Search

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study Design: Systematic review., Objective: To systematically review the evidence on health literacy (HL) of people diagnosed with spinal cord injury (SCI)., Methods: PubMed, Cochrane Library, Web of Science and Embase databases were used to identify studies published from 1974 to 2021. Two reviewers independently carried out the study selection process and assessed the methodological quality of the studies. The risk of bias in the studies was classified according to the Joanna Briggs Institute (JBI)., Results: In total, 1398 studies were identified from the initial search, and 11 were selected for reading thoroughly. After screening, five studies were included. All had a cross-sectional design, and most scientific production was from the United States. In the studies, people with SCI received assistance in rehabilitation services. The results were heterogeneous compared to the HL: reasonable HL; suitable HL; Inadequate HL. Better HL was identified in individuals from the white population compared to the black population with SCI., Conclusion: Studies on HL in the SCI population are limited. Guidance and personalized education provided in rehabilitation programs seem to have an influence on HL levels in this population. More research is needed to broaden the understanding of HL in the rehabilitation process of people diagnosed with SCI., (© 2023. The Author(s).)

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).)

Respiratory systems of birds may be parasitized by rhinonyssid and ereynetid mites, which are commonly found in their nasal cavities. Levels of infection caused by mites in relation to maturity and gender of birds have been poorly investigated. Although Columba livia is the host of both Tinaminyssus and Trispeleognathus species worldwide, there are no data on prevalence and mean intensity of infection by mites in immature and adult males and females. Therefore, this study aims to analyze infections in relation to characteristics of hosts in southern Brazil. In the sample of 160 birds under study, 24.38% were parasitized by rhinonyssid mites (Tinaminyssus melloi and Tinaminyssus columbae) while 5.0% were infested with ereynetid ones (Trispeleognathus striatus). Infections by rhinonyssid mites in immature and adult birds, as well as in male and female ones, were similar and there were no significant differences in prevalence and mean intensity of infection. However, when infections were analyzed separately, prevalence of T. melloi was significantly higher in immature (19.77%) than in adult (6.76%) birds (p = 0.021). Ereynetid mites, which parasitized only males, were more prevalent in adult (9.46%) than in immature (1.16%) birds (p = 0.025). Reproductive and behavioral characteristics of C. livia (e.g., year-round breeding and social behavior) may enable transmission and maintenance of mite populations, since direct contact among hosts and the presence of mites in their nests are considered forms of transmission. Even though information on the life history of mites is important to understand parasite-host relations, there is a gap in the biology of species commonly found in C. livia, which constitutes an area to be explored., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Stress is a consequence of or a general reaction to an action or situation that leads to physical, psychological or both demands on a person, which can cause major disabilities in different aspects of life. This study verified the presence and stress phase of physiotherapists in the musculoskeletal area, identifying the factors associated with stress., Method: Presence and phase of stress were assessed using the Lipp's Stress Symptoms Inventory for Adults, and sociodemographic, work, and subjective data through a structured questionnaire designed by the authors., Results: 91 physiotherapists from 219 presented stress (41.55%). The presence of stress was associated to the workplace (p = 0.006, x2 = 20.01), number of patients per week (p = 0.023, x2 = 7.55), weekly working hours (p = 0.023, x2 = 7.56), and the perception of the work influenced their personal life (p < 0.001, x2 = 14.81). 56.04% of the physiotherapists were in the resistance phase., Conclusions: Approximately half of the physiotherapists showed signs of stress. Moreover, workplace, number of working hours, number of patients per week and the perception of the influence of work on personal life were important aspects to stress.

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.

Aims: To assess the presence of pain, its location, intensity, and effects on the daily activities of patients with chronic kidney disease (CKD) undergoing hemodialysis (HD)., Participants/subjects: Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD)., Design: A systematic review., Methods: We carried out search for articles published until December 2020, including publications in Portuguese, English, and Spanish during the past 15 years (2005-2020), using the Embase, SciELO, PubMed, and Web of Science databases. The following information was collected: type of pain, pain treatment, pain assessment instrument, prevalence of pain, location, and influence of pain on quality of life., Results: Twenty-five studies were selected for a systematic review. These studies involved a total of 98,162 adult and elderly patients with CKD who were undergoing HD. There was a high prevalence of pain in patients with CKD on HD. The most frequent sites of pain were the head, back, bones, chest, and the upper and lower limbs. The presence of acute, chronic, neuropathic pain, and myalgia was also reported in the studies. In addition, there was a higher frequency of moderate and severe pain, which influenced daily activities, the ability to walk, mood, relationships with other people, sleep, and work in patients on dialysis., Conclusions: The analyzed studies suggest that acute and chronic pain is a prevalent complaint in adults and elderly patients undergoing HD. There was a higher frequency of moderate and severe pain in different parts of the body, and pain interfered with everyday activities., Competing Interests: Conflict of Interest None., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: This systematic review will aim to assess evidence of the prevalence of comorbid substance use disorders with anxiety disorders or post-traumatic stress disorder in people seeking treatment for substance use., Introduction: Research shows that anxiety disorders and post-traumatic stress disorder are highly prevalent in people with substance use disorders and can worsen the treatment outcomes, increasing the risk of relapse and poor adherence. However, evidence from systematic reviews on the prevalence of these comorbidities in substance use treatment settings is limited., Inclusion Criteria: Participants will be people seeking treatment for substance use. Studies will be included if they have investigated the prevalence of the comorbid substance use disorders with anxiety disorders or post-traumatic stress disorder in treatment settings., Methods: Primary studies will be screened from the databases MEDLINE, PsycINFO, CINAHL, and Embase, and from searches to source gray literature. Eligible cross-sectional and cohort studies published after 1994 with no language limits will be retrieved, and their methodological quality will be assessed. Data extraction will include study details, methods, and outcomes. Results will be described by narrative summary or, if studies are sufficiently similar, a meta-analysis will be performed. Prevalence data will be pooled for meta-analysis by a random effects model. The results will be presented graphically in a forest plot. Data heterogeneity will be statistically tested using χ2 and I2 tests. If substantial heterogeneity is detected, sources of heterogeneity will be explored by subgroup analysis and meta-regression, and results will be presented by a narrative summary., Systematic Review Registration Number: PROSPERO CRD42020149956., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 JBI.)

Objective: Voice is an essential working tool in the teaching profession and thus needs to be acknowledged and cared for by student teachers. This study aimed to investigate the presence of vocal symptoms among fourth-year students of teacher education programs and whether students had received voice care advice during their education., Methods: We conducted a descriptive cross-sectional study of 70 students in their final year of 9 teacher education programs at Regional Jataí of Universidade Federal de Goiás, Midwestern Brazil, from January to April 2017. Participants completed a questionnaire on sociodemographic, academic, and work-related characteristics, and were asked to answer an open-ended question on whether they had received any voice care advice during their education (and what type of advice if any). The Screening Index for Voice Disorder was then administered to all participants for self-reported vocal symptoms., Results: Of 70 students included in the study, 81.4% were women with a mean age of 30 years. Overall, 62.9% were employed: 47.7% in the field of education and 52.3% in other activities. As for vocal symptoms, 35.7% reported ≥ 5 symptoms, including strained speech (51.4%), dry throat (50.0%), dry cough (48.6%), hoarseness (37.1%), and phlegm (35.7%). Most students (87.14%) did not receive voice care advice during their education. Among those who received advice (12.86%), voice care was limited to lay advice, such as drinking plenty of water, speaking in a lower voice, avoiding straining the voice by shouting, avoiding cold beverages, and drinking ginger tea., Conclusion: Our findings highlight the need for the introduction of voice training during teacher education in order to promote efficient voice production and prevent occupational voice disorders among future teachers by raising awareness of the importance of voice care and the risk factors that may affect the voice directly or indirectly., (Copyright © 2020. Published by Elsevier Inc.)

Purpose: The recognition of the Brazilian Sign Language (Libras) as the official language of the Brazilian deaf, in 2002, reaffirms the linguistic and cultural particularities of the deaf population. Therefore, there is a lack of a validated instrument for assessing the Quality of Life of deaf people using Libras. With authorization from the World Health Organization (WHO), a version of the WHOQOL-Bref in Libras was developed, called WHOQOL-Bref/Libras. However, its psychometric properties have not been examined as yet. Therefore, the purpose of this work is to perform the psychometric validation of the WHOQOL-Bref/Libras., Methods: WHOQOL-Bref/Libras and a sociodemographic questionnaire were applied to 311 deaf people from the five Brazilian regions. To assess temporal stability, the questionnaire was readministered to 52 deaf people, over an interval of 2 weeks., Results: WHOQOL-Bref/Libras demonstrated satisfactory psychometric values for reliability, discriminant and construct validity, temporal stability, and internal consistency. Cronbach's alpha coefficient showed satisfactory values for each of the WHOQOL-Bref domains: Physical health (0.641), Psychological (0.705), Environment (0.710), and Overall-Bref domains (0.873). The WHOQOL-Bref/Libras is the appropriate option to assess the quality of life of deaf people who communicate through Libras., Conclusion: WHOQOL-Bref/Libras had a satisfactory psychometric performance; therefore, it is a valid option that will provide autonomous participation for the deaf in quality of life investigations.

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.

This study aimed to determine the impact of health on the quality of life (QoL) and quality of working life (QWL) of university teachers. A cross-sectional study was conducted with 284 teachersin the areas of health, sciences, human sciences, and agricultural sciences using a sociodemographic questionnaire containing health-related questions, the WHOQOL-bref, and TQWL-42. Results: the findings showed that teachers who practiced physical activity had better QoL,QWL, and sleep quality. Advanced age was also associated with better QoL.Furthermore, QoL and QWL were lower in teachers who used medications, had an imbalanced diet, and did not practice leisure activities. QoL and QWL are influenced by health-related factors.

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.

The scope of this article is to analyze the quality of work life of the physical therapy course teachers in the city of Goiânia in the state of Goiás. It involved a cross-sectional study of 65 physical therapy teachers in Goiânia. The participants who had worked for less than six months in the profession and those who failed to fill out the questionnaire in full were excluded from the research. A socio-demographic and the Total Quality of Work Life (TQWL-42) questionnaire were used to assess the quality of work life. It was established that the teachers who taught in graduate courses and who held management positions presented significantly better averages than those who only taught in undergraduate courses. Satisfaction with income and with the teaching activity also showed significant results influencing the quality of work life of the participants. Work in positions and locations that allow greater autonomy, status and remuneration, as well as subjective evaluation of satisfaction with income and teaching work, influenced the quality of work life of physical therapy teachers.

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.

The scope of this study was to analyze the quality of life of family caregivers of adults with spinal cord injury. Two researchers conducted a systematic review independently, based on articles published between 2000 to 2014, using the key words quality of life and caregivers or family and spinal cord, in Portuguese, English and Spanish. The search was conducted in the Virtual Health Library (BVS) and the United States National Library of Medicine (PubMED) databases. Caregivers of tetraplegics have a worse quality of life than caregivers of paraplegics. Changes in the quality of life for the caregivers were not significant over time. Different results were observed when comparing caregivers of adults with spinal cord injury and healthy subjects. Factors that negatively influence the quality of life of caregivers were the presence of chronic disease; greater care time, age and number of children; and lower schooling level of caregivers. There is a need for public health policy development and preparation of more comprehensive intervention strategies that include not only the patient but also the caregiver.

The aim of the study was to comprehend how the age group and the severity of the motor impairment of children with cerebral palsy modify the mothers' experiences of stress and to understand the coping strategies they use. A qualitative approach was used, with the method framed on Grounded Theory Analysis. Nineteen mothers of children and adolescents with different degrees of motor impairment participated in individual semi-structured interviews. A lack of support and increased time and effort invested in parenting, at the cost of other areas of life threaten participants' physical and emotional health. Mothers of children with mild impairment suffer more from the challenge of dealing with their children's emotional problems, aggression and learning difficulties. For mothers whose children have severe impairment, the major difficulties relate to coping with health complications and functional limitations. Mothers of younger children report diverse sources of stress and scarcity of resources; while mothers of adolescents have greater experience and are able to take up their life projects again. Experience, knowledge and support received are critical for adaptation.

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.

This article aims to select, evaluate and interpret critically the bibliographic production focused on the stress experienced by parents/caregivers of children with cerebral palsy. An integrative literature review was conducted. Sources for this search were the Virtual Health Library (VHL), the United States National Library of Medicine (PubMed) and manual search of references from the selected studies. It was decided to select studies published between 1998 and 2011. The sample included 13 articles. Parents of children with cerebral palsy have higher stress levels than parents of children without disabilities. Behavioral problems, psychological disorders and emotional needs of children were factors commonly associated with high levels of stress. Satisfaction with social support, satisfaction with the parental role, a good family rapport, an emotional bond between father/mother and child, spousal support and the sense of being an active participation in social life help reduce stress levels. Parents of children with cerebral palsy are likely to have their health affected by higher levels of stress. Thus, health professionals should give them special attention.

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.

The study sought to identify and analyze research related to knowledge and information received by parents of children with cerebral palsy or Down syndrome about these disabilities. It involves a bibliographical revision limited to the period from 1996 through 2008. Computerized data bases were used to collect information, using the following terms as key words: cerebral palsy, Down syndrome, knowledge and family. Fifty-seven studies were located from which 16 were selected; of these, seven were related to cerebral palsy, four to Down syndrome and five were related to sundry deficiencies. The parents receive little information from the healthcare staff and clearly have many doubts about cerebral palsy and Down syndrome. This makes it very difficult for the parents to assist in the treatment of their children, as well as interfering in educational practices and decision-making. There is a need for educational actions to change this reality. Only one research project sought to implement educational strategies which focused on broadening knowledge among family members about aspects related to Down syndrome. It was concluded that there is an urgent need to conduct research and develop actions that contribute to parents being better informed and more secure about their children's health care.

Aiming to investigate the prevalence of cardiovascular risk factors in the population of the Eastern Region of Goiania, Goiás, a transversal study was done involving 3.275 individuals, men and women, aging 15 years and up. Data was collected through home visits for identification and information on living habits, measures blood pressure, anthropometry, and blood collection for identifying dyslipidemias. The variables investigated were: weight, height, blood pressure, physical activity, use of tobacco, cholesterol, triglycerides and glucose. Estimated prevalence at intervals of 95% confidence, differences in proportions assessed using chi-square test and values (p <0,05) considered statistically significant. The study showed that 33,4% of subjects had hypertension, 44.1% overweight/obesity, 16.2% used tobacco regular/occasionally; 72.5% in sedentary leisure and 70% at work, 48.4% with the waist circumference increased; 8.2% hyperglycemia plus impaired glucose tolerance; 44.4% hypercholesterolemia, 13.3% and high triglycerides. High prevalence of cardiovascular risk factors were observed in the study population suggesting greater attention of the authorities in the actions of promotion and prevention of these diseases.

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.