic (PR:0.938, 95%CI:0.899-0.979; PR:0.925, 95%CI:0.888-0.9865; PR:0.937, 95%CI:0.899-0.977) and Evangelical (PR:0.956, 95%CI:0.922-0.992; PR:0.954, 95%CI:0.919-0.991) religions acted as a possible protective factor against suicidal behaviors. Suicidal ideation and attempt were associated with binge drinking. [ABSTRACT FROM AUTHOR]

In March 2020, the World Health Organization (WHO) had declared the coronavirus disease 2019 (COVID-19) pandemic. Three weeks after WHO's declaration, almost 900,000 cases of COVID-19 were confirmed, with more than 43,000 deaths worldwide. Containment measures were recommended, such as social distancing and hand hygiene. Although they are known to be helpful to slow down the spread of the COVID-19, the efficiency of these measures depends on people's adherence. We explore whether personality traits account for variations in the commitment to the COVID-19 containment measures. The sample consisted of 814 Brazilian adults who answered a questionnaire about adherence to COVID-19 containment measures (COVID-19 questionnaire), factors of the Personality Inventory for DSM-5 (PID-5), and the affective resonance factor of the Affective and Cognitive Measure of Empathy (ACME). We conducted a network analysis. All connections observed in the network analysis were significant (p <.05). Empathy was the personality trait to present more connections to the COVID-19 questionnaire variables. The strongest positive connection was observed for emotional lability (PID-5) and the tendency to be concern about others getting the COVID-19 (COVID-19 questionnaire). Our findings indicated that empathy and emotional lability might be key traits directly associated with the propensity to adhere to the COVID-19 containment measures. [ABSTRACT FROM AUTHOR]

Background: Occupational health and ergonomics (OHE) has been recognized as a Physiotherapy specialty in 15 countries; however, a lack of studies that provide profiles of OHE Physiotherapists (PTs) and their professional practices. Objective: To provides a profile of the OHE PTs in Brazil, identify and audit their current professional practices based on the Conselho Federal de Fisioterapia e Terapia Ocupacional (COFFITO) guidelines for this specialty. Method: This was a cross-sectional study. The participants were legally registered with the Regional Council of Physiotherapy and Occupational Therapy (CREFITO) in Brazil. An invitation to participate in the survey was sent to the members of the Association of Physiotherapists in Occupational Health and Ergonomics (ABRAFIT) and PTs recognized for their contributions to the OHE field. The participants were contacted through e-mail, Facebook posts, and LinkedIn messages. The questionnaire was distributed through the SurveyMonkey platform. Results: A total of 153 (86%) OHE PTs returned the survey. The mean age was 35.6 (SD 6.8) years, mean time in the OHE field was 8.5 (SD 5.6) years, the majority are women (61.5%). The OHE PTs were company employees or service providers. The OHE PTs reported satisfaction with their professional performance (74.8%). The OHE PTs' most frequent interventions include biomechanical exposure assessments, ergonomic workplace analysis, and occupational health management. Conclusion: The OHE PTs in Brazil are predominantly women with professional experience who earn higher salaries than other PTs specialties. The OHE PTs based on their audited practices within the COFFITO guidelines focus on ergonomic workplace analysis and biomechanical exposure assessment. [ABSTRACT FROM AUTHOR]

To investigate the feasibility and the preliminary effects of an individualized intensive goal training for adolescents with cerebral palsy (CP). Twelve adolescents with CP (12–17 years old, MACS II-III, GMFCS I-IV) identified functional goals to be practiced three hours/day, five days/week, for two weeks. The feasibility aspects included the participant's adherence (i.e., daily logs), the adequacy of the instruments used, and the participant's satisfaction with the intervention (i.e., structured questionnaire). Outcome measures included the Canadian Occupational Performance Measure (COPM), Pediatric Evaluation of Disability Inventory (PEDI) (self-care; mobility), Children Helping Out: Responsibilities, Expectations and Supports (CHORES), Participation and Environment Measure-Children and Youth (PEM-CY) (home) and Box and Blocks Test (BBT). Assessments were conducted one month and two days before the intervention, immediately and three months after the intervention. Friedman tests were used to test time-related differences in the outcome measures. All adolescents completed and reported satisfaction with the proposed intervention. Significant improvements were observed in performance and satisfaction (COPM), in functional skills and caregiver assistance in self-care and in the performance of household tasks. There were no significant differences in mobility skills, independence in mobility or household tasks, home participation, or manual dexterity. The intensive training was feasible and promoted improvements in functional goals and daily functioning of adolescents with CP. [ABSTRACT FROM AUTHOR]

The study aimed to identify the regional preparations most offered in the restaurants of the Brazilian northeast, as well as the motives that determined their offer. The research is an exploratory and quantitative study using a questionnaire. We collected data through the application of a questionnaire, consisting of a series of closed-questions, answered in writing, and without the researcher. For each Northeastern capital, a survey was elaborated, being a total of nine questionnaires. Each one had ten regional dishes that the person in charge (manager or dietitians) had to determine the frequency of serving them and the motives for offering them. An expert committee was applied to validate the questionnaire before sending it to the restaurants. The criteria established for the approval of the items was a minimal of 80% (W-values ≥ 0.8) of agreement between the experts. We applied the questionnaires to the restaurants of the nine capitals. We determined the most common dishes analyzing data when the response rate was, at least, 10%. We assessed the frequency of each dish's serving by transforming the given information on a monthly basis. The most common preparations served were: caldeirada maranhense, peixada, carne-de-sol, baião-de-dois, feijoada, and xinxim de galinha. The motives for offering were: the dish is regional, it is a food habit, and it is well accepted. Even though one of the motives for offering or not the dishes was the nutritional characteristics, this was not considered as very important for the offer by participants. [ABSTRACT FROM AUTHOR]

The use of Smart Homes has grown considerably in the past decade. Enabling end-users to develop rules to program their homes and devices is very important to empower them. Several studies have analysed trigger-action programming tools, primarily using form-based and data-flow approaches for programming interfaces. This study evaluated the usability of a block-based tool for end-user development of rules to control smart homes and compared the difficulties encountered by non-programmers and programmers. Evaluations involved 10 programmers and 10 non-programmers in Brazil. A thematic analysis of 247 problem instances (80 from programmers and 167 from non-programmers) yielded the following themes, with problems related to condition blocks, action blocks, states and actions, time-related tasks, block configuration and personalisation, information architecture, programming logic, conceptual model of smart homes, simulator and debugging, help and technical problems. Despite most non-programmers being able to experiment with blocks, their task completion rates were significantly lower than programmers. The analysis showed aspects where block-based programming can enhance the use for non-programmers. They also confirmed interaction aspects revealed by previous studies using form-based and data-flow approaches that also occur with block-based programming to design smart home rules, with important contributions to improve end-user development tools for smart homes. [ABSTRACT FROM AUTHOR]

To examine the psychological well-being of primary caregivers of infants and toddlers with Congenital Zika Syndrome (CZS), and the roles of family resources, parenting stress, and coping strategies in caregivers' adaptation. Family caregivers (N = 50) of children with CZS who were receiving treatment at a rehabilitation hospital in Recife, Brazil participated a cross-sectional survey study. Caregivers completed measures of anxiety and depression, coping strategies, family resources, and parenting stress. Mild to severe symptoms of depression were identified in 40% of caregivers and were a more prominent concern than symptoms of anxiety. Fewer family resources and high levels of parenting stress were significantly associated with both anxiety and depression. The association between parenting stress and depression was moderated by coping, such that parenting stress was associated with higher caregiver depression at low but not high levels of coping strategy use. Practitioners in Brazil should consider the role of family coping and resources as important resilience promoting factors in the development of new programs designed to promote psychological adaptation in caregivers to children with CZS. It is recommended that caregiver mental health support services be integrated into existing early intervention programs targeting children with CZS. Parents and other primary caregivers are encouraged to take an active role in the care and developmental monitoring of children born with CZS, but their ability to provide care may be compromised by difficulties in psychological adaptation. Moderate and severe symptoms of depression were more prominent in caregivers than moderate and severe symptoms of anxiety (20% versus 6%, respectively). Practitioners should include assessment of coping strategies, parenting stress and family resources conjointly with evaluation of symptoms of depression and anxiety as part of routine CZS family evaluations. A useful approach for caregivers in Brazil may be to more fully integrate caregiver mental health support services into existing early intervention programs for children with CZS. [ABSTRACT FROM AUTHOR]

The present study aimed to identify profiles of adolescents based upon body and appearance-related self-conscious emotions, and to examine whether these profiles differed from each other in terms of their exercise addiction (EA) symptoms. A sample of 703 Brazilian adolescents (41% girls) completed a self-report questionnaire. The results from a two-step cluster analysis identified four profiles: prideful (19.5%), low self-consciousness (31.7%), moderately high self-consciousness (29.2%), and shameful-guilty (19.6%). The prideful profile was characterized by a greater presence of boys, as well as by higher frequency/intensity levels of exercise than the remaining groups. The shameful-guilty profile was characterized by a greater presence of girls and by higher levels of BMI compared to the remaining groups. Regarding EA symptoms, the results from the ANCOVA/MANCOVA analyses revealed that the prideful profile showed (i) higher salience and tolerance levels than the low-level balanced self-consciousness profile, and (ii) higher salience and lower conflict compared to the shameful-guilty profile. Additionally, the moderately high self-consciousness profile showed (i) higher salience and tolerance levels than the low self-consciousness profile, and (ii) higher salience levels than the shameful-guilty profile. Identifying subgroups on the basis of body appearance-related self-conscious emotions contributes to explaining different EA symptoms in adolescents. [ABSTRACT FROM AUTHOR]

This article investigates the influence of land titles on farmers' perceptions about the ease of conducting three types of land transactions: land sales, leases, and transfers by bequest. A questionnaire survey was conducted in a Brazilian municipality. Results indicate that farmers who have land titles perceive that land sales can be conducted more easily than those who do not have titles. However, perceptions regarding land leases and transfers as bequest were unaffected by the status of titling. This indicate that land titles may be ineffective in stimulating transaction types that are not part of local culture. [ABSTRACT FROM AUTHOR]

Paralympic sport is characterized by the pursuit of better performance in sports played by people with disabilities. In wheelchair rugby, assistive technology (AT) equipment is used to enhance athletic performance. Assess the AT requirements of wheelchair rugby players, identify the psychosocial factors that contribute to their performance and AT use and assess user satisfaction with the recommended and implemented AT. Descriptive explanatory case study with a quantitative approach that included four athletes from the Brazilian national wheelchair rugby squad, who answered the Athletes with Disabilities Questionnaire, the AT Device Predisposition Assessment (ATD PA-BR) and Quebec User Evaluation of Satisfaction with AT (QUEST version 2.0). Statistical analysis consisted of frequencies and percentages, as well as the scores for each instrument. Items required: harnesses, gloves and cooling vests. The AT improved athletic performance and increased the overall satisfaction score from 1.6 to 4.8 after intervention. The factors considered to determine AT success were safety, comfort and effectiveness, and the positive psychosocial factors identified were support from family and friends and sufficient income to participate in the sport. The study achieved its objectives and the use of a conceptual model, standardized assessments and working in conjunction with the athletes and their trainers were essential. It is hoped that the baseline presented in this study can be used in future research in the fields of AT or parasports. Present the intervention of the occupational therapist in Assistive Technology (AT) for paralympic athletes; Identify personal and contextual factors in the use of AT in parasports (attitudes, support and services); Present satisfaction with the AT device in parasport before and after intervention; Present satisfaction with the AT service provided by the occupational therapist based on the Matching Person and Technology (MPT) model. Understand the objectives of AT in wheelchair rugby. Understand the use of the MPT conceptual model and application of the AT Predisposition Assessment (ATD PA-BR) to recommend and monitor AT use in the para-athlete population. Know the AT devices used and customized by wheelchair rugby athletes. [ABSTRACT FROM AUTHOR]

Impulsivity is both a risk factor for and a consequence of alcohol use disorder (AUD), for which mindfulness-based approaches have been proven to be effective. However, the specific relationship between mindfulness and impulsivity has been little explored in the literature, especially in people with AUD. This study aims to investigate the relationship between different facets of dispositional mindfulness and impulsivity among people with AUD in an inpatient setting in Brazil. Methods: Participants (n = 165) completed the following self-report measures: the Alcohol Use Disorders Identification Test (AUDIT), the Five Facets of Mindfulness Questionnaire (FFMQ-SF), and the Short UPPS-P Impulsive Behavior Scale (SUPPS-P). Multiple imputation techniques and linear models were employed to assess the relationships between dispositional mindfulness and impulsivity. Results: In complete case analysis, the UPPS-P facet "lack of premeditation" was inversely related to the FFMQ facet "non-reactivity" (B = −0.17; p = 0.01); and "positive urgency" was inversely related to "act with awareness" (B = −0.27, p = 0.02) and "non-reactivity" (B = −0.17, p = 0.01). Conclusion: Relationships of varying magnitudes between dispositional mindfulness and impulsivity domains among people with AUD were found, suggesting that higher mindfulness skills are related to less impulsive traits. Our results encourage further longitudinal studies evaluating the potential of specific mindfulness components to decrease impulsivity among AUD inpatients, including its underlying mechanisms. [ABSTRACT FROM AUTHOR]

We address the limited understanding around the overlap between violence and HIV in Brazil. Data was from two clinic-based samples of HIV-positive (n = 1534) and HIV-negative women (n = 1589) in São Paulo and Porto Alegre. We conducted latent class analysis and identified violence typologies by type of violence, life course timing, frequency, and perpetrator, stratified by city and HIV-status. Overall, HIV-positive women experienced more lifetime physical and sexual violence than HIV-negative women. Twelve unique violence latent classes were identified. In São Paulo, HIV-positive women were likely to have endured physical violence several times (Conditional Probability [CP]: 0.80) by an intimate partner (CP: 0.85), and sexual violence several times (CP: 0.46) by an intimate partner (CP: 0.62). In Porto Alegre, HIV-positive women endured physical violence several times (CP: 0.80) by an intimate partner (CP: 0.70) during childhood/adolescence (CP: 0.48), and sexual violence several times (CP: 0.54) by an intimate partner (CP: 0.60). Findings inform interventions to educate around gender equity, violence, and the health effects of violence including HIV, integrate HIV and violence services, and improve the provision of bio-medical HIV prevention among HIV-negative women who experience violence. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) develops as a multifaceted and complex disorder, with clinical and functional repercussions. Objective: To investigate the association among contextual factors (personal and environmental) and clinical features and the disability of COPD patients, with emphasis on activity and social participation. Methods: A cross-sectional study with stable COPD participants (n = 47) was conducted to assess personal and clinical characteristics, activity of daily living using the London Chest Activity of Daily Living scale (LCADL), disability by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and environmental factors by the Craig Hospital Inventory of Environmental Factors (CHIEF). Statistical analysis was performed by the multivariate method. Results: In the LCADL predictive analysis, the variables forced expiratory volume in 1 second (FEV1), dyspnea levels 3–4 by the modified Medical Research Council scale (mMRC), and active level of regular physical activity were included in the final model (adjusted R2 = 0.523). In addition, WHODAS was influenced by CHIEF physical structure score and mMRC 1–2 and mMRC 3–4 grades (adjusted R2 = 0.500). Conclusions: Disability is a complex in COPD patients and encompasses a prominent role of dyspnea levels in the prediction of activity and participation. Multivariate models presented clinical and contextual factors as functional predictors that included the physical structure of the environment in the determination of social participation. [ABSTRACT FROM AUTHOR]

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Purpose: The present research aims to contribute to the comprehension of the product development process (PDP) of Assistive Technology (AT) through methodological multi-case studies in Brazil. The following considerations presented in the study are part of a Master's degree thesis, conducted from 2013 to 2015. Methodology: The research adopted a multi-case study methodology by selecting four product developers from the Assistive technology field in Brazil, focusing on physical disability. Results: According to the findings, this research discusses the possible influences of Emotional Collaborative Design on the process of Assistive Technology, aiming at enhancing new perspectives about such tools on the product development process. As a result, it was possible to set a delimitation of PDP of AT stages in the four cases approached, in most of the methodological steps empirically developed. Conclusion: Final considerations of the study, collaborate with the comprehension of the assistive product development, stating there is still a little emphasis on the design concepts throughout these processes, also illustrates the necessity for further studies about the product development in the area. The visualization of a still scarce dialogue between the multiple areas that could contribute for AT development; The potential correlation between high dissatisfaction in several issues regarding use of ATs and the poor understanding of user needs; The predominance of a great functionality emphasis, and the negligence of the individual's emotional in AT development; The understanding that product design maybe is still poorly applied/understood in this field. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate health-related-quality-of-life and derive health-state-utility (HSU) from breast cancer patients, before and after routine therapy at a Brazilian reference public cancer center.Methods: In a prospective cohort study, a consecutive sample of outpatients newly diagnosed with breast cancer was submitted to two interviews (baseline, 6-month) to complete EQ-5D-3L/VAS and EORTC-QLQ-C30/BR23 questionnaires. Demographic and clinical information was reviewed from medical records.Results: For 196 patients, EQ-5D domains of pain/discomfort and anxiety/depression were mainly affected, but partially improved overtime, while mobility/usual activities/self-care worsened after therapy. EORTC-QLQ-C30/BR23 scales mostly affected were emotional functioning, insomnia, pain, sexual enjoyment and future self-health perspective at baseline, while financial difficulties, insomnia, fatigue and therapy side-effects at follow-up. Overtime mean scores were 71.4 (95%CI68.5-74.4) and 76.1 (95%CI73.3-78.8) for EQ-5D-VAS, and 0.712 (95%CI0.686-0.737) and 0.732 (95%CI0.707-0.757) for HSU. HSU was 0.689 (95%CI0.648-0.730) in stages III-IV, and 0.692 (95%CI0.652-0.731) under two/three chemotherapy regimens.Conclusion: In a context of impairments in emotional functioning, sexual enjoyment, symptoms burden, and poor future self-health perspective, breast cancer produced a mean HSU of 0.712. After routine care, there was a small improvement in quality of life, with lower HSU particularly in advanced disease and multiple chemotherapy regimens. [ABSTRACT FROM AUTHOR]

Background: Dementia training for Brazilian general practitioners (GPs) is underdeveloped. We investigated knowledge and attitudes to dementia management among Brazilian GPs and compared these with previous UK findings to inform future decisions about how training is structured. Methods: A total of 115 Brazilian GPs were asked to complete a Portuguese translation of a questionnaire previously used in the UK. This comprised a 14-item multiple-choice knowledge quiz, and a 5-point Likert-scale questionnaire assessing attitudes across 10 dementia management domains. Exploratory factorial analysis was conducted for attitudes. Results: Attitudes toward dementia demonstrated the same underlying factor structure, "heartsink" and "heartfelt" factors, in Brazil as in previous UK studies, explaining 61.6% of variance in responses. Knowledge scores were negatively correlated with heartfelt and heartsink factors. Conclusions: Greater knowledge about dementia was associated with some pessimism about dementia care. The similarity in the structure of attitudes toward dementia management between Brazilian and UK GPs provides a starting point for shared educational approaches targeting attitudes. [ABSTRACT FROM AUTHOR]

Background: College students are susceptible to using cognitive enhancement drugs, also known as smart drugs. Objectives: estimate the prevalence of smart drug use and investigate the factors related to access and use among undergraduate students. Methods: cross-sectional study performed among all students who entered the university in 2017 using an anonymous, self-administered questionnaire. Smart drug usage was defined as taking methylphenidate, modafinil or piracetam at any point in life and in the preceding 12 months. We characterized the means of obtaining smart drugs, reasons for using and students' residential situation. We asked students who did not use any medication if they were interested in taking it and the reasons for not using. Results: Out of 1865 respondents, 4.2% had used smart drugs in the last 12 months, and the prevalence among law students reached 14.3%. The most commonly used smart drug was methylphenidate. Among the students who did not present ADD diagnosis, the drug was obtained mostly through a friend. More than 300 students reported a desire to use some smart drug, but they did not, mainly due to the fear of side effects. Conclusions: The current study has found a variety of frequency of smart drug use among college students and has also showed that many students are willing to take some kind of cognitive enhancement drug. Therefore, it is important to discuss this issue from a public health perspective. [ABSTRACT FROM AUTHOR]

This study evaluated the test–retest reliability of a questionnaire assessing five domains of sedentary behaviour, and compared an overall indicator of sitting time with measures obtained by a multi-domain questionnaire, among adults living in Brazil. Data from two different studies carried out in Pelotas, Brazil, were used. Study A: evaluated 7-day reliability of a multi-domain sedentary behaviour questionnaire among 78 adults (≥18 years). Study B was a population-based study (n = 2,871 adults aged 20+ years) where a score of sedentary behaviour based on time spent sitting in five domains was compared with overall sitting time. Lin's Concordance Correlation coefficients (CCC) and Bland–Altman plots were used to assess agreement between measures. The 7-day reliability of multi-domain questionnaire did not show marked differences in the median of minutes spent in each domain (Study A). For the total score, the Lin's CCC was 0.87. When sitting time was measured by a single question, participants reported on average less sedentary time compared to the multiple-domain questionnaire (Study B). There was a slightly greater difference between measures among participants who reported higher sedentary time. Assessing sedentary behaviour in different domains would appear to be preferable to employing a general question on the total time spent sitting per day. [ABSTRACT FROM AUTHOR]

Objective: To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI). Design: Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME. Setting: Patients were referred from public primary or secondary care providers in Florianópolis, Brazil. Participants: Adult women with UI. Intervention: Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates. Main Outcome Measures: Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level. Results: 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy (r = 0.299); age (r = 0.242); and educational level (r = −0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence (R2 = 0.217). Conclusions: Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of individual and combination therapies (low-level laser therapy and physical exercises) on pain, stiffness, function, and spatiotemporal gait variables in subjects with bilateral knee osteoarthritis (OA). Methods: Subjects with knee OA (Grades 1–3) were evaluated and randomized into four groups: Control Group (CG), untreated; Laser Group (LG), treated with laser at 808 nm, 5.6 J; Exercise Group (EG), treated with exercise; and Laser + Exercise Group (LEG), treated with laser and exercises. The treatment was carried out twice a week for 2 months. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire was applied for evaluation and reevaluation; evaluation of spatiotemporal gait variables was performed using GAITRite equipment. Results: The EG showed significant improvement in pain (p = 0.006) and function (p = 0.01) according to WOMAC. Regarding gait variables, in intergroup analysis after 8 weeks all groups receiving intervention showed a significant increase in gait speed: LG versus CG (p = 0.03); EG versus CG (p = 0.04) and LEG versus CG (p = 0.005). Only the group treated with laser + exercise showed a significant increase (p = 0.009) in the cadence and duration of single right limb support (p = 0.04), and only the groups treated with exercise and laser + exercise showed significant decreases in the duration of right limb support (p = 0.035 and p = 0.003, respectively), compared to the CG. Conclusions: The group treated only with exercise showed improvement in WOMAC questionnaire scores. Regarding the gait variables, all groups undergoing the interventions showed increases in the gait speed compared to the CG. The laser and exercise combination therapy provided the best results for the other gait variables (cadence and duration of right limb support and duration of single right limb support). There are differences in gait patterns in patients with knee OA, including decreased gait speed, cadence, and step length. The results shown in the present study provide additional information about the physical therapy approaches that should be chosen during clinical practical to improve gait performance in individuals with knee osteoarthritis. The improvement in gait performance is a relevant issue due to the fact that is associated to physical independence and better quality of life. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the levels and factors that influence the abandonment of assistive products by users of a local reference rehabilitation center. Methods: This observational study involved users who received services and assistive products provided by our center of rehabilitation. Users were identified using the records of the center and their responses about the abandonment were collected through face-to-face interviews. Results: The abandonment level of assistive products was 19.38%. 83.5% of the users use at least one of the assistive products they have received. Rigid and folding frame wheelchairs, with and without postural support devices, as well as shower wheelchairs, presented the lowest abandonment levels, followed by canes and lower limb orthoses. Upper limb orthoses, Knee Ankle Foot Orthosis(KAFO), walkers, crutches and lower and upper limb prostheses all presented higher abandonment levels. Conclusion: The simultaneous use of mutiple assistive products, users perception on the importance of using them, and completing the rehabilitation treatment were found to impact on the short and long-term use of products. The study offers inputs to decision making and planning for assistive technology provision in developing countries with regard to expected demand and service delivery. Implications for Rehabilitation: Data about the abandonment of assistive products in Sao Paulo, Brazil, could assist informing decision making on provision and servicing of these products in similar settings. The strong correlation found between abandonment levels and the simultaneous use of multiple devices should be taken into account by health professionals when prescribing assistive products and providing guidance to users. The need for follow up on the use of assistive products after discharge from rehabilitation treatment becomes strikingly clear, as data show that completing treatment is significantly relevant when evaluating abandonment levels. As assistive products users’ perception about the importance of using these devices is shown to be significant in explaining abandonment, it is mandatory that health and rehabilitation professionals take it into account when providing guidance and training users. [ABSTRACT FROM AUTHOR]

Introduction: The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living. Objective: To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy. Methods: A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user’s satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil. Results: The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants. Conclusion: The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation: The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the level of burden and quality of life of family caregivers of stroke patients and to investigate the correlation between burden, quality of life (including physical, social, psychological, and environmental domains), age of caregivers, and the care period. A descriptive correlational cross-sectional study was performed, with a convenience sample of family caregivers (n = 30) of stroke patients in São Paulo, Brazil. Data were collected using a questionnaire on participants' characteristics, the Zarit Burden Interview Scale (ZBIS), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument. A descriptive analysis was performed, and correlations between variables were analyzed using Pearson's productmoment correlation coefficient. The average burden score on the ZBIS was 29.6, representing a moderate burden, and the average overall quality of life score on the WHOQOL-BREF was 62.06%, which indicates moderate quality of life. A significant weak negative correlation was observed between burden and environmental domains (r = -0.470; p = .009), quality of life (r = -0.414; p = .023), and physical domains (r = -0.394; p = .031). No significant correlations were found between burden and quality of life, and variables in the psychological and social domains, age of caregivers, or care period. Caregivers for stroke patients presented with moderate levels of burden and reduction in quality of life. Levels of burden correlated negatively with environmental domains, quality of life levels, and physical domains; however, these correlationswereweak, indicating the possible interference of other factors. [ABSTRACT FROM AUTHOR]

Initiatives to implement nationwide health information systems (HIS) have been developed in different countries. Despite the potential of these initiatives of improving the quality of healthcare, the evidence of failures are numerous. We analysed the perceptions of a nationwide hospital information system by a group of 36 managers and healthcare professionals of a university hospital, prior to its adoption (pre-implementation evaluation), with the purpose of identifying issues which were likely to affect its implementation and use. This research takes a qualitative approach. Interviews, questionnaires and documentary research were used to collect data. Analysis was based on coding and categorisation. The results point out to seven areas of concern of the participants of the research those emerged from the analysis: hardware and software; government management, politics and trade unions; workplace practices; education, training and support; implementation management; staff skills; and communication. We identified that these issues are similar to problems resulting from HIS evaluations performed after their adoption. This discovery reveals that problems that usually arise from the implementation and use of nationwide HIS can be anticipated and dealt with beforehand when pre-implementation qualitative evaluations are performed. These evaluations contribute to improve intra-organisational and inter-stakeholders’ communication in comprehensive nationwide HIS adoption programmes. [ABSTRACT FROM PUBLISHER]

Infertility has been negatively associated with sexual satisfaction. This study aimed to estimate the relation of infertility to sexual satisfaction from a cross-cultural perspective, comparing Italian and Brazilian women. Between June 2012 and January 2013, 528 women seeking assisted reproduction technology (ART) treatment in Italy (39%) or Brazil (61%) completed self-reports of sexual satisfaction (ISS) and infertility-related stress in the marital domain (IRS). IRS was the same across countries. ISS differed, with 34.31% of the Italians and 43.52% of the Brazilians being sexually dissatisfied at a clinical level (ISS score >30). Multiple logistic regression models showed that being sexually dissatisfied at a clinical level was associated with lower education and higher IRS among Italian women, regardless of having a diagnosed cause of infertility. It was instead associated with higher IRS only among the Brazilian women who had a diagnosed cause of infertility. These findings suggest that, regardless of nationality, sexual satisfaction and infertility-related stress need to be addressed in the treatment of infertile women turning to ART. However, as factors associated with these dimensions vary across countries, interventions to promote sexual satisfaction among infertile women should be adapted to their specific socio-cultural context. [ABSTRACT FROM AUTHOR]

Background: Non-adherence to oral antidiabetics drugs (OADs) has been a common problem and may contribute to poor glycemic control. Aim: To describe an experimental study protocol that aims at implementing and evaluating the effect of the "action planning and coping planning" interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services. Design: A randomized controlled trial. Methods: Two groups (intervention and control) will be followed over a period of 105 days. The intervention group will receive a combination of the "action planning" and "coping planning" intervention strategies. There will be in-person meetings and phone calls to reinforce the intervention. The control group will receive the usual care from the health unit. Conclusions: It is hoped that this study will help health professionals to improve their approach with patients who have T2DM in relation to medication adherence. [ABSTRACT FROM AUTHOR]

Aim: To describe the sociodemographic, clinical, and behavioral characteristics of women who seek treatment for smoking cessation and to investigate the relationship between these characteristics and the nicotine dependence level and treatment duration. Methods: Data were collected using questionnaires that were administered to 655 women. Regression of generalized linear model and regression logistic ordinal were used to assess the correlation between the variables being studied. Findings: The average age of women in the study was 49 years. Among them were those who were employed (54.9%), who had high levels of nicotine dependence (78.5%), and whose primary reason for seeking treatment was related to health concerns (62%). The treatment duration was positively correlated with depression (p = 0.04), hypertension (p < 0.01), and with seeking treatment due to health concerns (p = 0.02). Conclusions: Our study indicates that adherence in women can be increased by providing treatment that is accessible to the lower class. It also indicates the need to reconceptualize the way therapeutic group sessions are conducted. We hypothesize that the reason for the high dropout rate after 6 months of treatment could be related to the way that group sessions operate. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of non-cognitive skills never has been used in Brazil. This study aims to evaluate Multiple Mini Interviews (MMI) in the admission process of a School of Medicine in São Paulo, Brazil. Methods: The population of the study comprised 240 applicants summoned for the interviews, and 96 raters. MMI contributed to 25% of the applicants' final grade. Eight scenarios were created with the aim of evaluating different non-cognitive skills, each one had two raters. At the end of the interviews, the applicants and raters described their impressions about MMI. The reliability of the MMI was analyzed using the Theory of Generalization and Many-Facet Rasch Model (MFRM). Results: The G-study showed that the general reliability of the process was satisfactory (coefficient G = 0.743). The MMI grades were not affected by the raters' profile, time of interview (p = 0.715), and randomization group (p = 0.353). The Rasch analysis showed that there was no misfitting effects or inconsistent stations or raters. A significant majority of the applicants (98%) and all the raters believed MMIs were important in selecting students with a more adequate profile to study medicine. Conclusions: The general reliability of the selection process was excellent, and it was fully accepted by the applicants and raters. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to culturally adapt and validate the Revised Fibromyalgia Impact Questionnaire (FIQR) to Brazilian Portuguese, by the use of analysis of internal consistency, reliability, and construct and structural validity. Method: A total of 100 female patients with fibromyalgia participated in the validation process of the Brazilian Portuguese version of the FIQR (FIQR-Br). The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Pearson's rank correlation for construct validity, and confirmatory factor analysis (CFA) for structural validity. Results: It was verified excellent levels of reliability, with ICC greater than 0.75 for all questions and domains of the FIQR-Br. For internal consistency, alpha values greater than 0.70 for the items and domains of the questionnaire were observed. Moderate (0.400.70) correlations were observed for the scores of domains and total score between the FIQR-Br and FIQ-Br. The structure of the three domains of the FIQR-Br was confirmed by CFA. Conclusions: The results of this study suggest that that the FIQR-Br is a reliable and valid instrument for assessing fibromyalgia-related impact, and supports its use in clinical settings and research. The structure of the three domains of the FIQR-Br was also confirmed. [ABSTRACT FROM AUTHOR]

This study analysed the behaviour of the geometric curvature of the spine during sirshasana. The position of dorsal retroreflective markers was computed via stereophotogrammetric analysis in six males and five females (29.4 ± 8.8 years, 63.0 ± 11.4 kg, 1.66 ± 0.08 m [average ± standard deviation]). The spinal points were projected onto the sagittal and frontal planes of the trunk, a polynomial was fitted to the data and the two-dimensional geometric curvature was quantified. The inferior lumbar lordosis decreased compared to the orthostatic position and gait, which may favour the posterior protrusion of the lumbar spinal nucleus pulposus in people with posterior herniation. The lateral deviation at the middle of the thoracic spine increases during sirshasana, which may reflect increased difficulties for postural control and spinal loads. It could be useful for promoting positive spinal structural and functional chronic adaptations for healthy participants, if the yoga programme is carefully planned and the spinal alignment is carefully monitored during a headstand. However, it may aggravate some spinal diseases, especially scoliosis. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the association of combined physical activity (PA)/sedentary behaviour (SB) with depressive symptoms (DS) in older adults. A cross-sectional study was conducted with 622 individuals ≥ 60 years old. After adjusting for gender, years of study, and monthly household income, prevalence ratios for presence of DS were statistically significant for older adults with <150 min/week in PA and ≥75th percentile of SB on weekdays (PR = 2.11,95%CI: 1.54–2.90) and on weekends (PR = 2.20,95%CI:1.57–3.09). Older adults who do not meet the PA guidelines and spend more time in SB on weekdays or weekend days are more likely to present with DS compared to those who meet the recommendations of PA and spend less time in SB during the day. [ABSTRACT FROM PUBLISHER]

Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD).Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20–30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding.Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3).Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression [ABSTRACT FROM PUBLISHER]

Purpose:To translate and cross-culturally adapt the Foot and Ankle Ability Measure (FAAM) questionnaire and verify the psychometric properties of the Brazilian–Portuguese version of this instrument. Methods:Analysis of validity was carried out by applying the Rasch model and evaluating correlations with the Short Form-36 (SF-36) Physical Function (PF) subscale. Test–retest reliability and internal consistency were analyzed with the intraclass correlation coefficient (ICC2,1) and Cronbach’s alpha tests, respectively. Results:Ninety subjects with various foot and ankle musculoskeletal disorders (age 37.05 SD 10.49 years) were included. The ICC2,1was 0.88 and 0.82 with Cronbach’s alphas of 0.93 and 0.90 for the “Activities of Daily Living” (ADL) and “Sports” subscales, respectively. Correlations with the SF-36 PF were 0.78 (p < 0.01, CI95: 0.62–0.87) and 0.65 (p < 0.01, CI95: 0.45–0.79) for the ADL and Sports subscales, respectively. Item reliability indices in Rasch analysis were 0.91 (ADL) and 0.84 (Sports). Three items from the ADL subscale (14.2%) did not match the expectations of the model. All items from the Sports subscale fit the model. Conclusions:There is evidence of validity and reliability of the FAAM-Brazil. Rasch analysis indicated that three items of the ADL subscale did not fit the model in the sample studied.Implications for RehabilitationSelf-report questionnaires are commonly used in both clinical practice and research because of their ability to efficiently collect information. If the instrument is created properly, the information collected can be used to interpret the effect of clinical conditions on physical function.The Foot and Ankle Ability Measure (FAAM) is an evaluative instrument that assesses functional limitations for those with foot- and ankle-related disorders. It was translated into four languages and has evidence of validity, reliability, and responsiveness.Evidence of validity and reliability is provided for the FAAM-Brazil when applied to subjects with a wide range of foot and ankle musculoskeletal disorders. [ABSTRACT FROM PUBLISHER]

The spatial distribution of enteroparasitosis in an indigenous village from Paraná was evaluated to identify areas of risk for these infections. A cross-sectional study (from November 2010 to June 2011) was performed using Three Faecal Test®and Kato & Katz method and a questionnaire on housing and hygiene conditions was administered. Local geostatistical analyses were performed to determine the spatial distribution of intestinal parasitic infections. The overall prevalence of enteroparasites was 67.2 % (457/680), and the most prevalent taxa wereAscaris lumbricoides(48.8 %) andTrichuris trichiura (44.7 %). The prevalence of heavy infection by soil-transmitted helminths was 3.6 % and the families lived in houses with an average of 5.1 residents and < 2 bedrooms per household. The average number of species per individual present spatial heterogeneity with the highest values (≥0.8) in areas with high clustering of residences. The visualization of the spatial distribution of intestinal parasites in this indigenous village is an important contribution to determining health risk areas and planning decisions and services. [ABSTRACT FROM PUBLISHER]