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Background: The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429-444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization., Objective: To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil., Method: Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named "Escala de Confusão, Alvoroço e Ordem no Sistema familiar" (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale's factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents)., Results: The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents., Conclusion: Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil., (© 2024. The Author(s).)

Objective  To evaluate the relationship between sleep problems and psychopathologies in Brazilian preschool children. Materials and Methods  The present is a cross-sectional study with162 children: 81 with sleep problems referred for treatment (mean age: 3.67 years), matched by gender/age with 81 participants without sleep problems. Sleep problems were identified through a clinical interview with a specialist. Psychopathologies were evaluated using the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Results  Having sleep problems was a predictor of all forms of psychopathologies on the CBCL scales, except for the withdrawn scale. Aggressive behavior, depression/anxiety, affective problems, and oppositional defiant disorder were associated with presence of sleep problems. Conclusion  Given the probable bidirectionality of the association between sleep problems and psychopathologies in children, it is suggested that regular assessments of both phenomena should be performed in children referred for treatment of sleep problems and mental health problems in general., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Introduction: The World Health Organization defines quality of life as " an individuals' perception of their position in life, in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns." physicians, when dealing with illness and exposing themselves to the risks of their profession, must act without compromising their own health status in view of the function performed., Objectives: To evaluate and correlate physicians' quality of life, professional illness, and presenteeism., Methods: This is an epidemiological, cross-sectional, descriptive study with an exploratory quantitative approach. Overall, 309 physicians working in Juiz de Fora, state of Minas Gerais, Brazil were interviewed and answered a questionnaire with sociodemographic and health information and the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-BREF)., Results: Of physicians in the sample, 57.6% fell ill during their professional activities, 35% took sickness absence, and 82.8% practiced presenteeism. The most prevalent diseases were those involving the respiratory system (29.5%), infectious or parasitic diseases (14.38%), and those involving the circulatory system (9.59%). WHOQOL-BREF scores were boas, and were influenced by sociodemographic characteristics such as sex, age, and time of professional experience. Male sex, professional experience greater than 10 years, and age above 39 years were associated with beter quality of life. Previous illness and presenteeism were negative factors., Conclusions: The participating physicians had a good quality of life in all domains. Sex, age, and time of professional experience were relevant factors. The highest score was observed in the physical health domain, followed by psychological domain, social relationships, and environment, in a descending order., Competing Interests: Conflicts of interest: None

Objectives: To evaluate the association of sleep habits with the weight status of children aged 4-6 years., Methods: Data were obtained from the PREDI Study, a Brazilian birth cohort study. The current study was carried out in the homes of the participants during two follow-ups: 2016/17 and 2018. The participants were submitted to anthropometric assessment and demographic, socioeconomic and sleep data were obtained. The child's sleep habits were self-reported by the mother or caregiver on the day of the visit and included information on the following sleep habits during the past week: bedtime routine, rhythmicity, and separation affect determined with the Sleep Habits Inventory for Preschool Children and the Sleep Habits Inventory. Logistic regression and gamma-log regression analyses were used to examine the association of sleep habits with excess body weight of children in the two follow-ups according to sex., Results: Of the 217 and 185 children included in 2016/17 and 2018, respectively, 66 (30.6%) and 48 (25.9%) had a BMI >85th percentile at 4-6 years, respectively. The median rhythmicity score was higher in children with excess body weight (p = 0.05). Adjusted analysis showed that rhythmicity was associated with excess body weight of girls at ages 4-5 years (OR = 1.42, 95% CI: 1.09-1.86, p = 0.009) and 6 years (OR = 1.32, 95% CI: 1.06-1.65, p = 0.015), even after adjustment for other important covariates. Additionally, the sleep habit "separation affect" was inversely associated with the child's BMI in boys (β = -0.005, 95% CI: -0.010-0.000, p = 0.037)., Conclusions: In the present study, rhythmicity problems were associated with increased odds of girls aged 4-6 years having excess body weight. These results are important from a public health perspective since strategies aimed at preventing excess body weight in children need to consider the child's sleep quality as a potential risk factor, especially rhythmicity., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Nighttime fears in children are common, interfere with daily functioning, and result in considerable disruption in the family. The aim of the present review was to examine empirical literature from the past 25 years that investigated the assessment of nighttime fears in young children and the efficacy and effectiveness of psychosocial treatments for children's nighttime fears. The last review of this literature was in 1997 and examined studies conducted in and prior to 1995 (King et al. in Clin Psychol Rev 17:431-443, 1997). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review of the literature aimed at providing a synthesis of the Randomized Control Trials (RCTs) and controlled single-case multiple baseline design studies (MBLs) on the treatment of nighttime fears in children. A search of the literature identified 12 articles, with nine studies utilizing a between-group randomized controlled trial design and three studies utilizing a multiple baseline design. Results demonstrated significant improvements in children's nighttime fears and reductions in disruptive nighttime behaviors using behavioral interventions and cognitive-behavioral strategies. This review provides a commentary on the effectiveness and limitations of the assessment and treatment approaches for nighttime fears in children and suggests directions for future research., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Purpose: Non-adherence (NA) to medication is a major contributor to treatment failure in hypertensive patients. Factors of the ecological model, at family/healthcare professional, service, and system levels, are rarely evaluated as correlates of NA in hypertensive patients., Methods: This crossectional study assessed the prevalence of and associated factors of NA to antihypertensive medication among 485 hypertensive patients upon receiving secondary healthcare. The Morisky Green Levine Scale (MGLS) measured the implementation phase of adherence, and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA) instrument, health literacy. Multivariate analysis to NA included variables according to the levels of the ecological model., Results: Most patients were female (56.3%), white (53.2%), mean age of 62.0 ± 12.6 years, illiterate (61.6%), with low health literacy (70.9%), and low income (65.4%). Uncontrolled BP was frequent (75.2%); 57.1% of patients were nonadherent. In multivariate analysis based on the ecological model, adjusted for micro, meso- and macro-level correlates, NA was associated only with variables of patient-level: low health literacy (OR 1.62, CI 1.07-2.44, p = 0.020), income ≥ two reference wages (OR 0.46, CI 0.22-0.93, p = 0.031), lack of homeownership (OR 1.99, CI 1.13-3.51, p = 0.017), sedentarism (OR 1.78, CI 1.12-2.83, p = 0.014), and complexity of treatment (number of medications taken ≥ two times/day) (OR 1.56, CI 1.01-2.41, p = 0.042)., Conclusion: In this group of severely hypertensive patients with high cardiovascular risk, only patient-related characteristics were associated with NA. Our findings highlight the need for effective actions to optimize clinical outcomes in similar healthcare programs., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.)

Objective: to analyze the technological production of three professional master programs in the area of Nursing., Method: documentary research on primary sources. A total of 100 graduate nurses from three professional master's programs in Nursing in the Southeastern region of Brazil were analyzed, based on the following variables: time of training, typology of products; context of products and technological and educational classification, welfare and management. The study was guided by the question: "How is the technological production of the dissertation of the professional master's degree according to typology, context and technological classification? The analysis of the data was based on the construction of a table that categorized the products according to the typology., Results: development of techniques was the main type of product found, being expressed by flowcharts, protocols, guidelines and training courses. The products were mostly developed in the hospital context, in the educational technology format., Conclusion: the technological production of the analyzed programs is restricted, diffuse and, in its majority, of low social impact and has no relevance in the body of the dissertation. Despite the wide possibility of conclusion work, the dissertation, accompanied by an article and/or technical productions, is the main form of presentation.

Objective: To evaluate the medical knowledge regarding the application of the diagnostic criteria for brain death and to correlate it with training parameters for this diagnosis according to Federal Council of Medicine resolution 2,173 of 2017., Method: We interviewed 174 physicians with experience with comatose patients. A structured questionnaire adapted from previous studies was used. The associations of the variables were tested using the chi-square test for independence. A multivariate logistic model was fitted for associations with p values ≤ 0.20., Results: Among the interviewees, 40% had been working for more than 1 year in intensive care, and 23% had initiated ten or more brain death protocols complying with the new resolution. Forty-five percent of the interviewees reported having difficulty following the criteria, 94% acknowledged the need for complementary tests for diagnosis, and 8% of them reported the existence of incorrect tests. The difficulty with these criteria decreased with an increase in the number of years of medical training (OR = 0.487; p = 0.045; 95%CI 0.241 - 0.983) and with a higher number of initiated brain death protocols (OR = 0.223; p = 0.0001; 95%CI 0.117 - 0.424)., Conclusions: Difficulties in the application of brain death criteria were identified by a significant portion of the sample. However, among other factors, more years of training and a greater number of initiated brain death protocols were associated with greater ease in the application of brain death criteria according to the guidelines provided in Resolution 2,173 of the Federal Council of Medicine.

Functional Health Literacy (FHL) is the ability to retrieve, process and understand information in order to make appropriate decisions regarding self-care, defined by the World Health Organization as a social determinant of health. Its evaluation is important especially between patients with noncommunicable chronic diseases, given the need of permanent health care. This paper aims to evaluate the FHL in patients with chronic cardiovascular diseases and possible implications to the understanding of the disease and medical instructions and adherence to the measures proposed by health professionals. This is a cross-sectional and quantitative study with the application of tool S-TOFHLA and a structured questionnaire on 345 patients of a cardiovascular disease outpatient service in Juiz de Fora. Less than a half (49.3%) of the sample showed adequate FHL. Satisfactory FHL was associated with lower ageand higher schooling. Lower FHL evidenced that it can influence the impaired comprehension of the disease and medical instructions and the rare habit to question professionals. A high prevalence of inadequate FHL was identified in our sample and was associated with the impaired understanding of the disease and medical instructions, showing the need to streamline medical communication in this group.

Sixty-eight 4-6 year old children who co-slept with their parents and who avoided sleeping alone due to intense nighttime fears were randomized to a brief combined parent-based intervention (CBT-based bibliotherapy plus doll) or a wait list control group. After the waiting period, the wait list participants were offered treatment. Co-sleeping patterns, sleep records, anxiety, general fears, and behavior problems were assessed with parent-report measures. Nighttime fears were assessed with parent-report measures and a single item visual analogue scale for the young children. Assessments were completed pre-treatment, post-treatment, and at 3 months following treatment. Results showed that the combined intervention was superior to the wait list control condition and that treatment effects were maintained at 3-month follow-up. This study provides initial support for use of CBT-based bibliotherapy plus doll in the treatment of nighttime fears. Such a treatment might be used to supplement standard CBT approaches in routine clinical practice or in a stepped care approach to treatment., (Copyright © 2018. Published by Elsevier Ltd.)

Objectives: to describe the awareness about falls among elderly people living in their households in communities, to measure the other risks that they are exposed to in their homes and to evaluate the influence that knowledge on falling brings in the adoption of preventative measures., Method: The FRAQ-Brazil questionnaire was used on 473 elderly people as well as a questionnaire on elderly people being exposed to 20 household risk factors. Associations between the variables were analyzed using the chi-squared test with a confidence interval of 95%., Results: The age range was between 60 and 95 years with the average being 70.6 years. The majority of those interviewed were female (58.4%) who were earning 2 minimum wages (46.3%). The average amount of correct answers given with the use of the FRAQ-Brazil questionnaire was 19.5 out of 32 points and the elderly participants were, on average, exposed to 7.8 household risk factors. 180 of them stated that they had already received information on falls., Conclusion: The majority of the elderly population displayed little knowledge on falls and were exposed to a variety of daily risk factors. Individuals who were more advanced in years and who had more knowledge on falls, were exposed to less household risk factors. This may well have been due to the adoption of preventative measures through changing domestic environment.

In spite of long-term efforts to eliminate Triatoma infestans (Klug 1834) from Brazil, residual foci still persist in the states of Bahia and Rio Grande do Sul. Data on the genetic variability and structuring of these populations are however lacking. Using nine microsatellite loci, we characterized one residual T. infestans population from Bahia and four from Rio Grande do Sul, and compared them with bugs originally from an older focus in São Paulo; 224 bugs were genotyped. The number of alleles per locus ranged from 5 to 11. Observed and expected heterozygosities per locus ranged, respectively, from 0 to 0.786 and from 0 to 0.764. Significant departures from Hardy-Weinberg equilibrium, mainly due to heterozygote deficits, were detected in all loci and in most populations. Global indices estimated by AMOVA were: Fis was 0.37; Fst was 0.28; and Fit was 0.55; overall indices with p = 0.00 indicated substantial differentiation. Inter-population Fst ranged from 0.118 to 0.562, suggesting strong genetic structuring and little to no gene flow among populations. Intra-population Fis ranged from 0.301 to 0.307. Inbreeding was apparent in all populations except that from Bahia-which might be either linked by gene flow to nearby unsampled populations or part of a relatively large local population. The overall pattern of strong genetic structuring among pyrethroid-susceptible residual T. infestans populations suggests that their persistence is probably due to operational control failures. Detection and elimination of such residual foci is technically feasible and must become a public health priority in Brazil.

Twelve specimens of the bat Cormura brevirostris (Emballonuridae: Chiroptera) were collected from four localities in the Brazilian Amazon region and analyzed by classical and molecular cytogenetics. The diploid number and autosomal fundamental number were as previously reported (2n = 22 and FNa = 40, respectively). Fluorescence in situ hybridization using rDNA probes and silver nitrate technique demonstrated the presence of two NOR sites and the presence of internal telomeric sequences at pericentromeric regions of all chromosomes with exception of Y. Based on meiotic studies and chromosome banding we suggest that the sex chromosome pair of C. brevirostris was equivocally identified as it appears in the literature. Meiotic analysis demonstrated that at diplotene-diakinesis the cells had a ring conformation involving four chromosome pairs. This suggests the occurrence of multiple reciprocal translocations among these chromosomes, which is a very rare phenomenon in vertebrates, and has never been described in Eutheria.

The scope of the National Comprehensive Health Policy for the Black Population is to ensure equitable health care to this population. This policy is to compensate for the discrimination suffered by this ethnic group throughout the history of Brazil. The black population presents higher social and economic vulnerability, leading to shorter life expectancy and an increased susceptibility to diseases. The objective of the study is to investigate the black population's knowledge about this policy, its potential benefits and the difficulties of this population regarding access to health. It involves cross-sectional, quantitative and descriptive research. Structured interviews were conducted with 391 black people in Juiz de Fora. The sample was structured according to race (black and brown). Around 90% of the sample reported not knowing the existence of a health policy for the black population, and 53% stated that this policy could enhance racial discrimination. Having completed primary education and lower income was positively associated with higher discrimination in health care. Most of the sample didn't know the existence of the PNSIPN, but was in favor of its goals, despite the possibility that it can reinforce the legacy of Brazilian racial discrimination.

The small noncoding group of RNAs called stem-bulge RNAs (sbRNAs), first reported in Caenorhabditis elegans, is described as molecules homologous to the Y RNAs, a specific class of noncoding RNAs that is present in vertebrates. This homology indicates the possibility of the existence of sbRNAs in other invertebrate organisms. In this work, we used bioinformatic tools and conserved sequences of sbRNAs from C. Elegans and Y RNAs to search for homologous sbRNA sequences in the Bombyx mori genome. This analysis led to the discovery of one noncoding gene, which was translated into RNA segments and comparatively analysed with segments from human and hamster Y RNAs and C. elegans sbRNAs in molecular dynamic simulations. This gene represents the first evidence for a new sbRNA-like noncoding RNA, the BmsbRNA gene, in this Lepidoptera genome.