RESUMO
Objective: to evaluate the psychometric properties of the SelfCare Confidence Scale in heart failure in the Brazilian version of the Self Care Heart Failure Index, version 6.2, using the Rasch model criteria. Method: secondary study, of psychometric analysis, using the Rasch model, of the six items of the scale. The sample consisted of 409 patients with heart failure undergoing outpatient treatment [mean age 57.9 (standard deviation = 11.6) years, 54.8% male]. Results: of the total of six items, one ("De maneira geral, você está confiante sobre estar livre dos sintomas de insuficiência cardíaca?") presented maladjustment to the model (Infit = 1.84 and Outfit = 1.99). After the exclusion of this item, the others showed a good fit, composed one dimension and explained 55% of the variance in the data; the categories of response to the items were adequate, the values of separation and reliability of person were 2.13 and 0.82, respectively, and Cronbach's alpha was 0.87. Items of extreme difficulty were identified and there is no differential functioning of the items in relation to sex. Conclusion: with the exclusion of the first item, the Self-Care Confidence Scale showed good psychometric properties, with caution in interpreting the results of the six-item scale. Descriptors: Validation Study; Surveys and Questionnaires; Self Care; Patient Education as Topic; Heart Failure; Nursing.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Psicometria , Autocuidado , Inquéritos e Questionários , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate the differences in cigarette smoking prevalence rates in Brazil between 1989 and 2008. METHODOLOGY: We calculated absolute and relative differences in smoking prevalences, overall and stratified by gender, age, place of residence, educational level and birth cohort. Data were obtained from random samples from two National Household Surveys (1989,n=39,969; 2008,n=38,461). GLM models were specified to obtain estimates and assess whether differences in proportions of smokers differed by categories of the stratification variables. RESULTS: Adjusted absolute and relative differences in smoking prevalence rates between 1989 and 2008 were, respectively, -12.4% and -41.0%. Individuals aged 15-34 years and those with 9 or more years of education presented larger relative declines than their counterparts (p(s)≤0.001). After stratification by birth cohort, men presented larger reductions than women, only in the absolute scale (p(s)≤0.001), with the exception of the youngest birth cohort (i.e.,1965-1974). CONCLUSIONS: In Brazil, several tobacco control measures have been adopted since 1986, in particular increasing taxation of tobacco products and strong health warnings, which may have contributed to the marked decline in smoking prevalence. It is important to understand the evolution of the tobacco epidemic to propose new actions to prevent initiation and encourage cessation among those who started/continued smoking.
Assuntos
Assunção de Riscos , Fumar/tendências , Tabagismo/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Fumar/epidemiologia , Prevenção do Hábito de Fumar , Tabagismo/prevenção & controle , Adulto JovemRESUMO
Propionic and methylmalonic acidemias are inherited neurometabolic disorders biochemically characterized by tissue accumulation of propionic (PA) and methylmalonic (MMA) acids, respectively. Neurofilaments (NF) are important cytoskeletal proteins and phosphorylation/dephosphorylation of NF is important to stabilize the cytoskeleton. We investigated the effects of PA and MMA on the high molecular weight neurofilament subunit associated with the cytoskeletal fraction of rat cerebral cortex along development. Cortical slices from 9- to 60-day-old rats were incubated with 2.5 mM PA or MMA. The cytoskeletal fraction was extracted and the immunoreactivity for phosphorylated or total NF-H was analyzed by immunoblotting using specific antibodies. Results showed that treatment of tissue slices with the acids induced an increased Triton-insoluble phosphorylated NF-H immunoreactivity in up to 17-day-old rats. Furthermore, treatments significantly increased the total amount of NF-H in 12-day-old rats. These findings indicate that PA and MMA alter the dynamic regulation of NF-H assembly in the cytoskeletal fraction.
Assuntos
Córtex Cerebral/efeitos dos fármacos , Ácido Metilmalônico/farmacologia , Proteínas de Neurofilamentos/metabolismo , Propionatos/farmacologia , Animais , Western Blotting , Córtex Cerebral/metabolismo , Citoesqueleto/efeitos dos fármacos , Citoesqueleto/metabolismo , Técnicas In Vitro , Peso Molecular , Fosforilação , Ratos , Ratos WistarRESUMO
This article outlines the trajectory of the Brazilian Association of Nursing (ABEn) in Alagoas and its influence in the organization of the nursing profession in this federal state. It points out that ABEn-AL was the first institution to organize nursing in Alagoas, since it was founded prior to any nursing graduation course or even any nursing syndicate. Therefore, ABEn is considered a decisive landmark in the political and professional organization of nursing in the state of Alagoas.
Assuntos
Sociedades de Enfermagem/história , Brasil , História do Século XX , Sociedades de Enfermagem/organização & administraçãoRESUMO
BACKGROUND: To assess the impact of water sanitation and sewage disposal, part of a major environmental control programme in Rio de Janeiro, we carried out sero-prevalence studies for Hepatitis A virus (HAV) in three micro-regions in Rio de Janeiro. Each region varied with regard to level of sanitation. We are interested in assessing the discriminating power of age-specific prevalence curves for HAV as a proxy for improvement in sanitation. These curves will serve as baseline information to future planned surveys as the sanitation programme progresses. METHODS: Incidence rate curves from prevalence data are estimated parametrically via a Weibull-like survival function, and non-parametrically via maximum likelihood and monotonic splines. Sera collected from children and adults in the three areas are used to detect antibodies against HAV through ELISA. RESULTS: We compare baseline incidence curves at the three sites estimated by the three methods. We observe a strong negative correlation between level of sanitation and incidence rates for HAV infection. Incidence estimates yielded by the parametric and non-parametric approaches tend to agree at early ages in the microregion showing the best level of sanitation and to increasingly disagree in the other two. CONCLUSION: Our results support the choice of HAV as a sentinel disease that is associated with level of sanitation. We also introduce monotonic splines as a novel non-parametric approach to estimate incidence from prevalence data. This approach outperforms current estimating procedures.
Assuntos
Vírus da Hepatite A Humana/imunologia , Hepatite A/epidemiologia , Anticorpos Anti-Hepatite/análise , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Hepatite A/prevenção & controle , Hepatite A/virologia , Anticorpos Anti-Hepatite A , Humanos , Incidência , Lactente , Projetos Piloto , Prevalência , Estudos Retrospectivos , Saneamento/métodos , Saneamento/normas , Estudos Soroepidemiológicos , População UrbanaRESUMO
The validity of blood spotted on to filter-paper (BSOFP) eluates for the detection of antibodies against hepatitis A virus (HAV) was investigated in 718 individuals (children and adults) during a field study in a small area in Rio de Janeiro State, Brazil. Serum samples were considered the 'gold standard'. BSOFP eluates were analyzed by 2 different techniques: microplate competitive enzyme-linked immunosorbent assay (ELISA) of the whole study group and microparticle enzyme immune assay (MEIA) of a subsample of 59 individuals. For BSOFP eluates by ELISA, sensitivity and specificity were 89.6% (95% CI: 84.7-93.1) and 97.5% (95% CI: 95.6-98.7), respectively. For a seroprevalence of anti-HAV antibodies of 32%, the positive predictive value was 94.5% (95% CI: 90.3-97.0) and the negative predictive value was 95.2% (95% CI: 92.8-96.8). The test efficiency was 95.0% (95% CI: 93.1-96.4). Similar results were found for BSOFP eluates by MEIA. Agreement between the 2 techniques used for BSOFP (ELISA and MEIA) was also high (kappa = 0.93). These results encourage the more widespread application of BSOFP as a means of surveillance for large-scale epidemiological studies for hepatitis A.
Assuntos
Hepatite A/diagnóstico , Anticorpos Anti-Hepatite/sangue , Adolescente , Distribuição por Idade , Biomarcadores/sangue , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Hepatite A/epidemiologia , Hepatite A/imunologia , Anticorpos Anti-Hepatite A , Humanos , Lactente , Projetos Piloto , Valor Preditivo dos Testes , Prevalência , Sensibilidade e EspecificidadeRESUMO
Em 1972 MAUKSCH e DAVID fizeram algumas afirmaçöes sobre os benefícios de se utilizar a prescriçäo de enfermagem. Em 1987 DONNELY avaliou essas afirmaçöes frente a evoluçäo da profissäo. Com base nessas duas publicaçöes foram elaboradas algumas reflexöes que compöem a presente publicaçäo. Partimos do entendiemnto de que a implementaçäo do processo de enfermagem em nosso meio pode trazer decepçöes se a ele for atribuído o potencial de trazer soluçöes para os sérios problemas da prática de enfermagem.
Assuntos
Humanos , Processo de EnfermagemRESUMO
An epidemiological survey was carried out for the purpose of estimating the use of psycho-active substances and the prevalence of alcoholism. The target population consisted of people over 13 years old living in a district of Rio de Janeiro city-Brazil. A random sample of 1,459 people was researched. Data on the use of alcohol and on alcoholism are presented. The diagnosis of this latter, based upon the CAGE Test, showed that 51% used alcohol and 3% were suspected of alcoholism: 4.9% and 1.7% among men and women, respectively. The greatest prevalence of the use of alcohol and of alcoholism was found among men between 30 and 49 years of age. Abstinence from alcohol was more frequent among widowed, Evangelical and low-income groups.