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Supported by the Intergroup Threat Theory (ITT), this study analyzes the effect of multicultural ideology on attitudes towards immigrants mediated by realistic, symbolic, and zero-sum threats. With a sample of Portuguese participants ( N = 404)), polynomial regression analysis with response surface methodology was used to test the effects of multicultural attitude (MA) and perceived intergroup threat (PIT) on attitudes towards immigrants (ATI). This study also tested a model in which positive MA leads to a lower PIT, and consequently to more favorable ATI. Four hypotheses were proposed; all of which were confirmed. The results further showed that the direction of discrepancy between MA and PIT can provide a more comprehensive understanding of the complex role of multicultural ideology in predicting ATI. Findings, limitations, and directions for future research are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Mediterranean Diet (MedDiet) is a healthy eating pattern associated with a better quality of life among older adults and reduced risk of non-communicable diseases. Little is known about the MedDiet in immigrant communities from countries in which the MedDiet is a settled cultural heritage. Thus, we examined MedDiet adherence and perceived knowledge, benefits, and barriers to the MedDiet in a Portuguese immigrant community in Turlock, California. A cross-sectional study was conducted with 208 participants in Turlock and Livermore, California, which was used as a reference population. Univariate, multivariable, and logistic regression models were used for data analysis. Compared to the Livermore group, the Turlock group was younger and less educated, but had a higher average MedDiet score and active adherence to a MedDiet ( p < 0.001 for both). In the Turlock group, convenience, sensory appeal, and health were observed to be significant barriers to the MedDiet ( p < 0.05), while health, weight loss, natural content, familiarity, price, sensory appeal, and mood were significant benefit factors ( p < 0.05). In conclusion, participants in Turlock had greater MedDiet adherence despite lower education attainment. Furthermore, the perceived benefits of the MedDiet were key factors in MedDiet perception and adherence in a Portuguese immigrant community.

Objective: This study aimed to develop and validate a Portuguese version of the Menopause Representations Questionnaire (MenoSentations-Q), a self-report measure to assess cognitive appraisal of menopause, based on cognitive components of the Self-Regulation Model and the results from a previous Portuguese qualitative study., Methods: A total of 309 Portuguese women, aged 45-65 years, completed the questionnaire. Factorial, convergent, discriminant, and criterion validity, as well as reliability and psychometric sensitivity, were studied., Results: MenoSentations-Q has demonstrated acceptable factorial, convergent, and discriminant validity, as well as good values of sensitivity and reliability for the four factors (i.e. identity; positive consequences; negative consequences; and control, awareness, and cause). Criterion validity was only obtained for two factors., Conclusions: MenoSentations-Q, a brief measure of menopausal representations, in this sample of Portuguese women provides information to inform interventions that might include challenging unhelpful menopausal representations. This instrument could be used in both clinical and community settings.

Background: The Back Pain Attitudes Questionnaire (Back-PAQ) was developed to evaluate attitudes and beliefs of the general public, people with back pain, and healthcare professionals about the spine., Objectives: To translate and cross-culturally adapt the Back-PAQ (34-item and 10-item versions) into Brazilian-Portuguese (Back-PAQ-Br) and test its measurement properties in a Brazilian sample., Methods: The cross-cultural adaptation and testing of the measurement properties followed the recommendations of international guidelines. Members of the general public, people with back pain, and healthcare professionals, for a total of 139 individuals, took part in the assessment of internal consistency, construct validity, and ceiling and floor effects. The Hospital Anxiety and Depression Scale (HADS) and the Brazilian-Portuguese version of the Tampa Scale of Kinesiophobia (TSK) were used to evaluate construct validity. Test-retest reproducibility was determined on 77 participants. Retest was performed a minimum of 1 week and a maximum of 2 weeks from the original test., Results: There was very high agreement between translators (88.2%). The Back-PAQ-Br showed excellent internal consistency (Cronbach's alpha 0.92) and excellent reproducibility (ICC 0.94; SEM 5.14 points on a 136 point scale), with a smallest detectable change (90% confidence level) of 11.93 points. There was strong correlation between Back-PAQ-Br and TSK (r = -0.72) and very weak correlation between Back-PAQ-Br and HADS (r = -0.23 for both depression and anxiety domains). No ceiling/floor effects were observed., Conclusion: The translation process and cross-cultural adaptation had very high agreement between translators. The Back-PAQ-Br has excellent measurement properties that are similar to the properties of the original version., (Copyright © 2020 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To identify the strategies developed by people in the aging process to keep living in their own home, despite the weaknesses and difficulties they face., Methods: The research was carried out based on a survey of population aged 65 years or older in the Portuguese municipality of Portimão. Data were collected by questionnaire, in 2017, and submitted to statistical and content analysis., Results: Most respondents own their household, where they feel safe and satisfied, and they show awareness and concern about the changes they have to make in their home to stay there. In addition to housing and livability conditions, health, economic resources, social network, and available services play a major role in the community., Conclusions: We identified several strategies used by older adults to stay in their households as they age and the ways they mobilize their available resources, as well as constraints of aging in place.

The article analyzes the travel narratives to the hinterlands of the states of Mato Grosso and Goiás published in 1935 and 1936 by the São Paulo-based explorer Hermano Ribeiro da Silva, which proved a great publishing success and had a considerable impact on lettered society in Brazil. The analysis focuses on his ideas about the relationship between the environment in Central Brazil and the man who inhabited it, the potential economic exploitation of the region, and the role of the State in orchestrating initiatives capable of promoting its effective incorporation into the nationhood. It also seeks to understand how he grounded his discourse on generic scientific concepts and schemas endowed with rhetorical and argumentative power.

Background: Worldwide, different traditions of symbolic statements in graveyards can be found. However, studies on sub-Saharan Africa are rare. For BaKongo cemeteries, it is only known that they traditionally do not exhibit plants for decoration purposes. Our study wanted to inspect the influence of Portuguese culture due to the long shared colonial past., Methods: During 2015 and 2019, plant use in 87 graveyards in 13 municipalities of the province Uíge was documented. Five expert interviews with the village eldest in five municipalities completed the data collection., Results: While 24% of the graveyards didn´t have any planting, 27 plant species were found in the remaining ones, including a high percentage of alien species (59%), mainly from the Americas. The most abundant plant species are Euphorbia tirucalli (23%) and Agave sisalana (22%). With increasing distance from the city Uíge (especially towards the Democratic Republic of the Congo), the utilization of living plants in cemeteries is decreasing except along the road. In most of the cases, just one plant species per gravesite was found., Conclusions: This unexpected high number of plants might be interpreted as a strong evidence of outside influence. Cultural symbols of the BaKongo cosmology and Christianism appear to coexist or coalesce. Furthermore, plants are used as a marker for graveyards. Modern influences like the use of concrete in proximity to urban areas indicate a certain wealth., Competing Interests: The authors have declared that no competing interests exist.

The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice., (© 2019 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Although the Psoriasis Epidemiology Screening Tool (PEST) questionnaire is a useful tool for screening patients for psoriatic arthritis (PsA), it has not been validated in Portuguese. Our aim was to perform a cross-cultural validation of the PEST for Brazilian Portuguese, as well as to analyse its psychometric properties and to test the association of PEST scores with patient clinical characteristics. The first step was the translation and cross-cultural adaptation of the PEST questionnaire into Brazilian Portuguese, which included forward translation, synthesis, back translation, consolidation with an expert panel and cognitive debriefing with pilot testing. The second step was validation and psychometric testing, in which 124 dermatology patients with no previous PsA diagnosis completed the new adapted questionnaire (PEST-bp). Patients were initially assessed by a dermatologist for clinical characteristics, then they answered the Dermatology Life Quality Index (DLQI) and PEST-bp questionnaires. Afterwards, a rheumatologist, blind to former tests, evaluated the presence of PsA according to CASPAR criteria. The PEST-bp proved to be 0.81 accurate (95% CI: 0.73-0.88) in the ROC curve, indicating a cutoff score ≥ 3 as suggestive of PsA (sensitivity = 84.6%, specificity = 63.3%). The assessment of internal consistency, via the Cronbach test, presented a coefficient of 0.72 (acceptable). A higher PEST-bp score was positively associated with lower quality of life scores and with male patients. In conclusion, the PEST-bp questionnaire proved to be suitable as a screening tool for PsA in patients with psoriasis. Elevated PEST-bp scores are associated with decreased patient quality of life.

Migration is associated with HIV-1 vulnerability., Objectives: To identify long-term trends in HIV-1 molecular epidemiology and antiretroviral drug resistance (ARV) among migrants followed up in Portugal Methods: 5177 patients were included between 2001 and 2017. Rega, Scuel, Comet, and jPHMM algorithms were used for subtyping. Transmitted drug resistance (TDR) and Acquired drug resistance (ADR) were defined as the presence of surveillance drug resistance mutations (SDRMs) and as mutations of the IAS-USA 2015 algorithm, respectively. Statistical analyses were performed., Results: HIV-1 subtypes infecting migrants were consistent with the ones prevailing in their countries of origin. Over time, overall TDR significantly increased and specifically for Non-nucleoside reverse transcriptase inhibitor (NNRTIs) and Nucleoside reverse transcriptase inhibitor (NRTIs). TDR was higher in patients from Mozambique. Country of origin Mozambique and subtype B were independently associated with TDR. Overall, ADR significantly decreased over time and specifically for NRTIs and Protease Inhibitors (PIs). Age, subtype B, and viral load were independently associated with ADR., Conclusions: HIV-1 molecular epidemiology in migrants suggests high levels of connectivity with their country of origin. The increasing levels of TDR in migrants could indicate an increase also in their countries of origin, where more efficient surveillance should occur.

Introduction . The Functional Mobility Assessment (FMA) measures satisfaction with mobility devices in daily life. However, in Brazil, there is a lack of instruments which measure functional mobility., Objective: We aim to report the cross-cultural adaptation process and face validity of the FMA for use in Brazil., Methods: Two international guidelines were used in the cross-cultural adaptation process. Two independent translators translated the instrument from English to Brazilian Portuguese, and the two versions were reconciled. Two different translators back translated this reconciled version, and an expert committee analysed the resulting synthesis. For face validity, the FMA was applied with 24 participants, divided into two groups, users with disabilities ( n = 12) and occupational therapy students ( n = 12) and occupational therapy students (., Results: The cross-cultural adaptation of the FMA was concluded, and its face validity presented that both groups understood most or completely all instrument items., Conclusion: The Brazilian version of FMA is now available in Brazilian Portuguese and has face validation. Further studies should test its psychometric properties., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2020 Debora C. Paulisso et al.)

Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between co-ethnic density (i.e., the share of immigrants belonging to one's own ethnic group) and immigrant density (the share of all immigrants). This is all the more surprising since a high co-ethnic density can be expected to protect against substance use by increasing levels of social support and decreasing acculturative stress, whereas a high immigrant density can be expected to do the opposite by facilitating inter-ethnic conflict and identity threat. This study analyses how co-ethnic density and immigrant density are correlated with smoking among pupils of Portuguese origin in Luxembourg. A multi-level analysis is used to analyze data from the Luxembourg Health Behavior in School-Aged Children study ( N = 4268 pupils from 283 classes). High levels of co-ethnic density reduced current smoking. In contrast, high levels of immigrant density increased it. Thus, in research on the health of migrants, the distinction between co-ethnic density and immigrant density should be taken into account, as both may have opposite effects.

Background: Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese., Methods: This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed., Results: Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version., Conclusion: A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

This study examined how common thinking of and planning for the end of life (EOL) is among German and Portuguese centenarians, and whether patterns of EOL views are shaped by cultural and individual characteristics. A significant portion of centenarians in both countries reported not thinking about the EOL, not believing in the afterlife, and not having made EOL arrangements. Latent class analysis identified three EOL patterns: Class 1 ( EOL thoughts with EOL arrangements and afterlife beliefs ), Class 2 ( EOL arrangements and afterlife beliefs without EOL thoughts ), and Class 3 ( Overall low endorsement of EOL items ). The proportion of Portuguese centenarians was higher in Class 1 and of German centenarians higher in Classes 2 and 3. Centenarians' demographic, social, and health characteristics were significantly different across EOL patterns. As lack of EOL planning can result in poor EOL quality, enhancing communication among centenarians, family, and health-care professionals seems imperative.

Despite the occurrence of encouraging political and social changes in the past few years, many beliefs about women's role in intimate relationships persist, influencing their response to domestic violence (DV). This study aims to analyze the influence of recent policies against DV in Portugal, concerning particularly intimate partner violence against women and their perceptions about the victimization process. Two samples of women ( n = 126 each) reporting an aggressive act allegedly perpetrated by the current or former male partner were interviewed with a hiatus of 5 years (before and after some most relevant policy updates). Results suggest a positive influence of the recent policies against DV. Many significant and encouraging changes were found in the more recent women sample (S2) relatively to the first sample (S1) regarding their information, awareness, perceptions, and attitudes toward DV. They seem to show less tolerance and endurance to DV, placing responsibility on the offender, as well as seem more empowered to report. In S2, there was a decrease in the acceptance of violent behaviors as normal and of reasons to explain violence; the fears, shame, and helplessness about DV; the elapsed time between the beginning of the abuse and its report; and the prevalence of more severe types of physical abuse. In S2, there was an increase on the acknowledgment of DV as a crime, the number of reports in cases without cohabitation, the report of psychological abuses, and the feeling of safety and assurance while reporting.

Saudade is a psychological reaction to the absence of significant others and familiar places. This investigation examined differences in saudade in a sample of 227 Portuguese adults without migratory experience, and 202 Portuguese migrants living in Switzerland. Within the migrant group, the relation between saudade and acculturation and adaptation factors was also examined. Results indicate that migrants experienced higher levels of saudade than did non-migrants. Length of residence abroad influenced the level of saudade: the longer the time spent abroad the less saudade was felt. Acculturation and adaptation factors accounted for 44% of the explained variance in saudade. Among acculturation factors, higher Portuguese proficiency and separation, and lower assimilation predicted more saudade. Among the adaptation factors, higher sociocultural adaptation problems and lower migration satisfaction also predicted higher saudade. It is hoped that investigation on saudade continues, and suggestions are made for further research.

This study aimed to assess the risks and opportunities associated with Facebook usage and to explore the moderating role of psychosocial (mal)adjustment, nationality and age in these relationships. This correlational study involved a sample of 452 Brazilian and 500 Portuguese youths, aged between 14 and 20 years. Results showed that these youths spent a daily average of 61-120 minutes on Facebook, three to four times per week, displaying a positive attitude towards its use. These characteristics were most notable in the Brazilian youths [t(950) = 5.64, p < .001; t(950) = -5.07, p < .001; and t(950) = - 6.85, p < .001, respectively]. The Portuguese youths ran more risks than the Brazilians [t(950) = 6.36, p < .001], but both youths equally enjoyed the opportunities. In the case of the Portuguese youths, the risks and opportunities were moderated by the frequency of use, in other words "the higher the usage, the more risks and opportunities" (β = -.235 p < .001and β = -.167, p < .001, respectively). The psychosocial adjustment indicators did not moderate the effects of Facebook usage habits in risks and opportunities. The less psychosocially adjusted youths were those who ran more risks and also made the most of the opportunities. The results are discussed in light of the role of psychological, socio-cultural and developmental factors.

The aim of this study was to analyse the contribution of social support from family, friend and school (teacher and classmate) contexts in substance use (tobacco and alcohol use) and well-being (life satisfaction and health-related quality of life). Participants were 5,784 Portuguese and 22,610 Spanish adolescents aged 11 to 16 years, from the 2014 edition of the Health Behavior in School-aged Children (HBSC) study in Portugal and Spain. Results showed that for a higher life satisfaction, family (p < .001, partial η2 = .032), teacher (p < .001, partial η2 = .018) and classmate (p < .001, partial η2 = .031) support were important in Portugal, and family (p < .001, partial η2 = .056) and friend (p < .001, partial η2 = .015) support in Spain. Similarly, for a better health-related quality of life, all the social support variables were relevant in Portugal (family: p < .001, partial η2 = .063; teacher: p < .001, partial η2 = .032; classmate: p < .001, partial η2 = .054; friend: p < .001, partial η2 = .034) and in Spain (family: p < .001, partial η2 = .054; teacher: p < .001, partial η2 = .014; classmate: p < .001, partial η2 = .018; friend: p < .001, partial η2 = .040). In contrast, only family support (p < .001, partial η2 = .014) was relevant in Portugal for tobacco use. Therefore, social support was more relevant for adolescent well-being than for adolescent substance use, and the most relevant source of support was family support, in both Spain and Portugal.

Essential hypertension (EH) is a complex disease in which physiological, environmental, and genetic factors are involved in its genesis. The genetic variant of the alpha-adducin gene (ADD1) has been described as a risk factor for EH, but with controversial results.The objective of this study was to evaluate the association of ADD1 (Gly460Trp) gene polymorphism with the EH risk in a population from Madeira Island.A case-control study with 1614 individuals of Caucasian origin was performed, including 817 individuals with EH and 797 controls. Cases and controls were matched for sex and age, by frequency-matching method. All participants collected blood for biochemical and genotypic analysis for the Gly460Trp polymorphism. We further investigated which variables were independently associated to EH, and, consequently, analyzed their interactions.In our study, we found a significant association between the ADD1 gene polymorphism and EH (odds ratio 2.484, P = .01). This association remained statistically significant after the multivariate analysis (odds ratio 2.548, P = .02).The ADD1 Gly460Trp gene polymorphism is significantly and independently associated with EH risk in our population. The knowledge of genetic polymorphisms associated with EH is of paramount importance because it leads to a better understanding of the etiology and pathophysiology of this pathology.

Background: Psychological health problems are highlighted among the most relevant disease patterns in expatriates. The purpose of this study was to determine the psychological well-being in Portuguese expatriates in Angola and Mozambique, considering the increasing expatriation wave., Methods: A cross-sectional self-administered web survey was conducted in a sample of 352 Portuguese civil expatriates in Angola and Mozambique. Clinically significant psychological distress was determined using General Health Questionnaire (GHQ)-12 and associated factors were studied using multiple logistic regression analysis., Results: GHQ-12 items showed good internal consistency as reflected by the Cronbach's alpha. One-third of the screened expatriates corresponded to cases of clinically significant psychological distress. Age, country of birth, self-reported psychological symptoms and self-perception of general health in the previous 3 months were identified as independent variables associated with psychological distress., Conclusions: Increasing awareness and monitoring expatriates mental health should be in the health agenda, furthermore considering them a risk group in need of evidence-based mental health expatriate preparedness. The use of user-friendly validated tools, such as GHQ-12, allowing objective assessment and surveillance of these hard to reach populations should be reinforced., (© International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com)

Fear of movement (kinesiophobia) seems to play an important role in the development of chronic pain. However, for temporomandibular disorders (TMD), there is a scarcity of studies about this topic. The Tampa Scale for Kinesiophobia for TMD (TSK/TMD) is the most widely used instrument to measure fear of movement and it is not available in Brazilian Portuguese. The purpose of this study was to culturally adapt the TSK/TMD to Brazilian Portuguese and to assess its psychometric properties regarding internal consistency, reliability, and construct and structural validity. A total of 100 female patients with chronic TMD participated in the validation process of the TSK/TMD-Br. The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Spearman's rank correlation for construct validity and confirmatory factor analysis (CFA) for structural validity. CFA endorsed the pre-specified model with two domains and 12-items (Activity Avoidance - AA/Somatic Focus - SF) and all items obtained a loading factor greater than 0·4. Acceptable levels of reliability were found (ICC > 0·75) for all questions and domains of the TSK/TMD-Br. For internal consistency, Cronbach's α of 0·78 for both domains were found. Moderate correlations (0·40 < r < 0.60) were observed for 84% of the analyses conducted between TSK/TMD-Br scores versus catastrophising, depression and jaw functional limitation. TSK/TMD-Br 12 items and two-factor demonstrated sound psychometric properties (transcultural validity, reliability, internal consistency and structural validity). In such a way, the instrument can be used in clinical settings and for research purposes., (© 2017 John Wiley & Sons Ltd.)

Background: Increasing numbers of expatriates are working in sub-Saharan Africa. There is little published data on the complex population and this survey aimed at understanding expatriate morbidity by accessing self-reported health problems and malaria preventive practices., Methods: A cross-sectional web-based survey was conducted targeting Portuguese expatriates in Angola and Mozambique. Logistic regression analysis explored factors associated with self-reported health problems and psychological symptoms in the previous 3 months., Results: A total sample of 352 adult Portuguese urban civil occupational expatriates was obtained. Median length of expatriation was 3 years. Considering a 3-month timeframe, one in five expatriates reported new health problems and need of medical assistance, 5% were hospitalized and 64% reported general psychological symptoms. Less than 2% of subjects were on malaria chemoprophylaxis. Having chronic health conditions doubled the reporting of new health problems. Increasing length of expatriation was associated with decreasing reporting of general psychological symptoms. Directors and executive managers and expatriates living alone tended to report more general psychological symptoms., Conclusion: Expatriate communities deserve enhanced surveillance for the health issues that affect them. This will improve evidence-based preparation and intervention by public and travel health practitioners., (© International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com)

The aim of the present study was to examine the psychometric properties of the Reactive-Proactive Aggression Questionnaire (RPQ) among a forensic sample of incarcerated male juvenile offenders ( N = 221). The Portuguese version of the RPQ demonstrated promising psychometric properties, namely, in terms of factor structure, internal consistency, convergent validity, discriminant validity, and concurrent validity that generally justifies its use among this population. Statistically significant associations were found with conduct disorder, age of criminal onset, age of first problem with the law, crime seriousness, physical violence use in committing crimes, alcohol use, cannabis use, cocaine/heroin use, and having unprotected sex. The findings provide additional support for the extension of the RPQ across different cultures, ethnic groups, and samples.

Objective: The purpose of this study was to adapt and evaluate the psychometric properties of the ProFitMap-neck to Brazilian Portuguese., Methods: The cross-cultural adaptation consisted of 5 stages, and 180 female patients with chronic neck pain participated in the study. A subsample (n = 30) answered the pretest, and another subsample (n = 100) answered the questionnaire a second time. Internal consistency, test-retest reliability, and construct validity (hypothesis testing and structural validity) were estimated. For construct validity, the scores of the questionnaire were correlated with the Neck Disability Index (NDI), and the Hospital Anxiety and Depression Scale (HADS), the Tampa Scale of Kinesiophobia (TSK), and the 36-item Short-Form Health Survey (SF-36)., Results: Internal consistency was determined by adequate Cronbach's α values (α > 0.70). Strong reliability was identified by high intraclass correlation coefficients (ICC > 0.75). Construct validity was identified by moderate and strong correlations of the Br-ProFitMap-neck with total NDI score (-0.56 50%, Kaiser-Meyer-Olkin index > 0.50, eigenvalue > 1, and factor loadings > 0.2., Conclusion: Br-ProFitMap-neck had adequate psychometric properties and can be used in clinical settings, as well as research, in patients with chronic neck pain., (Copyright © 2017. Published by Elsevier Inc.)

Objective: This study investigated the pattern of decision-making (DM) on the Iowa Gambling Task (IGT) in a sample of Portuguese speaking healthy older women in Brazil with limited education: illiterate, 1-2 years, and 3-4 years of schooling., Methods: Around 164 non-demented community-dwelling women participated in the study. Among them 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini-Mental State Examination, Verbal Fluency Test (animal category), Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven's Coloured Progressive Matrices, Wisconsin Card Sorting Test, and IGT., Results: The three education groups were equivalent as to age, number of diseases, medications taken daily, depression, and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate and IGT performance improved linearly with higher levels of education. IGT performance correlated significantly with all cognitive test scores with the exception of the memorization of the pictures on the BCSB., Conclusion: The results suggested that education influences IGT performance, with worse scores among the illiterate. Results may be used by clinicians to interpret IGT performance among seniors with low literacy levels., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: This study was conducted to understand the experiences of intimate partner violence among women from Portuguese-speaking countries living in the Greater Toronto Area., Method: A social phenomenological study was conducted with ten Portuguese-speaking women who had experienced intimate partner violence who were selected by community centre leaders. The interviews were transcribed, translated and analysed by categories., Results: The consequences of violence included health problems, effects on children, and negative feelings among the victims. Factors preventing the women from leaving abusive partners included religious beliefs, challenging daily jobs, and the need to take care of their husband. Factors that encouraged them to leave included getting support and calling the police. Some women expressed hope for the future either with their husband. Others, desired divorce or revenge. Their plans to rebuild their lives without their husband included being happy, learning English, and being financially stable., Conclusion: Using these findings can implicate in the improvement of care for these women.

Background: Social integration and the health of adolescents with a migration background is a major concern in multicultural societies. The literature, however, has paid little attention to the wider determinants of their health behaviours, including the composition of their social networks. The aim of this study was to describe the composition of adolescents' social networks according to migration background, and to examine how social networks are associated with substance use., Method: In 2013, the SILNE study surveyed 11,015 secondary-school adolescents in 50 schools in six European cities in Belgium, Finland, Germany, Italy, the Netherlands, and Portugal, using a social network design. Each adolescent nominated up to five of their best and closest friends. Migration status was defined as first-generation migrants, second-generation migrants, and speaking another language at home. We computed two groups of network structural positions, the centrality of individual adolescents in networks, and the homophily of their social ties regarding migration (same-migration). Multilevel logistic regression was used to model the association between network structural position and smoking, alcohol use, and cannabis use., Results: Compared with non-migrant adolescents, adolescents with migration backgrounds had similar relationship patterns. But almost half their social ties were with same-migration-background adolescents; non-migrants had few social ties to migrants. For adolescents with a migration background, a higher proportion of social ties with non-migrants was associated with increased use of cannabis (OR = 1.07, p = 0.03) and alcohol (OR = 1.08, p < 0.01), but not with increased smoking (p = 0.60). Popular migrant adolescents were at less risk of smoking, alcohol use, and cannabis use than popular non-migrant adolescents., Conclusion: Homophily of social ties by migration background is noticeable in European schools. The tendency of migrant adolescents to have same-migration social ties may isolate them from non-migrant adolescents, but also reduces their risky health behaviours, in particular cannabis and alcohol use., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

In this study, we examined the lived experiences of an understudied subgroup, Portuguese American gay men, within the context of sexual script theory. We employed a phenomenological study design with eight men to provide a more in-depth analysis of their sociocultural sexual behaviours. Recruitment was conducted through word of mouth and a snowball approach beginning with two well-known HIV education and prevention outreach centres in southeastern Massachusetts. In this study, the sexual scripts of the participants were conceptualised within the three domains of cultural, interpersonal and intrapsychic scripts. Our findings suggest the three scripts are constantly interacting and informing one another. This ongoing negotiation influences the way our participants position their sexuality within the broader context of their everyday life within the US Portuguese community. Participants script their sexuality while they navigate multiple but separate entities within their culture, their religion and their families. Learning from these experiences could have important implications for the development of HIV prevention programmes for specific subgroups of men who have sex with men.

We report two families, members of which are carriers of a novel hemoglobin (Hb) variant that was named Hb Olivet [α13(A11)Ala→Thr (α1) (GCC > ACC); HBA1: c.40G > A; p.Ala14Thr]. The analysis of these cases allowed a clear description of this anomaly that behaves as a silent Hb. In the first family, of Portuguese ethnicity living in France, the proband, a 24-year-old male and his 57-year-old mother, both appeared to be carriers. The son presented with borderline mean corpuscular volume (MCV), while the mother was normocytic and normochromic. Hemoglobin separation on capillary electrophoresis (CE) was normal, while a slightly asymmetric peak was observed on high performance liquid chromatography (HPLC). In a second family, originally from Surinam but living in The Netherlands, the proband, a 6-year-old girl, showed a mild microcytosis at low ferritin levels. The abnormal Hb was inherited from the mother who was clearly iron depleted, was not present in the sister and brother of the proband. The microcytic hypochromic anemia was only shown in two out of a total of four carriers. It therefore seems likely that iron depletion is causative as two carriers are completely normal. Characterization and genotype/phenotype correlation are briefly described.

Drawing on medical anthropology and science and technology studies, I present a case study of the diagnosis of attention deficit hyperactivity disorder (ADHD) in Portugal. In a country where ADHD is a relatively recent medical category, still undergoing validation, the diagnosis is not primarily bound to an evidence-making role, and its epidemiology remains largely unknown. Notwithstanding, the diagnosis has been carried out by child psychiatrists and developmental clinicians who describe it as the most prevalent disorder that affects school-aged children and adolescents. In this article, I examine the global data, local diagnostic protocols, and clinical practices that are adapted and selectively mobilized in the making of the diagnosis, in a context in which making ADHD evident is at stake. The findings show that what counts as ADHD and what it means in each setting varies, and that the diagnosis may be understood as a situated process.

Purpose: Myocardial infarction can occur due to known risk factors and lifestyle choices. The difficulties that patients experience after discharge can lead to readmission and nonadherence to lifestyle change. The purpose of this study was to analyze the difficulties experienced by patients after hospitalization due to myocardial infarction and to identify the predictors of readmission and unchanged lifestyles., Methods: The study used a mixed-methods design across 106 patients who had experienced a first episode of acute myocardial infarction. The data were collected from two patient interviews and the patients' medical records. A logistic regression was used to predict unchanged lifestyle and readmission., Results: In the first interview, 74.5% of the patients reported receiving information prior to discharge. Six months after discharge, 80.2% mentioned that they had changed their lifestyles, but only 59.4% reported that their health had improved, and 75.5% continued to have concerns regarding their health. Patients described difficulties with regard to psychological problems, family dynamics, professional issues, problems with managing cardiovascular symptoms, and complications associated with hospital interventions. A follow-up assessment revealed that 12.3% of patients had been readmitted for cardiovascular disease., Conclusions: The analysis revealed significant predictors of readmission amongst patients with hypertension and three-vessel disease. Specifically, the number of people in the household, per capita income, and a lack of information/education provided at discharge as well as problems related to mental health after discharge predicted unchanged lifestyle. An educational program might be advantageous to clarify doubts and involve patients in their own disease management., (Copyright © 2016. Published by Elsevier B.V.)

A case of a young man diagnosed with perianal nodular melanoma with a gene mutation, accompanied by regional and pulmonary metastases on initial presentation, and later on with hepatic and bone involvement, is presented. The patient underwent wide local excision but was unresponsive to dacarbazine. Targeted therapy with vemurafenib had shown clinical improvement for a 5-month duration until he showed signs of disease progression. Just after the shift of adjuvant therapy to ipilimumab, he was diagnosed with multiple cerebral metastases that eventually led to his demise 6 months after initiation of vemurafenib, having had a 12-month survival period from the time of initial melanoma diagnosis., (2016 BMJ Publishing Group Ltd.)

The aim of this study was to explore the differences in patterns of risk factors for body dissatisfaction and disordered eating attitudes in both female and male adolescents from Portugal and Spain. The sample included 455 adolescents aged 12-16 years (M = 13.28, SD = 0.65) from two urban areas of each country. Body mass index, self-reported self-esteem, perfectionism, internalisation of sociocultural ideals, body dissatisfaction and disordered eating attitudes were assessed. Path analyses provided partial support for a cross-cultural model of body dissatisfaction and disordered eating in Western countries due to the presence of certain differences in the patterns of relationships across sex and country. The findings suggest the importance not only of identifying cultural specificities, even in "neighbouring" countries, but also of developing a global and comprehensive preventive approach that focuses on the influence of the ideal of beauty transmitted by Western societies., (Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Background: Tuberculosis is the most common mycobacterial disease in the world. The cutaneous form is rare in low endemic countries. The occurrence of several cutaneous tuberculosis cases in our dermatology department during 2011-2012 led us to investigate whether there was a resurgence of cutaneous tuberculosis in France. The aim was to analyse changes in cutaneous tuberculosis and the related clinical, microbiological and therapeutic data., Patients and Methods: We conducted a retrospective study in our hospital between 2005 and 2012 by querying the PMSI database (code: A 18.4). Epidemiological, clinical, paraclinical and therapeutic data were collected. Erythema induratum was regarded as a variety of cutaneous tuberculosis., Results: Thirteen patients presented cutaneous tuberculosis between 2005 and 2012. The most frequent clinical forms were erythema induratum of Bazin (n=6) and scrofuloderma (n=3). Microbiological evidence was provided in only 4 cases., Discussion: Diagnosis is difficult due to the varied clinical forms and to the relatively high frequency of paucibacillary forms. Further, the set of additional examinations is non-specific. In some cases, it is only therapeutic tests that allow diagnosis to be made. The place of new diagnostic tools must be clarified and a universally acceptable definition of erythema induratum devised., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Background: Information regarding the health status of migrants compared to subjects who remain in the country of origin is scarce. We compared the levels and management of the main cardiovascular risk factors between Portuguese living in Porto (Portugal) and Portuguese migrants living in Lausanne (Switzerland)., Methods: Cross-sectional studies conducted in Porto (EPIPorto, 1999 to 2003, n = 1150) and Lausanne (CoLaus, 2003 to 2006, n = 388) among subjects aged 35-65 years. Educational level, medical history and time since migration were collected using structured questionnaires. Body mass index, blood pressure, cholesterol and glucose levels were measured using standardized procedures., Results: Portuguese living in Lausanne were younger, more frequently male and had lower education than Portuguese living in Porto. After multivariate adjustment using Poisson regression, no differences were found between Portuguese living in Porto or in Lausanne: prevalence rate ratio (PRR) and (95% confidence interval) for Portuguese living in Lausanne relative to Portuguese living in Porto: 0.92 (0.71 - 1.18) for current smoking; 0.78 (0.59 - 1.04) for obesity; 0.81 (0.62 - 1.05) for abdominal obesity; 0.82 (0.64 - 1.06) for hypertension; 0.88 (0.75 - 1.04) for hypercholesterolemia and 0.92 (0.49 - 1.73) for diabetes. Treatment and control rates for hypercholesterolemia were higher among Portuguese living in Lausanne: PRR = 1.91 (1.15 - 3.19) and 3.98 (1.59 - 9.99) for treatment and control, respectively. Conversely, no differences were found regarding hypertension treatment and control rates: PRR = 0.98 (0.66 - 1.46) and 0.97 (0.49 - 1.91), respectively, and for treatment rates of diabetes: PRR = 1.51 (0.70 - 3.25)., Conclusions: Portuguese living in Lausanne, Switzerland, present a similar cardiovascular risk profile but tend to be better managed regarding hypercholesterolemia than Portuguese living in Porto, Portugal.

Background: Complaints of the arm, neck, and shoulders (CANS) have a multifactorial etiology, and, therefore, their assessment should consider both work-related ergonomic and psychosocial aspects. The Maastricht Upper Extremity Questionnaire (MUEQ) is one of a few specific tools available to evaluate the nature and occurrence of CANS in computer-office workers and the impact of psychosocial and ergonomic aspects on work conditions. The purpose of the present study was to perform a translation and cross-cultural adaptation of the MUEQ to Brazilian Portuguese and verify the reliability, internal consistency, and structural validity of the MUEQ in Brazilian computer-office workers., Methods: The cross-cultural adaptation consisted of five stages (forward translation of the MUEQ to Brazilian Portuguese, synthesis of the translation, back-translation, expert committee meeting, and the pre-final-version test). In the pre-final-version test, 55 computer-office workers participated. For reproducibility, a sample of 50 workers completed the questionnaire twice within a one-week interval. A sample of 386 workers from the University of São Paulo (mean age = 37.44 years; 95% confidence interval: 36.50-38.38; 216 women and 170 men) participated on the structural validation and internal consistency analysis. Intraclass correlation coefficient was used for the statistical analysis of reproducibility, Cronbach's alpha was used for internal consistency, and confirmatory factor analysis was used for structural validity., Results: The calculation of internal consistency, reproducibility, and cross validation provided evidence of reliability and lack of redundancy. The psychometric properties of the modified MUEQ-Br revised were assessed using confirmatory factor analysis, which revealed 6 factors and 41 questions. For this model, the comparative fit index (CFI), goodness-of-fit index (GFI), and non-normed fit index (NNFI) each achieved 0.90, and the consistent Akaike information criterion (CAIC), chi-square, expected cross-validation index (ECIV), and root mean square error of approximation (RMSEA) demonstrated better values., Conclusions: The results provide a basis for using the 41-item MUEQ-Br revised for the assessment of computer-office workers' perceptions of the psychosocial and ergonomic aspects of CANS and musculoskeletal-complaint characterization.

This is a study of final poststressed vowel devoicing following /s/ in Brazilian Portuguese. We contradict the literature describing it as deletion by arguing, first, that the vowel is not deleted, but overlapped and devoiced by the /s/, and, second, that gradient reduction with devoicing may lead to apocope diachronically. The following results support our view: (1) partially devoiced vowels are centralized; (2) centralization is inversely proportional to duration; (3) total devoicing is accompanied by lowering of the /s/ centroid; (4) the /s/ noise seems to be lengthened when the vowel is totally devoiced; (5) aerodynamic tests reveal that lengthened /s/ has a final vowel-like portion, too short to be voiced; (6) lengthened /s/ favors vowel recovery in perceptual tests. This seems to be a likely path from reduction to devoicing to listener-based apocope., (© 2015 S. Karger AG, Basel.)

This paper investigates similarities between lexical consonant clusters and CVC sequences differing in the presence or absence of a lexical vowel in speech perception and production in two Portuguese varieties. The frequent high vowel deletion in the European variety (EP) and the realization of intervening vocalic elements between lexical clusters in Brazilian Portuguese (BP) may minimize the contrast between lexical clusters and CVC sequences in the two Portuguese varieties. In order to test this hypothesis we present a perception experiment with 72 participants and a physiological analysis of 3-dimensional movement data from 5 EP and 4 BP speakers. The perceptual results confirmed a gradual confusion of lexical clusters and CVC sequences in EP, which corresponded roughly to the gradient consonantal overlap found in production., (© 2015 S. Karger AG, Basel.)

In this study, we present findings of the Portuguese national prevalence study, "Aging and Violence," the purpose of which was to estimate the prevalence of abuse and neglect of older people in family settings over a 12-month period and examine the relationship between abuse and sociodemographic and health characteristics. Through a telephone survey of a representative probability sample (N = 1,123), we evaluated 12 abusive behaviors and demographic data. Overall, 12.3% of older adults experienced elder abuse in family settings. The prevalence rates of specific types were as follows: psychological, 6.3%; financial, 6.3%; physical, 2.3%; neglect, 0.4%; and sexual, 0.2%. Logistic regression was employed to determine the relationship between abuse and covariates. The study suggests that education level, age, and functional status are significantly associated with abuse. Accurate estimates of the prevalence of elder abuse and understanding of victim and perpetrator characteristics are fundamental to designing effective strategies for prevention and intervention.

This article presents an anthropological analysis of heterosexual seduction behaviors of men and women (from 18 to 65 years old, with varying civil status) who attended nightclubs located in the movida areas of Lisbon, Portugal. These behaviors were analyzed according to structure versus communitas theories. Nighttime seduction behaviors were observed and recorded in a field diary, and in-depth semistructured interviews with 60 men and 60 women were conducted. Interviews were analyzed using the thematic content analysis model. Results suggested that the communitas domain was evinced in the various seduction strategies. These courtship behaviors tended to follow a specific pattern: nonverbal seduction, visual seduction, verbal seduction, and acting-consisting of caresses, touches, and kisses. When this escalation process evoked positive responses, it generally culminated in the complete synchrony of movements between the two bodies. The seduction process encompassed both masculine and feminine initiatives: Women engaged primarily in nonverbal and visual seduction, while men appeared to orchestrate verbal courtship and acting. However, sometimes men and women did not want to seduce or be seduced because they were married (especially women) or were with their partners (especially young men) and did not want to endanger the structure domain.

Background: Knowing when to seek professional help for health problems is considered an important aspect of health literacy. However, little is known about the distribution of help-seeking knowledge in the general population or specific subpopulations., Methods: We analysed data from the "Health Monitoring of the Swiss Migrant Population 2010" and used a short survey tool to study the distribution of help-seeking knowledge. We sampled members of four migrant groups (from Portugal, Turkey, Serbia and Kosovo; n = 2,614). Our tool contained 12 items that addressed common physical and psychological health problems. A total sum score measured help-seeking knowledge. Two sub-scores analysed knowledge related to potential overuse (minor symptoms) or potential underuse (major symptoms). We applied linear regression to show variations in help-seeking knowledge by age, sex, region of origin and length of stay., Results: Controlling for self-rated health, we found that region of origin, higher education, female gender and younger age were significantly associated with higher knowledge scores., Conclusions: We present empirical evidence of unequal distribution of help-seeking knowledge across four migrant populations in Switzerland. Our findings contribute to current conceptual developments in health literacy, and provide starting points for future research.

Background: Recent evidence suggests that specific language impairment (SLI) might be secondary to general cognitive processing limitations in the domain of executive functioning. Previous research has focused almost exclusively on monolingual children with SLI and offers little evidence-based guidance on executive functioning in bilingual children with SLI. Studying bilinguals with SLI is important, especially in the light of increasing evidence that bilingualism can bring advantages in certain domains of executive functioning., Aims: To determine whether executive functioning represents an area of difficulty for bilingual language-minority children with SLI and, if so, which specific executive processes are affected., Methods & Procedures: This cross-cultural research was conducted with bilingual children from Luxembourg and monolingual children from Portugal who all had Portuguese as their first language. The data from 81 eight-year-olds from the following three groups were analysed: (1) 15 Portuguese-Luxembourgish bilinguals from Luxembourg with an SLI diagnosis; (2) 33 typically developing Portuguese-Luxembourgish bilinguals from Luxembourg; and (3) 33 typically developing Portuguese-speaking monolinguals from Portugal. Groups were matched on first language, ethnicity, chronological age and socioeconomic status, and they did not differ in nonverbal intelligence. Children completed a battery of tests tapping: expressive and receptive vocabulary, syntactic comprehension, verbal and visuospatial working memory, selective attention and interference suppression., Outcomes & Results: The bilingual SLI group performed equally well compared with their typically developing peers on measures of visuospatial working memory, but had lower scores than both control groups on tasks of verbal working memory. On measures of selective attention and interference suppression, typically developing children who were bilingual outperformed their monolingual counterparts. For selective attention, performance of the bilingual SLI group did not differ significantly from the controls. For interference suppression the bilingual SLI group performed significantly less well than typically developing bilinguals but not monolinguals., Conclusions & Implications: This research provides further support to the position that SLI is not a language-specific disorder. The study indicates that although bilingual children with SLI do not demonstrate the same advantages in selective attention and interference suppression as typically developing bilinguals, they do not lag behind typically developing monolinguals in these domains of executive functioning. This finding raises the possibility that bilingualism might represent a protective factor against some of the cognitive limitations that are associated with SLI in monolinguals., (© 2014 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

A measure of subjective social status (SSS) was examined among high (White), and low (Black and Roma) ethnic status children in Portugal within a developmental design including 6-8-year-old and 9-12-year-old children. White children favoured their in-group over the Black and Roma out-groups on the SSS measure, social preferences and positive as well as negative trait attributions. Generally, the Black and Roma showed equal SSS, preferences and trait attribution for their in-group and the high status White out-group, but not the other low-status out-group. With age White children generally demonstrated higher SSS for Black and Roma, preferred them more and attributed more positive traits. For low-status groups, an age effect was found only for Black children who preferred the Roma more with age and attributed more positive traits. Changes on preferences and trait attribution depending on age-group were mediated by SSS. It is concluded that minority group's SSS does not parallel the objective status hierarchy but, rather, is a dynamic reorganisation of group's relative positions serving strategies to cope with their minority condition., (© 2013 The British Psychological Society.)

Two studies tested the prediction that more positive intergroup contact would be associated with reduced aggressive intergroup action tendencies, an effect predicted to occur indirectly via reduced intergroup threat perceptions, and over and above well-established effects of contact on intergroup attitudes. Study 1, using data based on a cross-section of the general population of eight European countries (France, Germany, Hungary, Italy, the Netherlands, Poland, Portugal, and the UK; N = 7,042), examined this hypothesis in the context of aggressive action tendencies towards immigrants. Study 2, using longitudinal data obtained from a general population sample in Northern Ireland, considered effects on aggressive action tendencies between ethno-religious groups in conflict. Both studies confirmed our predictions, showing that while perceived threat was associated with greater intergroup aggressive tendencies, positive intergroup contact was indirectly associated with reduced aggressive action tendencies, via reduced intergroup threat. Findings are discussed in terms of the theoretical contributions of this research for understanding the relationship between intergroup contact and intergroup aggression., (© 2013 Wiley Periodicals, Inc.)

Purpose: The aim of this study was to validate the Rhinoplasty Outcomes Evaluation (ROE) questionnaire adapted to the Brazilian Portuguese., Method: A prospective study was conducted with ROE administration to 56 patients submitted to rhinoplasty (preoperatively, and then 15-day and 90-day postoperatively) and 100 volunteers without the need or desire of cosmetic or functional nasal surgery. Reliability (internal consistency and test-retest reproducibility), validity, responsiveness and clinical interpretability were assessed., Results: Rhinoplasty patients' mean preoperative score was 7.14, 15 days post-op 17.73 and 90 days post-op 20.50, while controls presented 17.94 points (p < 0.0001), showing the questionnaire's validity and responsiveness. Internal consistency was 0.86. Inter- and intra-examiner test-retest reproducibility was 0.90 and 0.94, respectively. The effect size caused by the surgery was considered large (15 days post-op compared to the preoperative score: effect size = 3.22; 90 days post-op compared to preoperative score: effect size = 4.06). The minimally important difference was 8.67 points, so changes smaller than 9 points in ROE might not be perceived by the patient as an improvement or worsening., Conclusion: The Brazilian Portuguese version of ROE is a valid instrument to assess results in rhinoplasty patients.

Warfarin is the most common anticoagulant prescribed and its metabolism has been linked to two specific genes, CYP2C9 and VKORC1. This study analyzed 113 patients from 4 different ethnic backgrounds (Asian, Native Hawaiian, Portuguese, and Caucasian) and investigated the association between the mean daily dose of warfarin and ethnicity. Caucasian patients required the highest mean daily dose of warfarin 4.4 mg/day while Asian patients required the lowest mean daily dose of warfarin 2.5 mg/day. Portuguese patients and Native Hawaiian patients required mean of 3.8 mg/day. All three groups required a significantly lower dose than Caucasians. When adjusted for weight in kilograms, Native Hawaiian patients required a dose of 4.3 × 10(-2) mg/kg, Portuguese 4.4 × 10(-2) mg/kg and Asians 4.0 × 10(-2) mg/kg. These three populations had similar mean milligrams/kilogram dose requirements while Caucasians required a significantly higher dose of 5.3 × 10(-2) mg/kg. This data suggests that ethnicity should be taken into consideration when dosing warfarin.