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Background: The clinical pharmacist is an essential member of the healthcare team and plays an important role in health care in the primary care and the hospital setting. Knowledge regarding the instruments that evaluate the different activities of the clinical pharmacist, as well as the evaluation of the psychometric properties of these instruments, is necessary., Methods: A literature search was performed in the PubMed and Scopus electronic databases without time and language restrictions. For the search strategy, the "pharmaceutical services," "validity studies," and "professional performance" domains were used. To assess the quality of the instruments, the five sources of validity evidence of contemporary psychometry were used, and the Joanna Briggs Institute's standardized instrument was used to assess the methodological quality of the studies. After screening 4096 articles, 32 studies were selected., Results: A total of 32 studies were included, and 32 instruments were identified to be used by pharmacists acting in various pharmaceutical practice scenarios. It was found that the available instruments were developed or adapted from others, with variation in the methods, constructs, dimensions, and domains, as well as the psychometric properties. Most of the instruments addressed community pharmacies, and evidence of content validity and internal structure was found most frequently. A standardized and validated instrument that comprehensively assessed the performance of the clinical pharmacist, addressing clinical activities, was not identified for all practice environments., Conclusions: Without standardized and validated instruments specifics to assess the performance of the clinical pharmacist, it is hard to establish the main clinical activities performed by pharmacists in their pharmaceutical practice environments and to propose training actions to improve professional practice. Despite the large number of instruments available and considered validated by the authors, it is questioned to what extent the validity indicators presented in the different studies really show the validation status., Systematic Review Registration: PROSPERO CRD 42018099912., (© 2022. The Author(s).)

Background: Health-related quality of life (HRQoL) is determined by multiple factors that include components such as spirituality and religiousness (S/R). Even though various systematic reviews have investigated the association between S/R and improved health outcomes in the most different groups, healthy young individuals are seldom addressed., Objective: To assess the association between S/R and HRQoL among young, healthy individuals., Methods: Systematic review of papers published in the last ten years and indexed in four academic research databases (PubMed, Web of Science, Cochrane Library, and Scopus) and two gray literature databases. Inclusion criteria were studies assessing S/R and HRQoL using validated instruments and assessing healthy adults (i.e., non-clinical patients, not belonging to any specific group of chronic diseases), aged between 18 and 64 years old., Results: Ten out of 1,952 studies met the inclusion criteria: nine cross-sectional and one longitudinal cohort study, in which 89% of the participants were college students. Nine studies report a positive association between S/R and HRQoL, while one study did not report any significant association. The main HRQoL domains associated with S/R were the psychological, social relationships, and environment domains, while the S/R most influent facets/components were optimism, inner strength, peace, high control, hope, and happiness., Conclusions: Higher S/R levels among healthy adult individuals were associated with higher HRQoL levels, suggesting the S/R can be an important strategy to deal with adverse environmental situations even among those without chronic diseases, enhancing the wellbeing of individuals. Registration of systematic review: PROSPERO-CRD42018104047., (© 2021. The Author(s).)

Although pain is a frequent complaint of patients with chronic kidney disease who undergo hemodialysis, few studies have assessed the functional interference of pain in activities of daily living (ADLs). Hence, the aim of this study was to evaluate the prevalence, location, intensity, and functional interference of pain in ADLs of chronic kidney disease patients undergoing hemodialysis and to estimate the association of specific pain sites with severe functional interference by pain in ADLs. This cross-sectional study included patients with chronic kidney disease undergoing hemodialysis. The prevalence, intensity, and functional interference of pain in ADLs were assessed using the brief pain inventory. Poisson regression was used to calculate the prevalence ratio. A total of 65 patients participated in the study. The overall prevalence of pain was 89.23%; the prevalence of headache was 18.46% and that of pain in the trunk was 55.38%, upper limbs was 35.38%, and lower limbs was 60.00%. The prevalence of moderate and severe pain at the time of hemodialysis was 13.85% and 21.54%, respectively. A high prevalence of severe functional interference of pain in general activity (61.54%), mobility (56.92%), and disposition (55.38%) was observed. Pain is a frequent complaint in patients undergoing hemodialysis, mainly musculoskeletal and intradialytic, and it interferes with ADLs and incapacitates the patient. Pain was highly prevalent in the upper and lower limbs and the trunk. Furthermore, a higher prevalence of severe pain at the time of hemodialysis and functional interference of pain, mainly in general activity, mobility, and disposition, were observed.

Background: The quality of life (QoL) of traffic and transit workers has been a focus of much attention; motorcyclists are the workers most susceptible to accidents and exposure to pollutants. These factors added to smoking might result in respiratory disorders and influence the workers' QoL., Objective: To analyze the QoL of smoking or not motorcycle taxi drivers., Method: Longitudinal and epidemiological study with quantitative approach conducted with 95 motorcycle taxi drivers from Jatai, southeastern Goias, Brazil, in two stages in 2014 and 2015. We administered a questionnaire to collect sociodemographic and occupational data and self-perceived state of health, and WHOQOL-BREF. Statistical analysis was performed with software Statistical Package for Social Sciences ® and STATA ® ; the significance level was set to p<0.05., Results: Most participants were male (98.9%), nonsmokers (89.5%), had already suffered work accidents (67.4%); their average age was 39.1 years old, and 48.5% described their state of health as good. The score on the physical health domain of QoL decreased (from 86.07 to 74.28; p=0.091) and the one on the environment domain increased (from 58.43 to 64.06; p=0.285) among smokers. Also among nonsmokers the score on domain physical health decreased (from 79.87 to 76.38; p=0.014) and the one on domain environment increased (from 58.27 to 67.32; p<0.001). We found association of age and smoking with QoL domain physical health (p=0.014; 0.027)., Conclusion: Motorcycle taxi drivers are exposed to several factors which might influence their living and working conditions. New public health policies targeting this population of workers are needed.

Background: In this article, conceptualization of well-being is a starting point. According to Diener, subjective well-being refers to all kinds of evaluation, both positive and negative, people make about their own lives. It includes cognitive assessments, such as satisfaction with life and satisfaction with work, as well as affective reactions to life events, such as sadness and contentment. Low levels of health and well-being in workers lead to many consequences. Sick leave, low productivity, and absenteeism are some examples. In this systematic review, the main objective is to assess workers' subjective well-being., Methods: The studies should include workers, whether they are paid or volunteers. Also, they must assess workers' subjective well-being. Observational peer-reviewed studies will be included. Qualitative studies will be excluded. The primary outcomes to be considered are the subjective well-being indicators described. Only studies that used six (6) instruments, developed by Diener, will be included. The instruments are Satisfaction With Life Scale (SWLS), Scale of Positive and Negative Experience (SPANE), Positive Thinking Scale (PTS), Flourishing Scale (FS), Comprehensive Inventory of Thriving (CIT), and Brief Inventory of Thriving (BIT). The studies will come from Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), MEDLINE, Embase, Web of Science, and Global Index Medicus databases. The studies must be written in Portuguese, English, or Spanish., Discussion: As far as we know, this is the first systematic review related specially to workers' subjective well-being. We hope that this study contributes to the "well-being at work" discussion and also to the development of effective interventions, used outside and inside organizations, that could improve well-being scores and increase correlate variables scores such as general health, social relations, and quality of life., Systematic Review Registration: PROSPERO CRD42016039520.

Background: The quality of life theme is much studied in the area of plastic surgery; however, there are few studies on the quality of life of plastic surgeons. The main aim of this study was to describe the quality of life of the plastic surgeon in Center-West of Brazil., Methods: A cross-sectional study was performed of plastic surgeons in the greater state of Goias, Center-West of Brazil, registered until January 2015. A sample with power of 80%, 115 surgeons from 163 WHOQOL-BREF, and a social-demographic and professional questionnaire were used as instruments. The data were compared between qualitative variables of the questionnaire and WHOQOL-BREF using the Mann-Whitney and Kruskal-Wallis tests., Results: One hundred sixteen surgeons answered; for WHOQOL-BREF, domain statistics were as follows: physical, 57.85; psychological, 62.9; social, 74.13; and environment, 68.56. The higher scores in each domain were related: physical: monthly income higher than US$ 11,200, more than 10 years of experience, weekly work hours lower than 40, being an associate or full member, and more than 4 surgeries/week; psychological: man, married, and having only private patients; social: man, monthly income higher than US$15,000, more than 20 years of experience, and weekly work hours lower than 40; and environment: monthly income higher than US$15,000, more than 10 years of experience, weekly work hours lower than 60, and more than 4 surgeries/week., Conclusion: The study demonstrates that the youngest surgeon, with a duration of less than 10 years, has the worst quality of life.

Background: As general population life expectancy has increased, the need to investigate the quality of life has arisen, especially because it is important that people have a healthy long life and with good quality. Studies are done with specific populations, and in the case of this investigation, the target studies are the ones done with women. Female population is growing demographically and professionally. Women have shown increased levels of stress and higher number of illness. It is known that many practices can be used to improve the level of quality of life and that one of them is the dance. Dance is an activity which combines physical and psychosocial aspects. Moreover, it promotes self-expression, self-esteem, and self-confidence. It relieves women of stress. And it also helps in a variety of aspects such as group interaction, motivation, and positive emotions. In this systematic review, the main objective is to assess the effect of dance on quality of life of adult women., Methods: Only quantitative studies will be included. Studies will be accepted with any amount of dance practice time. They will have been published in the following bibliographic databases: Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), MEDLINE, Embase, and Cochrane from inception until June 30, 2018. There will be no restrictions for geographical location. It will be included studies published in Portuguese, English, and Spanish. Only published ones will be included in the review., Discussion: There is a variety of systematic review studies with men and women on quality of life and dance, but this is the first one focused exclusively on adult female audience. It is expected that this review will be useful to promote the discussion about quality of life of adult women and the interest of this population for dance practice. In order to summarize and to explain the characteristics and findings of those studies, tables and information from texts will be used in a systematic narrative synthesis., Systematic Review Registration: PROSPERO CRD42016039961.

Background: Quality of life must be one of the main purposes for the treatment of drug users, requiring a better understanding of the association between the quality of life and the severity of dependency. This study aimed to investigate the correlation between severity of substance use in various areas of human functioning and quality of life of illicit drug users in a psychosocial care center for alcohol and drugs., Methods: This cross-sectional study included 60 participants - illicit drug users - treated at a psychosocial care center for alcohol and drugs. Participants were evaluated with the short version of World Health Organization Quality of Life (WHOQOL-Bref) instrument to measure the quality of life, the 6th version of Addiction Severity Index (ASI-6) to assess the severity of dependence in several areas and the Mini International Neuropsychiatric Interview (MINI) to identify the presence of psychiatric disorders. Pearson and Spearman correlation tests and linear regression were applied to verify the association between the severity of dependence and the quality of life, and Student's t-test to compare the mean quality of life between individuals with and without psychiatric comorbidities., Results: Negative correlation was found between the severity of dependence on the drugs dimensions: alcohol, psychiatric, medical, legal, family/social support and family/social problems of ASI-6, and the quality of life domains measured by the WHOQOL-Bref. The evidence was strongest in the psychiatric and medical dimensions. There was a significant difference in the quality of life mean among participants presenting or not presenting psychiatric comorbidities, for the psychological domain in anxiety disorders, and for the physical and psychological domains in mood disorders., Conclusion: The quality of life decreased as the severity of dependence increased, with different results in the various areas of the participant's life. This result emphasizes the need for training the professional team which works in the substance use disorders area for more comprehensive diagnostic evaluations and more appropriate therapeutic interventions for each area. The associations were more evident in the medical and psychiatric fields, indicating the need for greater attention to be paid in relation to medical and psychiatric comorbidities.

CONTEXT AND OBJECTIVE The cognitive processes relating to the development of clinical reasoning are only partially understood, which explains the difficulties in teaching this skill in medical courses. This study aimed to understand how clinical reasoning develops among undergraduate medical students. DESIGN AND SETTING Quantitative and qualitative exploratory descriptive study conducted at the medical school of Universidade Federal de Goiás. METHODS The focus group technique was used among 40 students who participated in five focus groups, with eight students from each year, from the first to fifth year of the medical school program. The material was subjected to content analysis in categories, and was subsequently quantified and subjected to descriptive statistical analysis and chi-square test for inferential statistics. RESULTS The content of the students' statements was divided into two categories: clinical reasoning - in the preclinical phase, clinical reasoning was based on knowledge of basic medical science and in the clinical phase, there was a change to pattern recognition; knowledge of basic medical science - 80.6% of the students recognized its use, but they stated that they only used it in difficult cases. CONCLUSION In the preclinical phase, in a medical school with a traditional curriculum, clinical reasoning depends on the knowledge acquired from basic medical science, while in the clinical phase, it becomes based on pattern recognition.

Objective: To compare the gain in elbow flexion in patients with traumatic injury of the brachial plexus following muscle transfer from latissimus dorsi with the gain following free muscle transfer from the medial belly of the gastrocnemius., Methods: This was a retrospective study in which the medical files of a convenience sample of 13 patients operated between 2000 and 2010 were reviewed. Group 1 comprised seven patients who underwent transfers from the gastrocnemius and group 2 (controls) comprised six patients who underwent transfers from the latissimus dorsi. The following functions were evaluated: (1) range of motion (ROM) of elbow flexion, in degrees, using manual goniometry and (2) grade of elbow flexion strength, using a muscle strength scale. Satisfactory results were defined as: (1) elbow flexion ROM ≥ 80° and (2) elbow flexion strength ≥ M3. The Fisher exact and Kruskal-Wallis tests were used (p < 0.05)., Results: The patients' mean age was 32 years (range: 17-56) and 72% had been involved in motorcycle accidents. Elbow flexion strength ≥ M3 was observed in seven patients (100%) in group 1 and in five patients (83.3%) in group 2 (p = 0.462). None of the patients presented M5, and one patient (16.7%) in group 2 had a poor result (M2). Elbow flexion ROM with a gain ≥ 80° (daily functions) was found in six patients (86%) in group 1 and in three patients (50%) in group 2 (p = 0.1)., Conclusion: The patients in group 1 had greater gains in strength and ROM than did those in group 2, but without statistical significance. Thus, transfers from the gastrocnemius become a new surgical option, if other techniques cannot be used.

Objective: To evaluate sociodemographic and clinical aspects of patients undergoing operations due to traumatic lesions of the brachial plexus., Method: This was a retrospective study in which the medical files of a convenience sample of 48 patients operated between 2000 and 2010 were reviewed. The following were evaluated: (1) range of motion (ROM) of the shoulder, elbow and wrist/hand, in degrees; (2) grade of strength of the shoulder, elbow and wrist/hand; (3) sensitivity; and (4) visual analogue scale (VAS) (from 0 to 10). The Student's t, chi-square, Friedman, Wilcoxon and Kruskal-Wallis tests were used (p < 0.05)., Results: The patients' mean age was 30.6 years; 60.4% of them had suffered motorcycle accidents and 52.1%, multiple trauma. The mean length of time until surgery was 8.7 months (range: 2-48). Thirty-one patients (64.6%) presented complete rupture of the plexus. The frequent operation was neurosurgery in 39 cases (81.3%). The ROM achieved was ≥30° in 20 patients (41.6%), with a range from 30° to 90° and mean of 73° (p = 0.001). Thirteen (27.1%) already had shoulder strength ≥M3 (p = 0.001). Twenty-seven patients (56.2%) had elbow flexion ≥80°, with a range from 30° to 160° and mean of 80.6° (p < 0.001). Twenty-two had strength ≥M3 (p < 0.001). Twenty-two patients (45.8%) had wrist extension ≥30° starting from flexion of 45°, with a range from 30° to 90° and mean of 70° (p = 0.003). Twenty-seven (56.3%) presented wrist/hand extension strength ≥M3 (p = 0.002). Forty-five (93.8%) had hypoesthesia and three (6.2%) had anesthesia (p = 0.006). The initial VAS was 4.5 (range: 1.0-9.0) and the final VAS was 3.0 (range: 1.0-7.0) (p < 0.001)., Conclusion: Traumatic lesions of the brachial plexus were more prevalent among young adults (21-40 years), men, people living in urban areas, manual workers and motorcycle accidents, with multiple trauma and total rupture of the plexus. Neurosurgery, with a second procedure consisting of muscle-tendon transfer, was the commonest operation. Surgery for traumatic lesions of the brachial plexus resulted in significant improvement in the ROM and strength of the shoulder, elbow and wrist/hand, improvement of the sensitivity of the limb affected and reduction of the final pain.

Objectives: to evaluate parental stress of mothers of children and adolescents with cerebral palsy; to verify whether parental stress undergoes variations according to the level of motor compromise, the child's phase of life, and sociodemographic variables., Method: a cross-sectional, descriptive study, with 223 mothers of children and adolescents with cerebral palsy., Results: 45.3% of the mothers presented high levels of stress; there were differences in stress between mothers of children with mild and severe motor impairment; mothers of older children were more stressed than mothers of younger children and of adolescents; paid work and leisure activities reduced the stress., Conclusion: mothers of children and adolescents with cerebral palsy, whose children present mild to severe motor impairment are vulnerable to parental stress. Paid work and leisure activities were the factors that contributed most to reducing the stress.

This work redeems, contextualizes and features the social, historical and cultural aspects of the deaf community that uses the Brazilian Sign Language focusing on the social and anthropological model. The scope of this study was to conduct a bibliographical review in scientific textbooks and articles available in the Virtual Health Library, irrespective of the date of publication. 102 articles and 53 books were located, including 33 textbooks and 26 articles (four from the Lilacs database and 22 from the Medline database) that constituted the sample. Today, in contrast with the past, there are laws that guarantee the right to communication and attendance by means of the Brazilian Sign Language. The repercussion, acceptance and inclusion in health policies of the decrees enshrined in Brazilian laws is a major priority.

Objective: To construct versions of the WHOQOL-BREF and WHOQOL-DIS instruments in Brazilian sign language to evaluate the Brazilian deaf population's quality of life., Methods: The methodology proposed by the World Health Organization (WHOQOL-BREF and WHOQOL-DIS) was used to construct instruments adapted to the deaf community using Brazilian Sign Language (Libras). The research for constructing the instrument took placein 13 phases: 1) creating the QUALITY OF LIFE sign; 2) developing the answer scales in Libras; 3) translation by a bilingual group; 4) synthesized version; 5) first back translation; 6) production of the version in Libras to be provided to the focal groups; 7) carrying out the Focal Groups; 8) review by a monolingual group; 9) revision by the bilingual group; 10) semantic/syntactic analysis and second back translation; 11) re-evaluation of the back translation by the bilingual group; 12) recording the version into the software; 13) developing the WHOQOL-BREF and WHOQOL-DIS software in Libras., Results: Characteristics peculiar to the culture of the deaf population indicated the necessity of adapting the application methodology of focal groups composed of deaf people. The writing conventions of sign languages have not yet been consolidated, leading to difficulties in graphically registering the translation phases. Linguistics structures that caused major problems in translation were those that included idiomatic Portuguese expressions, for many of which there are no equivalent concepts between Portuguese and Libras. In the end, it was possible to create WHOQOL-BREF and WHOQOL-DIS software in Libras., Conclusions: The WHOQOL-BREF and the WHOQOL-DIS in Libras will allow the deaf to express themselves about their quality of life in an autonomous way, making it possible to investigate these issues more accurately.

Unlabelled: Nystagmus tests to diagnose BPPV are still relevant in the clinical evaluation of BPPV. However, in everyday practice, there are cases of vertigo caused by head movements, which do not follow this sign in the Dix-Hallpike maneuver and the turn test., Aim: To characterize BPPV without nystagmus and treatment for it., Materials and Methods: A non-systematic review of diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) without nystagmus in the PubMed, SciELO, Cochrane, BIREME, LILACS and MEDLINE databases in the years between 2001 and 2009., Results: We found nine papers dealing with BPPV without nystagmus, whose diagnoses were based solely on clinical history and physical examination. The treatment of BPPV without nystagmus was made by Epley maneuvers, Sémont, modified releasing for posterior semicircular canal and Brandt-Daroff exercises., Conclusion: From 50% to 97.1% of the patients with BPPV without nystagmus had symptom remission, while patients with BPPV with nystagmus with symptom remission ranged from 76% to 100%. These differences may not be significant, which points to the need for more studies on BPPV without nystagmus.

This study aims to analyze the quality of life of mothers of children with cerebral palsy, correlated with the evolution of their children's gross motor function after ten months of rehabilitation. An observational, longitudinal study was carried out in Goiânia, Goiás, Brazil, involving 100 mothers and children with cerebral palsy. The children's motor function was evaluated using the Gross Motor Function Measure (GMFM) and the mothers' quality of life using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36). After ten months of rehabilitation, the children's gross motor function had significantly improved (p<0.001), while the mothers only presented a significant improvement (p<0.001) in the bodily pain domain. The improvement in the motor function of children with cerebral palsy did not influence the changes in the mothers' quality of life.

Unlabelled: Non-verbal communication is important when caring for deaf patients, fostering excellence in health care., Aim: an analysis of the legal and sociocultural aspects of the relation between deaf patients and physicians., Methods: Computerized databases for the period between 1996 and 2006 were used for collecting data; the keywords 'patient', 'deaf person', 'communication' and 'health' were used. A non-systematic search was made in scientific publications., Results: These studies were grouped into two categories: communication between deaf patients and physicians, who has to deal with communication barriers when caring for deaf patients, and the importance of non-verbal communication in healthcare. Deaf persons, their language, and their relation with physicians show the importance of sign language, endorsed by the Federal Law 10.436/02., Conclusions: When deaf patients and physicians meet, they need to overcome communication barriers that may hinder the necessary bond in healthcare and the care that is provided; this may also affect the diagnosis and treatment. It is clear that public institutions should create programs for training healthcare professionals in the appropriate care of deaf patients.

The purpose of this systematic literature review is to analyze and identify the communication between deaf patients and health professionals, as well as to investigate the care offered. The computerized databases were used for data collection, using the keywords paciente (patient), surdo (deaf person), and comunicação (communication). The results were grouped in three categories: communication, health professional education, and legal aspects. The communication category deals with communicative barriers, written language and the presence of the interpreter. In the second category, the focus is on the education of the professionals in relation to the deaf community. The third category reports the legal aspects involved in caring for deaf patients. The review showed that there are communication barriers between deaf patients and health professionals, and that health care is a challenge for both. It also emphasized that there is a need for education regarding the deaf patients.

Objective: To study survival and prognostic factors associated with mortality in patients with systolic heart failure followed up since symptom onset., Methods: We carried out a study with a cohort of 204 consecutive patients with systolic heart failure, whose symptom onset occurred within the 6 weeks preceding the first medical visit. They were followed up for 46 months. The prognostic variables analyzed were collected when the patients were included in the study and were correlated with cardiovascular mortality. An EF < or =40% on echocardiography characterized systolic ventricular dysfunction., Results: The overall survival rates according to the Kaplan-Meier technique were 98.0%, 90.6%, and 70.2% at 3, 12, and 48 months of follow-up, respectively. The multivariate analysis identified the independent effect of 6 variables on the risk of cardiovascular death. Functional classes III and IV increased risk 2.7 times as compared with class II; 10-mmHg increments in systolic blood pressure reduced the risk of death by 25%; each 10-bpm increase in heart rate increased the risk of death 1.6 times; and each 0.25-mg/dL increment in serum creatinine caused a 60% increase in risk. The presence of the third cardiac sound caused a 3-fold increase in the risk of death, and chagasic etiology was also associated with cardiovascular mortality (P<0.0001)., Conclusion: Evidence shows that mortality in the initial phase is not elevated, and that etiology, advanced functional class, arterial hypotension, tachycardia, presence of the third cardiac sound, and elevated serum creatinine lead to a worse prognosis.