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Background: Chagas disease is a silent illness with high mortality burden in many Latin American countries, such as Brazil. Bahia has the fourth highest mortality rate in Brazil. This study analyzed the temporal trends and regional differences in the mortality rate of Chagas disease in Bahia State from 2008 to 2018., Methods: A time-series analysis of Chagas disease-related deaths was conducted using data from the Mortality Information System of Brazil. We compared the mortality rate due to Chagas disease as the primary cause and mention of the disease in the death certificate, standardized by age and health macroregion/residence municipality, and mapped hot and coldspots., Results: The Chagas Disease Mortality Rate in Bahia during the study period revealed a stationary trend, ranging from 5.34 (2008) to 5.33 (2018) deaths per 100,000 inhabitants. However, the four health macroregions showed an upward trend in mortality rates. The mortality rate (age-adjusted) ranged from 4.3 to 5.1 deaths per 100,000 inhabitants between 2008 and 2018. We observed a upward trend in the mortality rate among individuals aged ≥70 years and a higher incidence of death among men than among women. Of the total number of deaths (8,834), 79.3% had Chagas disease as the primary cause and the death certificates of 20.7% mentioned the disease. Cardiac complications were reported in 85.1% of the deaths due to Chagas disease., Conclusions: The regional and individual differences in the mortality rate of Chagas disease highlighted in this study may support health planning that considers the peculiarities of the territory.

Objective: to test the factorial structure, reliability and convergent validity of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version., Method: this was a psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Seven hundred and seventeen participants answered the data collection instrument consisting of two parts. Part I included a structured questionnaire to collect sociodemographic data and the participants' perceptions and satisfaction with their current health status. Part II consisted of the tool being tested. The internal structure was assessed using Confirmatory Factor Analysis. Convergent validity was evaluated by the correlation of the tool scores with the rates corresponding to self-perception and satisfaction with current health status. Reliability was assessed using Cronbach's alpha., Results: the Confirmatory Factor Analysis confirmed a three-factor solution. The factor loadings were significant and varied from 0.16 to 0.75; the fit indices suggested moderate fit of the model. Internal consistency for all three components varied between 0.779 and 0.919., Conclusion: the findings suggest that the tool is valid and reliable to be used in the Brazilian population, although caution is recommended when interpreting the results due to the moderate fit of the model., Background: (1) The FHPAST-BR is a structured, valid and reliable Nursing-driven assessment tool., Background: (2) The tool provides a way of organizing clinical data and easing decision-making., Background: (3) The FHPAST-BR can be used in clinical practice and research.

This study compares fundamental frequency (f o ) and fundamental frequency standard deviation (f o SD) of COVID-19 patients with the same parameters in the speech of subjects without COVID-19, and verifies whether there is an effect of age and sex in the patient group. Both groups, subjects with and without COVID-19, are formed by Brazilian Portuguese speakers. Speech samples were obtained from 100 patients with mild to severe symptoms of COVID-19, and 100 healthy subjects. A single 31-syllable Portuguese sentence was used as the elicitation material for all subjects. The recordings were divided into four age groups. The acoustic measures were semi-automatically extracted and analyzed by a series of analyses of variance. Patients with COVID-19 present vocal differences in f o -related parameters when compared to healthy subjects, that is, patient voices presented higher f o and f o SD with respect to control voices. In addition, for patient voices, there was an age and sex effect on f o SD values. Vocal parameters of women and elderly subjects showed more marked differences in f o -related parameters, indicating that patient voices are higher-pitched and have a higher variation of f o SD. Consequently, f o -related parameters may be tested as vocal biomarkers in the screening of respiratory insufficiency by voice analysis, in patients with severe symptoms of COVID-19.

Purpose: To assess the validity of a Written Clinical Reasoning Prompt (WCRP) to help nursing students' clinical reasoning (CR)., Method: This is a methodological study of translation and cross-cultural adaptation into Brazilian Portuguese of instruments that aim to promote CR improvement, composed of (1) WCRP; (2) two case studies; (3) a questionnaire about students' perceptions during decision-making in case studies; (4) a scoring rubric for correcting case studies. For translation and cross-cultural adaptation, stages 1-8 of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network were adopted. Agreement values among experts >80% and content validity coefficient (CVC) > 0.8 were considered satisfactory. For the pretest, a randomized clinical trial was carried out with 24 nursing students (intervention group, n = 14, using the WCRP to solve case studies; control group, n = 10, without using the WCRP)., Findings: The WCRP was translated and adapted into Brazilian Portuguese, requiring minimal adjustments to obtain agreement among the judges above 80% and CVC above 0.80. Regarding face validation, an adequate agreement was obtained in the assessment by students. There was no difference in the accuracy of nursing diagnoses between the intervention and control groups in the pretest., Conclusion: The WCRP was translated and adapted into Brazilian Portuguese and had adequate face and content validity estimates; however, there was no association with improving nursing students' diagnostic accuracy., Implications for Nursing Practice: The translated and adapted versions of all instruments into Brazilian Portuguese had adequate evidence of content and face validity. The use of WCRP was not associated with a significant improvement in nursing students' diagnostic accuracy. New studies with larger samples, a sample power of at least 80%, and a level of significance of 5% are needed., (© 2021 NANDA International, Inc.)

Disparate cultural practices suggest that small foot size may contribute to female attractiveness. Two hypotheses potentially explain such a pattern. Sexual dimorphism in foot size may lead observers to view small feet as feminine and large feet as masculine. Alternately, because small female feet index both youth and nulliparity, evolution may have favored a male preference for this attribute in order to maximize returns on male reproductive investment. Whereas the observational hypothesis predicts symmetrical polarizing preferences, with small feet being preferred in women and large feet being preferred in men, the evolutionary hypothesis predicts asymmetrical preferences, with the average phenotype being preferred in men. Using line drawings that varied only in regard to relative foot size, we examined judgments of attractiveness in nine cultures. Small foot size was generally preferred for females, while average foot size was preferred for males. These results provide preliminary support for the hypothesis that humans possess an evolved preference for small feet in females.