RESUMO
Background: The Direct Assessment of Functional Status (DAFS) is the only instrument validated in Brazil that assesses functionality directly with the patient. However, this clinical tool takes a long time to be administered. This limits its use in hospitals and outpatient clinics that require brief assessment instruments. Additionally, we need to count with a direct assessment because the number of older adults living alone is increasing and we thus lack reliable informants. Objective: This study aimed to present the development and content validity evidence of a direct complex functionality test for older adults, the Brief Instrument for Direct Functionality Assessment (BIDFA). Method: A total sample of 30 older adults and eight expert judges took part in the study stages. The BIDFA construction stages were: (1) literature review of functionality instruments; (2) development of seven ecological tasks to evaluate the performance of daily complex activities with the older adults; (3) content analysis by eight expert judges; (4) pilot study with 30 older adults; (5) the ecological analysis of items; (6) focus group analysis; and (7) final version of the BIDFA. Results: The BIDFA had evidence of content validity with an agreement index of 96.5%. The final version of BIDFA was left with six domains of complex functionality divided into semantic memory and time orientation; shopping skills; executive attention, math and finance skills; organization; planning and procedural memory; and problem-solving. The complex functionality score by BIDFA ranges from 0 to 100 points. Conclusion: The BIDFA was found to have good content validity by the expert judges and by the ecological analysis of the items by the older adults. The new instrument is expected to help assess the functional status of older adults, in an abbreviated context including complex functionality demands, with a wider range of total and subdomain scores.
RESUMO
Microalgas constituem o principal alimento para moluscos bivalvos. Porém no fitoplâncton podem ser encontradas microalgasnocivas como Dinophysis, implicadas na produção da toxina ácido okadaico (AO). A baía de Sepetiba, RJ, apresenta áreasadequadas à malacocultura, principalmente na região da ilha Guaíba. Nessa região localiza-se um dos maiores bancosnaturais do mexilhão Perna perna neste estado, que fornece sementes para cultivos nas baías de Sepetiba e Ilha Grande.O AO, principal causador do Envenenamento Diarréico por Moluscos, apresenta como efeito agudo sintomatologiagastrintestinal. Como efeito crônico relata-se a promoção de tumores (estômago e intestinos). Este estudo objetivou detectaro AO e identificar Dinophysis spp. na região estudada. Coletaram-se mexilhões em bancos naturais (ilhas Guaíba e Madeira),para a detecção do AO e amostras de fitoplâncton para a identificação das microalgas durante a primavera/verão 2003/2004.A análise por Cromatografia Líquida de Alta Eficiência detectou o AO, em baixas concentrações, em todas as amostras.Identificaram-se cinco espécies de Dinophysis, das quais D. acuminata apresentou a maior abundância relativa para ogênero no período analisado. Os resultados sugerem um perfil toxígeno de baixo potencial, porém constante. Nessacircunstância, consumidores regulares de moluscos poderiam estar expostos ao perigo representado pelos efeitos crônicosdesta ficotoxina.(AU)
The major source of food for bivalve molluscs is microalgae. In the phytoplancton can be found potentially toxic microalgae as Dinophysis spp., often involved in the production of the toxin okadaic acid (OA). Sepetiba Bay, RJ, presents appropriated sites to malacoculture, mainly in the region of the Guaiba Island. In this region is located one of the largest natural bed of mussel Perna perna in the state, going to seed crops in the Sepetiba and Ilha Grande bays. OA, which is the most implicated toxin of Diarrhoetic Shellfish Poisoning, presents gastrointestinal symptoms as acute effect. Chronic effects related are promotions of tumors in stomach and intestines. The present study aimed to detect OA and identify Dinophysis present in studied sites. Mussels were collected from natural beds (Guaiba and Madeira islands) for the detection of OA and phytoplankton samples collects were carried out for the identification of harmful microalgae, during spring and summer 2003/2004. Chemical analysis using High Performance Liquid Chromatography detected the presence of OA in all samples in low concentrations. Five species of potentially toxic Dinophysis were identified, from which D. acuminata showed higher relative abundance to genera in the period. The results suggest a constant low profile of the toxigenic potential. Thus regular consumers of shellfish could be exposed to the chronic effects of this phycotoxin.(AU)
Assuntos
Animais , Microalgas/química , Microalgas/enzimologia , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendênciasRESUMO
Microalgas constituem o principal alimento para moluscos bivalvos. Porém no fitoplâncton podem ser encontradas microalgasnocivas como Dinophysis, implicadas na produção da toxina ácido okadaico (AO). A baía de Sepetiba, RJ, apresenta áreasadequadas à malacocultura, principalmente na região da ilha Guaíba. Nessa região localiza-se um dos maiores bancosnaturais do mexilhão Perna perna neste estado, que fornece sementes para cultivos nas baías de Sepetiba e Ilha Grande.O AO, principal causador do Envenenamento Diarréico por Moluscos, apresenta como efeito agudo sintomatologiagastrintestinal. Como efeito crônico relata-se a promoção de tumores (estômago e intestinos). Este estudo objetivou detectaro AO e identificar Dinophysis spp. na região estudada. Coletaram-se mexilhões em bancos naturais (ilhas Guaíba e Madeira),para a detecção do AO e amostras de fitoplâncton para a identificação das microalgas durante a primavera/verão 2003/2004.A análise por Cromatografia Líquida de Alta Eficiência detectou o AO, em baixas concentrações, em todas as amostras.Identificaram-se cinco espécies de Dinophysis, das quais D. acuminata apresentou a maior abundância relativa para ogênero no período analisado. Os resultados sugerem um perfil toxígeno de baixo potencial, porém constante. Nessacircunstância, consumidores regulares de moluscos poderiam estar expostos ao perigo representado pelos efeitos crônicosdesta ficotoxina.
The major source of food for bivalve molluscs is microalgae. In the phytoplancton can be found potentially toxic microalgae as Dinophysis spp., often involved in the production of the toxin okadaic acid (OA). Sepetiba Bay, RJ, presents appropriated sites to malacoculture, mainly in the region of the Guaiba Island. In this region is located one of the largest natural bed of mussel Perna perna in the state, going to seed crops in the Sepetiba and Ilha Grande bays. OA, which is the most implicated toxin of Diarrhoetic Shellfish Poisoning, presents gastrointestinal symptoms as acute effect. Chronic effects related are promotions of tumors in stomach and intestines. The present study aimed to detect OA and identify Dinophysis present in studied sites. Mussels were collected from natural beds (Guaiba and Madeira islands) for the detection of OA and phytoplankton samples collects were carried out for the identification of harmful microalgae, during spring and summer 2003/2004. Chemical analysis using High Performance Liquid Chromatography detected the presence of OA in all samples in low concentrations. Five species of potentially toxic Dinophysis were identified, from which D. acuminata showed higher relative abundance to genera in the period. The results suggest a constant low profile of the toxigenic potential. Thus regular consumers of shellfish could be exposed to the chronic effects of this phycotoxin.