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The Postpartum Bonding Questionnaire is a self-report questionnaire designed to screen disorders of the mother-infant relationship, which has been adapted to several countries. The aim of this study was to investigate validity evidence of the Brazilian version of the Postpartum Bonding Questionnaire (PBQ-Br) based on its internal structure (dimensionality, reliability, and measurement invariance between mothers with and without depressive symptoms) and on relations to other variables (depression). The present study is part of the Ribeirão Preto and São Luís Brazilian Cohort Studies, encompassing data collected from February 2011 to September 2013. Data were available for 2207 mothers from the general population of Ribeirão Preto and São Luís cities, who were assessed using the PBQ and the Edinburgh Postnatal Depression Scale. Regarding internal structure, the results of confirmatory factor analyses did not support the original four-factor model, nor the alternative structures tested. Exploratory factor analysis suggested a one-factor model with eight items for the collected data, accounting for 38.7% of the total variance with good internal consistency (α = 0.83). Concerning validity evidence based on relations to other variables, the mean PBQ-Br score for mothers with depressive symptoms was significantly higher than for mothers with no depressive symptoms. In conclusion, we found good validity evidence and the PBQ-Br proved to be a useful tool for assessing the mother-infant relationship in the Brazilian general population rather than for its original purpose, i.e., assessing bonding disorders. The results also highlight the importance of developing cross-cultural studies in order to provide useful measures for specific populations. Highlights: PBQ-Br proved to be a useful tool for assessing the mother-infant relationship in Brazil. PBQ-Br is more suitable for assessing routine issues of the mother-infant relationship rather than for its original purpose, i.e., assessing bonding disorders. Data for PBQ-Br validity evidence were available for 2207 Brazilian mothers. The results indicated a one-factor model with eight items as the best factor structure. The results highlight the importance of developing further cross-cultural research in order to assess this construct and measure it in other contexts. [ABSTRACT FROM AUTHOR]

Background: Few studies have assessed dietary patterns (DPs) and the changes in these patterns over time in adults. The present study aimed to investigate whether possible changes in DPs in two assessments are associated with obesity and excess body fat. Methods: A prospective study was conducted in which data were collected from 1082 adults of a Brazilian birth cohort during two periods 15 years apart (T1: 2002–2004; T2: 2016–2017). Food consumption was assessed in both periods using validated food frequency questionnaires. Three similar DPs were found in the two assessments, and adherence to these patterns was classified as prudent, risk or mixed. Nine DPs changes were defined. At T2, subjects with a body mass index ≥ 30.0 kg m–² were classified as obese, and men and women with a body fat (BF) percentage ≥ 25.0 and ≥ 35.0, respectively, were classified as having excess BF. A directed acyclic graph was built to adjust the association for confounding variables. Results: At T2, 34.4% of the subjects were obese and 61.4% had excess BF. In the adjusted analysis, the changes associated with obesity and excess BF were prudent–mixed (prevalence ratio [PR] 1.55; 95% confidence interval [CI] = 1.04–2.29 and PR = 1.35; 95% CI = 1.10–1.65), risk–risk (PR = 1.49; 95% CI = 1.03–2.13 and PR = 1.27; 95% CI = 1.04–1.53), risk–mixed (PR = 1.56; 95% CI = 1.05–2.31 and PR = 1.33; 95% CI = 1.07–1.63) and mixed–risk (PR = 1.61; 95% CI = 1.10–2.35 and PR = 1.29; 95% CI = 1.04–1.58). Conclusions: A decline in food quality over time or stagnation in an unhealthy DP can lead to obesity and excess BF. Key points: Assessment of adult dietary patterns at two points in time. [ABSTRACT FROM AUTHOR]

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Objective: To investigate a possible association between the intensity of staff workload and intermediate adverse events, such as accidental extubation, obstruction of the endotracheal tube, and accidental disconnection of the ventilator circuit, during neonatal mechanical ventilation in high-risk neonatal units. Method: This prospective cohort study analyzed data of 543 newborns from public neonatal intensive care units (NICUs) in the city of São Luís, state of Maranhão, Northeastern Brazil, for 6 months, during which 136 newborns were submitted to mechanical ventilation in 1,108 shifts and were observed a total of 4,554 times. Results: Adverse events occurred 117 times during this period. The associations between workload and adverse events were analyzed by means of generalized estimating equations. The adjustment variables were: birth weight, gender, maternity unit, Clinical Risk Index for Babies score, and care demand, the latter measured by the Northern Neonatal Network Scale. The larger the number of newborns classified by care demand (NCCD) per nurse and nursing technician, the more likely the occurrence of intermediate adverse events linked to mechanical ventilation. A number of NCCD > 22 per nurse (relative risk [RR] = 2.86) and > 4.8 per auxiliary nurse (RR = 3.41) was associated with a higher prevalence of intermediate adverse events. Conclusions: The workload of NICU professionals seems to interfere with the intermediate results of neonatal care and thus should be taken into consideration when evaluating NICU outcomes. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about a serologic survey on the incidence of hantavirus infection in Brazil.

In 2000, the first outbreak of hantavirus pulmonary syndrome was recognized in the Brazilian Amazon (Maranhao State). An epidemiologic study identified a 13.3% prevalence of hantavirus-specific immunoglobulin G. The analysis of risk factors suggests that persons are occupationally exposed to infected rodents in the crop fields. [ABSTRACT FROM AUTHOR]