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Background: Occupational stress and workplace violence are highly prevalent risk factors among healthcare professionals and can affect not only the psychosocial well-being of workers but also that of patients and healthcare organizations. Objective: The objective of this study is to translate and cross-culturally adapt the ENvironmental PRotectors against hOspital work Stress scale to facilitate future psychometric validation of the instrument. Methods: A methodological study was conducted at the School of Medicine of São Paulo State University (UNESP) in São Paulo, Brazil. This study involved three steps: translation and backtranslation by independent native language speakers, analysis by an expert panel, and a pre-test phase. Ten specialists adjusted and approved the final version for semantic, idiomatic, and cultural accuracy across nine items. Results: The content validity index was satisfactory (CVI ≥ 0.80). The final version was administered to 36 nursing and medical staff at a public hospital in São Paulo. No items were excluded from the instrument. Satisfactory content and face validity were achieved, and the criteria recommended by the literature were met. Conclusions: The Portuguese version of ENPROS is appropriate and culturally adapted for use in Brazil. [ABSTRACT FROM AUTHOR]

BackgroundBehavioral and psychological symptoms (BPSD) can be a prodrome of dementia, and the Neuropsychiatric Inventory (NPI) is widely used for BPSD evaluation.ObjectiveTo compare the prevalence of BPSD according to cognitive status, and to determine NPI cutoffs that best discern individuals with mild cognitive impairment (MCI) and dementia from those without dementia.MethodsWe included 1,565 participants (mean age = 72.7±12.2 years, 48% male). BPSD and cognitive status were assessed with the NPI and the Clinical Dementia Rating (CDR). We used multivariable logistic regression models to investigate the association of BPSD with cognitive status. The area under the curve (AUC) was used to assess model discrimination, and to determine the best NPI cutoff for MCI and dementia.ResultsParticipants were cognitively normal (CDR = 0; n = 1,062), MCI (CDR = 0.5; n = 145), or dementia (CDR≥1.0, n = 358). NPI symptoms were more frequent in dementia and MCI when compared to cognitively normal. Higher odds for delusions, hallucinations, disinhibition, and psychomotor alterations were found among participants with dementia and MCI than in those who were cognitively normal. The best NPI cutoff to discern participants with dementia from those cognitively normal was 11 (AUC = 0.755). Poor discrimination (AUC = 0.563) was found for the comparison of MCI and those cognitively normal.ConclusionsWe found an increase in BPSD frequencies across the continuum of cognitive impairment. BPSD severity and frequency in MCI was more similar to individuals cognitively normal than with dementia. NPI scores≥to 11 in individuals with no diagnosis of dementia can support the decision for further investigation of dementia.

This is a theoretical-reflective study that aimed to analyze the contexts associated with gynaecological care for women with physical disabilities. Discussion consisted of contextual analysis according to Hinds, Chaves and Cypress, leading to four interconnected layers: immediate, specific, general and metacontext. Analysis showed that gynaecological assistance to clients with physical disabilities is influenced by attitudinal, structural, financial and informational barriers. Other influential issues are social beliefs and stigmas and the persistence of a biomedical model, which is hegemonic in this type of assistance. Therefore, gynaecological care must be valued based on the holistic paradigm offered by a transdisciplinary team in order to provide quality care to women with physical disabilities.

Este experimento investigou o efeito do treino de relações condicionais entre estímulos fracionários na forma de figuras e numéricos, com e sem treino de composição, sobre a aprendizagem do conceito de proporção. Avaliou-se a formação de classes de equivalência, sua expansão e generalização, e a resolução de problemas, com lápis e papel, com estímulos fracionários. Participaram 20 alunos do sexto ano do Ensino Fundamental. Os grupos GEQ e GEQTC passaram por treinos e testes de relações condicionais, mas este último foi exposto, adicionalmente, ao treino de composição de frações antes dos treinos das relações condicionais; dois grupos controle fizeram apenas as avaliações inicial e final. Os resultados indicaram a formação de classes de equivalência, mas não evidenciaram efeito do treino de composição.

ABSTRACT Objective: to know the praxis of nurses in the hospital context and, from this, to define a concept about Care-Educational Technologies. Method: qualitative, exploratory-descriptive research, developed in a university hospital in Rio Grande do Sul State, Brazil, with 21 nurses (non-probabilistic sampling), through non-participant observation and semi-structured interview, conducted from March to December 2015. Records were analyzed through content analysis. Results: the results showed that in the context of nurses' work, it is possible to deduce care-educational possibilities, based on the person-person, person-tool and/or person-universe relationship. The concept was defined based on the intertwining of caring-training and training-caring for oneself and other people. Final considerations: the reflections point to the need to develop or strengthen the autonomy of those involved in the health-disease process. This is based on the empowerment of people under their lives' conditions, in their multidimensionality, within human praxis.

Resumo O artigo explora como se arquiteta um discurso de acusação em torno da sexualidade feminina “irresponsável” no interior de instituições públicas. A discussão parte de etnografia realizada em creches públicas situadas num complexo de favelas da Zona Norte (RJ). Apresento as principais etapas de acesso às vagas na instituição, assim como as estratégias mobilizadas pelas famílias para conseguir uma vaga. Acompanho de que maneira algumas situações são conduzidas a partir de uma pedagogia do constrangimento, nas quais “esporros” públicos configuram um campo de tensão entre funcionárias e mulheres usuárias dos serviços. A relação entre mulheres é marcada pela ambivalência de uma ação administrativa que, ao mesmo tempo em que acolhe as demandas pelo cuidado das crianças, é feita de censuras e constrangimentos morais. Ao final, discuto a presença de um Estado feminino, uma ação que mescla qualidades de cuidado ao lado de expedientes de cobrança e responsabilização.

ABSTRACT Objective: to validate a booklet on dengue prevention in order to make it an educational technology to be used with the population. Method: methodological study, carried out with two groups of judges specialized in health and other areas. For data analysis, the calculation of Content Validity Index was carried out. Results: the booklet, in general, was considered valid by the expert judges, since it obtained an overall CVI of 70%. However, it has undergone a textual and aesthetic re-elaboration. The changes were based on the substitution of expressions, phrases, information additions and language adequacy. The illustrations were redone, adding clarity, expressiveness, movement, interaction and contextualization. Conclusion: the booklet is valid to be used for the population, with the purpose of informing, in a playful way, the forms of prevention and combat to mosquito transmitting dengue.

The relationship between soccer and chronic traumatic encephalopathy (CTE) is not well established. We report clinicopathological correlations in an 83-year-old retired center-back soccer player, with no history of concussion, manifesting typical Alzheimer-type dementia. Examination revealed mixed pathology including widespread CTE, moderate Alzheimer's disease, hippocampal sclerosis, and TDP-43 proteinopathy. This case adds to a few CTE cases described in soccer players. Furthermore, it corroborates that CTE may present clinically as typical Alzheimer-type dementia. Further studies investigating the extent to which soccer is a risk for CTE are needed.

Argyrophilic grain disease (AGD) is a frequent late-onset, 4-repeat tauopathy reported in Caucasians with high educational attainment. Little is known about AGD in non-Caucasians or in those with low educational attainment. We describe AGD demographics, clinical, and neuropathological features in a multiethnic cohort of 983 subjects ≥50 years of age from São Paulo, Brazil. Clinical data were collected through semistructured interviews with an informant and included in the Informant Questionnaire on Cognitive Decline in the Elderly, the Clinical Dementia Rating, and the Neuropsychiatric Inventory. Neuropathologic assessment relied on internationally accepted criteria. AGD was frequent (15.2%) and was the only neuropathological diagnosis in 8.9% of all cases (mean, 78.9 ± 9.4 years); it rarely occurred as an isolated neuropathological finding. AGD was associated with older age, lower socioeconomic status (SES), and appetite disorders. This is the first study of demographic, clinical, and neuropathological aspects of AGD in different ethnicities and subjects from all socioeconomic strata. The results suggest that prospective studies of AGD patients include levels of hormones related to appetite control as possible antemortem markers. Moreover, understanding the mechanisms behind higher susceptibility to AGD of low SES subjects may disclose novel environmental risk factors for AGD and other neurodegenerative diseases.

ABSTRACT Objectives: to assess the reliability and validity of the 46 items version of the comfort scale for family members of people in critical condition. Methods: a methodological study, carried out with 278 family members of critically ill patients, admitted to adult and pediatric intensive care units, in a city in the interior of the state of São Paulo, in Brazil. The analyzes were based on the Classical Test Theory and Item Response Theory. Results: Horn’s parallel analysis and exploratory and confirmatory factor analysis did not identify the scale’s unidimensionality nor the tridimensionality. The maximum factor loads were positive. The scale proved to be reliable (α=0.93 and Ω=0.63), most item-total correlations were greater than 0.28 and the discrimination coefficients were greater than one. Conclusions: the scale showed satisfactory reliability and relative construct validity. However, the recommended tridimensional structure for the scale has not been confirmed.