RESUMO
Guatemala has a concentrated HIV epidemic disproportionately affecting men who have sex with men (MSM) and transgender women. We recruited 205 self-identified MSM, bisexuals, transvestites, and transgender women in western Guatemala using long-chain peer referral, wherein "seed" participants were asked to invite as many as three acquaintances to participate in the study. Self-reported sexual or gender identity was MSM, 46%; bisexual, 28%; transvestite, 21%, and transgender woman, 5%. Median age of the participants was 23 years, and 36% self-identified as being indigenous. Indigenous persons were more likely to self-identity as transvestite (32.9% vs 13.8%, P = 0.04), strongly perceive themselves at risk for HIV (87.7% vs 51.5%, P = 0.001), have had an HIV test in the last 12 months and know the result (97.3% vs 85.4%, P = 0.008), and experience barriers to testing and treatment (86.3% vs 67.7%, P = 0.004). HIV prevention services for indigenous MSM should especially target transvestites and how to overcome stigmatization and barriers to care.
Assuntos
Infecções por HIV/prevenção & controle , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Adulto , Estudos Transversais , Feminino , Guatemala/epidemiologia , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Percepção , Assunção de Riscos , Adulto JovemRESUMO
Objective: To analyze the reliability, validity and operational equivalence of the nutritional screening method "Assessing The Nutritional Condition Of The Elderly". Method: This study was conducted with a subsample of 174 elderly persons from the Health, Welfare and Aging (SABE) study. The "Assessing The Nutritional Condition Of The Elderly" method consists of ten questions which classify individuals according to nutritional risk. Anthropometric and nutritional indicators were adopted as gold standard measures for comparison with the values of the method. Reliability was verified using the McNemar and Bland Altman tests, the validity of the discriminant type was assessed by the Mann-Whitney test and operational equivalence was identified through data relating to the time required to apply the method and the degree of understanding of the same using the Likert scale (1 to 5). Results: Of the 174 elderly persons interviewed, 63.8% were women and 52.3% were in the 60-74 years age group. It was found that 43.1% and 33.3% of the subjects had moderate to high nutritional risk, respectively, with a higher prevalence of high nutritional risk among women (33.3%) and those aged 60-74 years (43.4%). The method analyzed showed satisfactory results for reliability and discriminant validity. The average time required to apply this method was approximately seven minutes and the overall mean grade of understanding was 4.8. Conclusion: The method studied can be used by health professionals in epidemiological and clinical studies to identify the presence of nutritional risk in elderly persons living at home.
Objetivo: Analisar a confiablidade, a validade e a equivalência operacional do método de triagem nutricional "Verifique a condição nutricional do idoso". Método: Este estudo foi realizado com subamostra de 174 idosos do Estudo Saúde, Bem-estar e Envelhecimento (SABE). O método "Verifique a condição nutricional do idoso", consiste de 10 perguntas, que classifica os indivíduos, segundo risco nutricional. Adotou-se a antropometria e indicadores nutricionais, como medidas padrão-ouro para comparação com os valores desse método. A confiabilidade foi verificada pelo teste de McNemar e gráficos de Bland Altman, a validade do tipo discriminante foi avaliada por meio do teste Mann-Whitney e a equivalência operacional do método foi identificada pelos dados referentes à duração de realização do método e pelo grau de entendimento do mesmo pela escala Likert (entre 1 e 5). Resultados: Dos 174 idosos entrevistados, 63,8% eram mulheres e 52,3% eram do grupo etário de 60 a 74 anos. Constatou-se que 43,1% e 33,3% dos indivíduos apresentavam risco nutricional moderado e alto, respectivamente, sendo maior a prevalência de risco nutricional alto nas mulheres (33,3%) e naqueles do grupo de 60 a 74 anos (43,4%). O método analisado apresentou resultados satisfatórios para confiabilidade e validade discriminante. A duração média de realização do método foi de aproximadamente sete minutos e nota média geral de entendimento foi de 4,8. Conclusão: O método estudado pode ser utilizado em estudos epidemiológicos e clínicos, por profissionais de saúde, para identificar a presença de risco nutricional em idosos domiciliados.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Avaliação Nutricional , Reprodutibilidade dos Testes , Estudo de Validação , Nutrição do IdosoRESUMO
Resumo O objetivo deste artigo é descrever o processo de adaptação transcultural do método de triagem nutricional, Determine Your Nutritional Health® (DNH), para utilização na população idosa brasileira. O DNH consiste de 10 questões com enunciados afirmativos, às quais são atribuídas pontuações específicas e cuja soma corresponde ao escore final, que classifica os indivíduos de acordo com a presença ou a ausência de risco nutricional. O processo de adaptação transcultural do método DNH envolveu as seguintes etapas: tradução; retrotradução; equivalência semântica; avaliação dos especialistas; pré-teste e versão final do método. Foram realizadas adaptações de palavras e expressões do método DNH, para a realidade brasileira. A versão final do método foi definida para o Brasil como "Verifique a condição nutricional do idoso", apresentando as mesmas questões da versão original do DNH, contudo, em formato mais claro, por meio de perguntas, consideradas acessíveis e de fácil entendimento, segundo a avaliação de profissionais de saúde e de idosos. A versão brasileira do método de triagem nutricional, "Verifique a condição nutricional do idoso", encontra-se traduzida e adaptada para uso em idosos brasileiros domiciliados.
Abstract This article aims to describe the process of cross-cultural adaptation of the Determine Your Nutritional Health® (DNH) screening method for the elderly Brazilian population. The DNH consists of 10 questions with affirmative statements, to which specific scores are assigned and when added up correspond to the final score, which classifies individuals according to the presence or absence of nutritional risk. The process of cross-cultural adaptation of the DNH method involved the following stages: translation; back translation; semantic equivalence; evaluation by the experts; pre-test and final version of the method. Adjustments were made in words and expressions of the DNH method for the Brazilian reality. The final version of the method has been defined for Brazil as "Verify the nutritional conditions of the elderly," presenting the same questions as in the original version of the DNH. It was in a clearer format, through questions, considered accessible and easy to understand, according to the assessment of health professionals and the elderly. The Brazilian version of the nutritional screening method, "Verify nutritional conditions of the elderly," was translated and adapted, for use in Brazilian elderly in assisted living accommodation.
RESUMO
BACKGROUND: Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Stigma, a lack of standardized therapy and a limited number of assessment tools hinder advances in treatment. This study provides preliminary data on the Portuguese-language version of the Kleptomania Symptom Assessment Scale (P-K-SAS) and preliminary data on an outpatient program. METHODS: Experts in the field analyzed an initial P-K-SAS version, produced through translation/back-translation, in order to arrive at a final version. Eight patients currently on cognitive-behavioral therapy (CBT) and 10 patients under maintenance CBT were initially assessed, then re-assessed 6months later. RESULTS: The mean P-K-SAS score was higher among patients initiating CBT than among those under maintenance CBT (21.1±8.0 vs. 11.3±7.5; Mann-Whitney U=15.0, P=.024). The final version of the P-K-SAS presented excellent reliability (Cronbach's alpha=0.980; inter-item correlation, 0.638-0.907). CONCLUSIONS: The P-K-SAS presented solid psychometrics and seems ready for use in assessing the effectiveness of treatments for kleptomania. The findings suggest that kleptomania patients need follow-up treatment that goes beyond the traditional 12-session structure.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapia , Escalas de Graduação Psiquiátrica/normas , Psicometria/instrumentação , Adulto , Brasil/etnologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Reprodutibilidade dos Testes , Avaliação de Sintomas , Resultado do TratamentoRESUMO
Resource-limited settings have made slow progress in integrating TB and HIV care for co-infected patients. We examined the impact of integrated TB/HIV care on clinical and survival outcomes in rural western Guatemala. Prospective data from 254 newly diagnosed TB/HIV patients (99 enrolled in the pre-integrated program from August 2005 to July 2006, and 155 enrolled in the integrated program from February 2008 to January 2009) showed no significant baseline differences between clients in the two periods. They were principally male (65.5 %), Mayan (71 %), median age 33 years, and CD4 count averaged 111 cells/mm³. TB/HIV co-infected patients were more likely to receive antiretroviral therapy in the integrated program than in the pre-integrated program (72 vs. 22 %, respectively) and had lower mortality (HR 0.22, 95 % CI 0.140.33). This study shows how using a TB setting as the entry point for integrated TB/HIV care can improve health outcomes for HIV-positive patients in rural Guatemala.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Antituberculosos/uso terapêutico , Prestação Integrada de Cuidados de Saúde/organização & administração , Infecções por HIV/tratamento farmacológico , Avaliação de Programas e Projetos de Saúde , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Coinfecção/epidemiologia , Prestação Integrada de Cuidados de Saúde/métodos , Feminino , Guatemala/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/métodos , Desenvolvimento de Programas/métodos , Estudos Prospectivos , Serviços de Saúde Rural/organização & administração , População Rural , Análise de Sobrevida , Resultado do Tratamento , Tuberculose/complicações , Tuberculose/mortalidade , Adulto JovemRESUMO
HIV and sexually transmitted infection (STI) are of concern in Mayan districts of Guatemala in which labor migration is common. This study assessed whether the migration status of men is associated with reported STI symptoms among their female primary partners. In a multivariate analysis of survey data taken from a larger Mayan sexual health study, the odds of reporting STI symptoms were twofold higher among women who reported that their partner migrated (OR 2.08, 95 % CI, 1.16-3.71), compared to women whose partners did not. Women from the Mam and Kaqchikel ethnolinguistic groups reported higher rates of STI symptoms after adjustment for their partners' migration status.
Assuntos
População Rural , Comportamento Sexual/etnologia , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/etnologia , Migrantes/estatística & dados numéricos , Populações Vulneráveis/etnologia , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Cultura , Feminino , Guatemala/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/psicologia , Infecções Sexualmente Transmissíveis/transmissão , Fatores Socioeconômicos , Populações Vulneráveis/psicologia , Adulto JovemRESUMO
This study analyzed data from two consecutive retrospective cohort samples (1983 to 1998 and 1999 to 2002) of Brazilian children with AIDS (N = 1,758) through mother-to-child-transmission. Late-stage diagnosis (CDC category C) was investigated in relation to the following variables: year of birth, year of HIV diagnosis, and time periods related to changes in government treatment guidelines. Late-stage diagnosis occurred in 731 (41.6%) of cases and was more prevalent in infants under 12 months of age. The rate of late-stage diagnosis decreased from 48% to 36% between the two periods studied. We also observed a reduction in the proportion of late-stage diagnoses and the time lapse between HIV diagnosis and ART initiation. A significant association was found between timely diagnosis and having been born in recent years (OR = 0.62; p = 0.009) and year of HIV diagnosis (OR = 0.72; p = 0.002/OR = 0.62; p < 0.001). Infants under the age of 12 months were more likely to be diagnosed at a late stage than older children (OR = 1.70; p = 0.004). Despite advances, there is a need to improve the effectiveness of policies and programs focused on improving early diagnosis and management of HIV/AIDS.
Assuntos
Diagnóstico Tardio/estatística & dados numéricos , Infecções por HIV/diagnóstico , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
This study analyzed data from two consecutive retrospective cohort samples (1983 to 1998 and 1999 to 2002) of Brazilian children with AIDS (N = 1,758) through mother-to-child-transmission. Late-stage diagnosis (CDC category C) was investigated in relation to the following variables: year of birth, year of HIV diagnosis, and time periods related to changes in government treatment guidelines. Late-stage diagnosis occurred in 731 (41.6%) of cases and was more prevalent in infants under 12 months of age. The rate of late-stage diagnosis decreased from 48% to 36% between the two periods studied. We also observed a reduction in the proportion of late-stage diagnoses and the time lapse between HIV diagnosis and ART initiation. A significant association was found between timely diagnosis and having been born in recent years (OR = 0.62; p = 0.009) and year of HIV diagnosis (OR = 0.72; p = 0.002/OR = 0.62; p < 0.001). Infants under the age of 12 months were more likely to be diagnosed at a late stage than older children (OR = 1.70; p = 0.004). Despite advances, there is a need to improve the effectiveness of policies and programs focused on improving early diagnosis and management of HIV/AIDS.
Analisaram-se dados de duas coortes retrospectivas consecutivas (1983-1998, 1999-2002) de crianças brasileiras com AIDS (n = 1.758), expostas ao HIV por transmissão vertical. Ocorrência de diagnóstico tardio (categoria C-CDC) foi verificada para: ano de nascimento, ano de diagnóstico da infecção e períodos relacionados a mudanças das diretrizes terapêuticas governamentais. Encontramos 731 (41,6%) crianças com diagnóstico em estágio tardio, especialmente com < 1 ano de idade. No segundo período o desempenho do diagnóstico melhorou (36 vs. 48% de atraso diagnóstico no primeiro período). Verificou-se melhoria da proporção de crianças com diagnóstico tardio e do tempo entre o diagnóstico da infecção e a introdução da terapia antirretroviral. Ano de nascimento (OR = 0,62; p = 0,009) e ano de diagnóstico da infecção (OR = 0,72; p = 0,002/OR = 0,62; p < 0,001) mais recentes estiveram significativamente associados a diagnóstico oportuno. Crianças com idade < 1 ano tiveram maior risco para diagnóstico tardio do que as mais velhas (OR = 1,70; p = 0,004). Apesar dos avanços, há necessidade de potencializar diagnóstico e manejo oportunos.
Se analizaron datos de dos cohortes retrospectivas consecutivas (1983-1998, 1999-2002) de niños brasileños con SIDA (N = 1.758), expuestos al VIH por transmisión vertical. La ocurrencia de diagnóstico tardío (categoría C-CDC) fue verificada para: año de nacimiento, año de diagnóstico de la infección y períodos relacionados con cambios de las directrices terapéuticas gubernamentales. Hubo 731 (41,6%) niños con diagnóstico en estadio tardío, especialmente con < 1 año de edad. En el segundo período el desempeño del diagnóstico mejoró (36 versus 48% de atraso diagnóstico). Se verificó una mejoría de la proporción de niños con diagnóstico tardío y del tiempo entre diagnóstico de la infección e introducción de la terapia antirretroviral. Los años de nacimiento (OR = 0,62; p = 0,009) y años de diagnóstico de la infección (OR = 0,72; p = 0,002/OR = 0,62; p < 0,001) más recientes estuvieron significativamente asociados a un diagnóstico oportuno. Los niños con edad < 1 año tuvieron mayor riesgo para un diagnóstico tardío que los más viejos (OR = 1,70; p = 0,004). A pesar de los avances, existe una necesidad de potenciar el diagnóstico y tratamientos oportunos.
Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Diagnóstico Tardio/estatística & dados numéricos , Infecções por HIV/diagnóstico , Brasil/epidemiologia , Estudos de Coortes , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Estudos RetrospectivosRESUMO
This study aimed to describe the translation into Brazilian Portuguese and the analysis of conceptual, semantic, and instrumental equivalences and assessment of internal consistency of the Male Body Dissatisfaction Scale (MBDS). The study included the steps of (1) translation; (2) synthesis of translation; (3) back-translation; (4) review by experts - judges - analysis of the semantic and instrumental equivalences; (5) pre-test - assessment of verbal understanding of the instrument by specialists and male students; (6) analysis of the internal consistency by Cronbach's α coefficient. The MBDS was translated and adapted into Brazilian Portuguese maintaining its original 25 items, showed good verbal comprehension, and had an internal consistency coefficient of 0.92. The scale was translated and adapted with satisfactory results, thus confirming its initial psychometric qualities. The instrument requires further analysis of internal and external validity, and reproducibility.
Assuntos
Imagem Corporal , Semântica , Inquéritos e Questionários , Tradução , Brasil , Comparação Transcultural , Humanos , Masculino , TraduçõesRESUMO
With the increase in research on the components of Body Image, validated instruments are needed to evaluate its dimensions. The Body Change Inventory (BCI) assesses strategies used to alter body size among adolescents. The scope of this study was to describe the translation and evaluation for semantic equivalence of the BCI in the Portuguese language. The process involved the steps of (1) translation of the questionnaire to the Portuguese language; (2) back-translation to English; (3) evaluation of semantic equivalence; and (4) assessment of comprehension by professional experts and the target population. The six subscales of the instrument were translated into the Portuguese language. Language adaptations were made to render the instrument suitable for the Brazilian reality. The questions were interpreted as easily understandable by both experts and young people. The Body Change Inventory has been translated and adapted into Portuguese. Evaluation of the operational, measurement and functional equivalence are still needed.
Assuntos
Imagem Corporal , Inquéritos e Questionários , Adolescente , Brasil , Características Culturais , Humanos , Semântica , TraduçõesRESUMO
Com o crescimento das pesquisas acerca dos componentes da imagem corporal, fazem-se necessários instrumentos válidos que avaliem suas dimensões. O Body Change Inventory (BCI) avalia as estratégias adotadas para modificação do corpo entre adolescentes. O objetivo deste estudo foi descrever o processo de tradução e avaliação da equivalência semântica do BCI para a língua portuguesa. O processo envolveu as etapas de (1) tradução do questionário para o idioma português; (2) retrotradução para o inglês; (3) avaliação da equivalência semântica; e, (4) análise da compreensão verbal por especialistas e jovens brasileiros. As seis subescalas que compõem o instrumento foram traduzidas para o português. Foram realizadas adaptações na linguagem a fim de tornar o instrumento adequado à realidade brasileira. As questões foram interpretadas como de fácil compreensão tanto por especialistas quanto pelos jovens. O Questionário de Mudança Corporal encontra-se traduzido e adaptado para o idioma português, sendo ainda necessária a avaliação das equivalências operacional, de mensuração e funcional.
With the increase in research on the components of Body Image, validated instruments are needed to evaluate its dimensions. The Body Change Inventory (BCI) assesses strategies used to alter body size among adolescents. The scope of this study was to describe the translation and evaluation for semantic equivalence of the BCI in the Portuguese language. The process involved the steps of (1) translation of the questionnaire to the Portuguese language; (2) back-translation to English; (3) evaluation of semantic equivalence; and (4) assessment of comprehension by professional experts and the target population. The six subscales of the instrument were translated into the Portuguese language. Language adaptations were made to render the instrument suitable for the Brazilian reality. The questions were interpreted as easily understandable by both experts and young people. The Body Change Inventory has been translated and adapted into Portuguese. Evaluation of the operational, measurement and functional equivalence are still needed.
Assuntos
Adolescente , Humanos , Imagem Corporal , Inquéritos e Questionários , Brasil , Características Culturais , Semântica , TraduçõesRESUMO
Pregnancies in women without knowledge of their HIV-positive status increase the risk of mother-to-child transmission, and of disease progression. This study aimed to characterize the frequency of multiple pregnancies and of HIV-positive children in the family, during HAART era. We analyzed data of a national multicenter cohort study among Brazilian children with AIDS diagnosed between 1999 and 2002. In total, 945 children and their 928 mothers were included. Five hundred and ninety (64.6%) women had a history of multiple pregnancies, and 49.5% attended prenatal care (mean: 3.5 consultations; SD 3.6). In 483 child cases, HIV status of the sibling was known; 130 (26.9%) of these were infected with HIV. In 38.5% of cases, the child with AIDS included in the cohort study was the first case in the family. Despite the overall positive results of the Brazilian control policy of HIV/AIDS, our study shows that HIV infection in pregnant women was often undetected and that consequently there was a high frequency of repeated HIV-infected children. There is a need to improve comprehensive prenatal and postnatal care of Brazilian women. HIV-affected families are most vulnerable and should be targeted by specific control programs, preventing additional HIV infections in other children.
Assuntos
Terapia Antirretroviral de Alta Atividade , Soropositividade para HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Cuidado Pré-Natal/normas , Irmãos , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Progressão da Doença , Feminino , Soropositividade para HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Masculino , Serviços de Saúde Materna , Mães , Gravidez , Estudos RetrospectivosRESUMO
OBJETIVO: Este estudo teve por objetivo a adaptação transcultural do Internet Addiction Test (IAT) para o idioma português. MÉTODOS: O trabalho consistiu em cinco etapas: (1) tradução; (2) retradução; (3) revisão técnica e avaliação da equivalência semântica por profissionais da área; (4) avaliação do instrumento por uma amostra de estudantes, avaliando-se o seu grau de compreensão; e (5) análise da consistência interna por meio do coeficiente alfa de Cronbach. RESULTADOS: O instrumento foi traduzido e adaptado para o idioma português, demonstrando ser facilmente compreendido e apresentando valor de consistência interna de 0,85. CONCLUSÃO: O instrumento encontra-se traduzido e adaptado para o português e apresenta consistência interna satisfatória. São necessárias análises de equivalência de mensuração e reprodutibilidade.
OBJECTIVE: The aim of this study was to cross-culturally adapt the Internet Addiction Test (IAT) to the Portuguese language. METHODS: The translation and evaluation process consisted of five steps: (1) translation; (2) back-translation; (3) peer review and evaluation of semantic equivalency by experts; (4) instrument evaluation through a sample of students, by evaluating their understanding level; and (5) analysis of the instrument's internal consistency (Cronbach's alpha-coefficient). RESULTS: The instrument was translated and adapted to Portuguese. As shown, the Portuguese version of the IAT was easily understood and the internal consistency value was 0.85. DISCUSSION: The translated and adapted IAT displays a satisfactory internal consistency. In a further step, measurement and reproducibility analyses have to be conducted.
Assuntos
Comparação Transcultural , Escalas de Graduação Psiquiátrica , Estudo de Validação , Internet , Reprodutibilidade dos TestesRESUMO
OBJETIVOS: traduzir e adaptar o instrumento Children's Eating Attitude Test (Cheat) para o idioma português, avaliar a equivalência semântica e a compreensão verbal. MÉTODOS: envolveu quatro etapas: (1) tradução, (2) retradução, (3) revisão técnica e avaliação semântica, (4) pré-teste - avaliação da compreensão verbal por especialistas em transtorno alimentar. RESULTADOS: as 26 questões foram traduzidas e adaptadas para o idioma português. A versão final constou dos mesmos 26 itens apresentando-se de forma clara e de fácil compreensão (valores médios superior a 4,5 - máximo 5,0). CONCLUSÕES: o instrumento encontra-se traduzido e adaptado para o idioma português demonstrando bons resultados no processo de adaptação transcultural. São necessárias análises de validade externa, equivalência de mensuração e reprodutibilidade.
OBJECTIVES: to translate and adapt the Children's Eating Attitude Test (Cheat) to Portuguese and evaluate the semantic equivalence and verbal comprehension. METHODS: the process involved four stages: (1) translation, (2) back-translation, (3) technical review and semantic evaluation, (4) pre-test - evaluation of verbal comprehension by specialists in eating disorders. RESULTS: the 26 questions were translated and adapted for Portuguese. The final version contained the same 26 items presented in a clear and easy-tounderstand format (average score higher than 4.5 - maximum 5.0). CONCLUSIONS: the tool has been translated and adapted for Portuguese and the transcultural adaptation process was a success. There is still a need for analyses of external validity, measurement equivalence and reproducibility.
Assuntos
Pesos e Medidas , Semântica , Tradução , Estudo de Validação , Aprendizagem Verbal , Transtornos da Alimentação e da Ingestão de AlimentosRESUMO
OBJECTIVE: To evaluate the semantic and measure equivalence of the body image sub-scale of the Offer Self Image Questionnaire (OSIQ). METHODS: Participants were 386 teenagers, 10 to 18 years old, both sexes, enrolled in a private school (junior and high school age). Translation, back-translation, technique revision and evaluation were conducted. The Portuguese instrument was evaluated for internal consistency, discriminate and concurrent validity. RESULTS: Internal consistency showed values from 0.43 to 0.54 and was able to discriminate all groups studied--the whole population, boys and girls, and boys in early adolescence, by nutritional status (p<0.001; p<0.009; p=0.030; p=0.043, respectively). Concurrent analyses showed significant correlation with anthropometric measures only for girls (r=-0.16 and p=0.021; r=-0.19 and p=0.007), early adolescence (r=-0.23 and p=0.008; r=-0.26 and p=0.003) and intermediate adolescence (r=-0.29 and p=0.010) and the retest confirmed reliability by the coefficient of interclass correlation. Although the instrument has proven its ability to discriminate between the groups studied by nutritional state, other results were less satisfactory. More studies are necessary for full transcultural adaptation, including the application of other comparative scales. CONCLUSION: The body image sub-scale of the OSIQ was translated, but the results are not promising and require more studies.
Assuntos
Imagem Corporal , Autoimagem , Inquéritos e Questionários , Adolescente , Brasil , Criança , Feminino , Humanos , Masculino , TraduçõesRESUMO
OBJETIVO: Apreciar a equivalência semântica e de mensuração da subescala de imagem corporal do Offer Self Image Questionnaire (OSIQ). MÉTODOS: Participaram 386 adolescentes, na faixa etária de 10 a 18 anos, de ambos os sexos, de uma escola particular de ensino fundamental e médio. Realizou-se tradução, retrotradução, revisão técnica e avaliação do instrumento. Avaliou-se a consistência interna, a validade discriminante e concorrente e a confiabilidade. RESULTADOS: O instrumento apresentou, para a consistência interna, valores que variaram de 0,43 a 0,51 e foi capaz de discriminar os grupos estudados - população total, meninos, meninas, e meninos em fase inicial de adolescência, segundo o estado nutricional (p<0,001; p<0,009; p=0,030; p=0,043, respectivamente). Na validade concorrente, houve correlação significativa entre algumas medidas antropométricas somente para o sexo feminino (r=-0,16 e p=0,021; r=-0,19 e p=0,007); fase inicial (r=-0,23 e p=0,008; r=-0,26 e p=0,003) e intermediária (r=-0,29 e p=0,010) e no reteste confirmou sua confiabilidade por meio da correlação intraclasse. Embora o instrumento tenha comprovado sua capacidade em discriminar os grupos estudados, de acordo com o estado nutricional, os demais resultados foram menos satisfatórios. Mais estudos são necessários para sua adaptação transcultural, com a aplicação de outras escalas comparativas. CONCLUSÃO: A subescala de imagem corporal do OSIQ encontra-se traduzida, no entanto, os resultados apresentados não são promissores, exigindo-se mais estudos.
OBJECTIVE: To evaluate the semantic and measure equivalence of the body image sub-scale of the Offer Self Image Questionnaire (OSIQ). METHODS: Participants were 386 teenagers, 10 to 18 years old, both sexes, enrolled in a private school (junior and high school age). Translation, back-translation, technique revision and evaluation were conducted. The Portuguese instrument was evaluated for internal consistency, discriminate and concurrent validity. RESULTS: Internal consistency showed values from 0.43 to 0.54 and was able to discriminate all groups studied - the whole population, boys and girls, and boys in early adolescence, by nutritional status (p<0.001; p<0.009; p=0.030; p=0.043, respectively). Concurrent analyses showed significant correlation with anthropometric measures only for girls (r=-0.16 and p=0.021; r=-0.19 and p=0.007), early adolescence (r=-0.23 and p=0.008; r=-0.26 and p=0.003) and intermediate adolescence (r=-0.29 and p=0.010) and the retest confirmed reliability by the coefficient of interclass correlation. Although the instrument has proven its ability to discriminate between the groups studied by nutritional state, other results were less satisfactory. More studies are necessary for full transcultural adaptation, including the application of other comparative scales. CONCLUSION: The body image sub-scale of the OSIQ was translated, but the results are not promising and require more studies.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Imagem Corporal , Autoimagem , Inquéritos e Questionários , Brasil , TraduçõesRESUMO
The objective of this study is to describe preliminary results from the cross-cultural adaptation of the Quality of Life Assessment Questionnaire, used to measure health related quality of life (HRQL) in Brazilian children aged between 5 and 11 with HIV/AIDS. The cross-cultural model evaluated the Concept, Item, Semantic and Measurement Equivalences (internal consistency and intra-observer reliability). Evaluation of the conceptual, item, semantic equivalences showed that the Portuguese version is pertinent for the Brazilian context. Four of seven domains showed internal consistency above 0.70 (α: 0.76-0.90) and five of seven revealed intra-observer reliability (ricc: 0.41-0.70). This first Portuguese version of the HRQL questionnaire can be understood as a valuable tool for assessing children's HRQL, but further studies with large samples and more robust analyses are recommended before use in the Brazilian context.
Assuntos
Características Culturais , Infecções por HIV/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Traduções , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Idioma , MasculinoAssuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Pesquisa Biomédica/organização & administração , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Pesquisa Biomédica/tendências , Brasil/epidemiologia , Feminino , Política de Saúde , Humanos , MasculinoRESUMO
BACKGROUND: HIV infection in children is an important public health problem in the world, mainly in poorer countries. If all recommendations are followed, the elimination of HIV vertical transmission is a concrete possibility. This study aims to estimate vertical transmission rates of HIV in São Paulo State, Brazil, based on pregnant women diagnosed and reported in 2006, identifying potentially associated factors. METHODS: This study involves a retrospective cross-sectional analysis of information systems and records of infected pregnant women and children exposed to HIV. The rate of vertical transmission was estimated and variables associated with the antenatal, delivery, and postnatal periods were analyzed by the chi-square test, and Fisher exact test was used for variables with an expected frequency <5. The relative risks were calculated with 95% confidence intervals. RESULTS: The rate of vertical transmission in São Paulo state was 2.7% (95% confidence interval: 1.86 to 3.94) in 2006, decreasing 83.1% in comparison with 1988-1993. The main associated variables were lack of prenatal visits or <6 visits, no antiretroviral prophylaxis during labor or neonatal use for <6 weeks, and maternal breastfeeding. CONCLUSIONS: There is a decreasing trend of HIV vertical transmission in São Paulo with levels approaching elimination, which seems to be associated with antiretroviral policy and interruption of breastfeeding. Although there are serious operational issues, conditions exist to respond effectively. São Paulo state demonstrates that it is possible to achieve advanced levels of control for this mode of HIV transmission.
Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Brasil , Aleitamento Materno , Estudos Transversais , Feminino , Fidelidade a Diretrizes , Humanos , Incidência , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil. METHODS: This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed. RESULTS: In total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001). CONCLUSIONS: Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.