Carlos Henrique Alves de Rezende

Health-related quality of life of medical students

Medical Education 2010: 44 : 227–235

Mortalidade materna em cidade de médio porte, Brasil, 1997

INTRODUCTION The real magnitude of maternal mortality in the city of Uberlândia, Brazil, is fairly unknown. The aim is to identify the characteristics of maternal mortality in the city during 1997. METHODS Death certificates of women between 10-49 years old from Uberlândia were used as a main data source with additional interviews with family members. Only women between 10- 49 years of age at time of death were included. Maternal deaths were further confirmed at the health services level by checking medical records and interviewing physicians. All maternal deaths occurring up to one year after delivery were investigated. Data was collected on delivery conditions, frequency of prenatal care visits, gestational age at death, previous pregnancy complications, site of death, and any avoidable conditions. Maternal mortality rates (MMR) per 100,000 newborns were calculated. RESULTS There were a total of 204 deaths, but only 173 were from Uberlândia residents. Six maternal deaths were registered, four (66.7%) up to 42 days after delivery, and two (33.3%) up to 43 days to 1 year. Direct obstetric causes (toxemia- 60%; haemorrhage- 40%) were associated with 5 deaths (83.3%), and indirect (16.7%) with 1 death (cardiac disease). The MMR calculated from death certificates was 22.2 but the adjusted rate was 66.6. CONCLUSIONS The MMR is above the expected. It is necessary to pay more attention to the quality of prenatal and delivery care as well as to the correct way of filling out death certificates.OBJETIVO: A real magnitude do problema das mortes maternas em Uberlândia, MG, Brasil, e pouco conhecida, sendo que o objetivo do estudo e conhecer o perfil da mortalidade materna desse municipio. METODO: Utilizaram-se, como fonte de dados, as declaracoes de obito de mulheres falecidas entre 10 e 49 anos de idade, residentes no municipio de Uberlândia, MG. Entrevistaram-se as familias dessas mulheres para identificar o estado gestacional no momento do obito. As mortes caracterizadas como maternas foram investigadas nos servicos de saude, em prontuarios e em entrevistas medicas. Foram analisados os obitos maternos ocorridos ate um ano apos o termino da gestacao, considerando-se: pre-natal, periodo gestacional, tipo de parto, complicacoes em gestacoes anteriores, causa basica da morte, local de ocorrencia e possibilidade de se evitar o obito. Calcularam-se os coeficientes de mortalidade materna (CMM) por 100.000 nascidos vivos. RESULTADOS: Do total de 204 obitos, analisaram-se 173 de residentes no municipio. Ocorreram 6 mortes maternas, sendo 4 (66,7%) ate 42 dias apos o parto e 2 (33,3%) de 43 dias a 1 ano; 5 (83,3%) foram devidas a causas obstetricas diretas (toxemia- 60% e hemorragia - 40%) e 1 (16,7%), indireta (cardiopatia). O CMM a partir das mortes maternas declaradas foi de 22,2 e o corrigido elevou-se para 66,6. CONCLUSOES: O CMM encontrado esta acima do aceitavel. Faz-se necessaria uma analise acurada da qualidade do pre-natal e do parto, bem como do registro das declaracoes de obito.

Enteroparasitoses em manipuladores de alimentos de escolas públicas em Uberlândia (Minas Gerais), Brasil

Procedeu-se ao controle das enteroparasitoses em manipuladores de alimentos de escolas publicas de primeiro grau de Uberlândia, Minas Gerais, a partir de estudo prospectivo baseado em inquerito parasitologico. Foram acompanhados 264 individuos de 57 escolas, com tres coletas de fezes (C), sendo C1 em setembro de 1989, C2 em abril de 1990 e C3 em setembro de 1990. Entre os participantes 259 eram do sexo feminino e cinco do sexo masculino, com idades entre 20 e 66 anos. As 792 amostras de fezes foram conservadas em formol a 10% e analisadas pelo metodo de Hoffman, Pons e Janer. A ocorrencia de parasitas intestinais foi de 17, 10 e 10% para C1, C2, e C3, respectivamente. Em C1 detectou-se: Giardia lamblia (8%), ancilostomideos (6%), Ascaris lumbricoides (3%), Entamoeba histolytica, (2%), Strongyloides stercoralis, Hymenolepis nana, Taenia sp. e Trichuris trichiura (menos de 1% cada um deles). Em C2 detectou-se: ancilostomideos (5%), G. lamblia (2%), A. lumbricoides (1%), S. stercoralis, H. nana, Taenia sp., Enterobius vermicularis (menos de 1% cada um deles). Em C3 observou-se: ancilostomideos (5%), G. lamblia (3%), A. lumbricoides (2%), S. stercoralis e E. vermicularis (menos de 1% cada um deles). Os individuos infectados receberam tratamento especifico apos o diagnostico em cada coleta. Recomendamos a implantacao de vigilância epidemiologica atraves do exame parasitologico periodico, tratamento especifico e treinamento sobre manejo higienico de alimentos e higiene pessoal para todos os manipuladores de alimentos.

Translation, Cross-Cultural Adaptation, and Validation of the Parkinson's Disease Quality of Life Questionnaire (PDQL), the "PDQL-BR", into Brazilian Portuguese

Translate, culturally adapt, and validate the “Parkinsons Disease Quality of Life” (PDQL) BR, into Brazilian Portuguese. Fifty-two patients answered the PDQL-BR. Twenty-one patients answered the PDQL-BR again 14 days later. The UPDRS and HY scale was applied. Validation was evaluated using psychometric properties, checking the quality of the data, reliability, and validity. Quality of the data was evaluated based on occurrence of ceiling and floor effects. Reliability was evaluated based on: internal consistency of an item, homogeneity, and reproducibility. Validation was checked through the evaluation of convergent and discriminatory validation. There was no ceiling and floor effect. When evaluating reliability, items 20, 30, and 37 showed correlation of 0.34, 0.26, and 0.37, respectively, to your scale; the other items was higher than 0.4. The alpha Cronbach coefficient was higher than 0.7 for most domains. There was good reproducibility. There were no meaningful changes in the PDQL-BR translation and cross-cultural adaptation.

Portuguese-language cultural adaptation of the Items Banks of Anxiety and Depression of the Patient-Reported Outcomes Measurement Information System (PROMIS)

O Patient-Reported Outcome Measurement Information System (PROMIS), estruturado em dominios fisicos e psicossociais, superou lacunas ao propor nova ferramenta de avaliacao de resultados aplicaveis as doencas cronicas com base em tecnicas avancadas de estatistica (TRI) e testes adaptativos computadorizados (CAT). O objetivo do estudo foi adaptar culturalmente os Bancos de Itens de Ansiedade e Depressao do PROMIS para a lingua portuguesa. O processo seguiu rigorosas recomendacoes do FACIT por meio da traducao avancada, reconciliacao, retrotraducao, revisao do FACIT, revisores independentes, finalizacao das etapas pelo FACIT, pre-teste e incorporacao dos resultados do pre- teste. A versao traduzida foi pre-testada em dez pacientes, sendo necessaria a modificacao nos itens 3, 46 e 53 de Ansiedade e no item 46 de Depressao. As alteracoes alcancaram a equivalencia de significado e a versao final foi compativel com as habilidades linguisticas e culturais da populacao brasileira. Concluiu-se que a versao traduzida e semântica e conceitualmente equivalente aos originais.The Patient-Reported Outcome Measurement Information System (PROMIS), structured in Itens Banks, provides a new tool for evaluating results that apply to various chronic diseases through advanced statistical techniques (TRI) and computerized adaptive testing (CAT). The aim of this study was to culturally adapt the Items Banks of Anxiety and Depression of PROMIS to the Portuguese language. The process followed the recommendations of PROMIS through the advanced translation, reconciliation, back-translation, FACIT review, independent review, finalization, pre-test, and incorporation of the results from the pre-test. The translated version was pre-tested in ten patients, and items 3, 46, and 53 of the Bank of Anxiety and item 46 of the bank of Depression had to be changed. Changes affected equivalence of meaning, and the final version was consistent with the Brazilian populations linguistic and cultural skills. In conclusion, for the Brazilian population the translated version proved semantically and conceptually equivalent to the original.

Adaptação transcultural dos Bancos de Itens de Ansiedade e Depressão do Patient-Reported Outcomes Measurement Information System (PROMIS) para língua portuguesa

O Patient-Reported Outcome Measurement Information System (PROMIS), estruturado em dominios fisicos e psicossociais, superou lacunas ao propor nova ferramenta de avaliacao de resultados aplicaveis as doencas cronicas com base em tecnicas avancadas de estatistica (TRI) e testes adaptativos computadorizados (CAT). O objetivo do estudo foi adaptar culturalmente os Bancos de Itens de Ansiedade e Depressao do PROMIS para a lingua portuguesa. O processo seguiu rigorosas recomendacoes do FACIT por meio da traducao avancada, reconciliacao, retrotraducao, revisao do FACIT, revisores independentes, finalizacao das etapas pelo FACIT, pre-teste e incorporacao dos resultados do pre- teste. A versao traduzida foi pre-testada em dez pacientes, sendo necessaria a modificacao nos itens 3, 46 e 53 de Ansiedade e no item 46 de Depressao. As alteracoes alcancaram a equivalencia de significado e a versao final foi compativel com as habilidades linguisticas e culturais da populacao brasileira. Concluiu-se que a versao traduzida e semântica e conceitualmente equivalente aos originais.The Patient-Reported Outcome Measurement Information System (PROMIS), structured in Itens Banks, provides a new tool for evaluating results that apply to various chronic diseases through advanced statistical techniques (TRI) and computerized adaptive testing (CAT). The aim of this study was to culturally adapt the Items Banks of Anxiety and Depression of PROMIS to the Portuguese language. The process followed the recommendations of PROMIS through the advanced translation, reconciliation, back-translation, FACIT review, independent review, finalization, pre-test, and incorporation of the results from the pre-test. The translated version was pre-tested in ten patients, and items 3, 46, and 53 of the Bank of Anxiety and item 46 of the bank of Depression had to be changed. Changes affected equivalence of meaning, and the final version was consistent with the Brazilian populations linguistic and cultural skills. In conclusion, for the Brazilian population the translated version proved semantically and conceptually equivalent to the original.

Knowledge and attitudes of puerperal women relating to breastfeeding in a university hospital

Breastfeeding (BF) has presented, among other benefits, a reduction in infant mortality, a prevention of respiratory infections and a reduction in the risks of developing diseases. Therefore, the objectives of this study were to evaluate the knowledge and attitudes of puerperal in relation to BF in a university hospital, as well as the sources from which this information was obtained and the professional categories responsible for same. The work was carried out at the Hospital das Clinicas, Federal University of Uberlândia (HC-UFU). Structured interviews were conducted to obtain data for the evaluation of information and exercise of the BF practice with puerperal hospitalized in the accommodation complex, for mother and child, from July 1 to December 31, 2010. Of the total of 907 women interviewed, 617 (68.0%) intended to BF for 12 months or more, 566 (62.4%) performed the BF within the first hour of birth, in 551 cases (60.8%) the decision to BF was taken by the woman before the current pregnancy and 828 (91.3%) received help in BF. Of the women who received help, 788 (95.1%) were assisted by professionals from the nursing team. It was shown that the majority of the puerperal intended to breast-feed for 12 months or more, considering that they also carried out BF in the first hour after child birth. The study also noted the importance of the nursing staff in taking care of the mother/child pair, promoting better interaction and acceptance of BF.

Traducción y adaptación cultural de Bancos de Datos de Ansiedad y Depresión del Patient-Reported Outcomes Measurement Information System (PROMIS) en portugués

O Patient-Reported Outcome Measurement Information System (PROMIS), estruturado em dominios fisicos e psicossociais, superou lacunas ao propor nova ferramenta de avaliacao de resultados aplicaveis as doencas cronicas com base em tecnicas avancadas de estatistica (TRI) e testes adaptativos computadorizados (CAT). O objetivo do estudo foi adaptar culturalmente os Bancos de Itens de Ansiedade e Depressao do PROMIS para a lingua portuguesa. O processo seguiu rigorosas recomendacoes do FACIT por meio da traducao avancada, reconciliacao, retrotraducao, revisao do FACIT, revisores independentes, finalizacao das etapas pelo FACIT, pre-teste e incorporacao dos resultados do pre- teste. A versao traduzida foi pre-testada em dez pacientes, sendo necessaria a modificacao nos itens 3, 46 e 53 de Ansiedade e no item 46 de Depressao. As alteracoes alcancaram a equivalencia de significado e a versao final foi compativel com as habilidades linguisticas e culturais da populacao brasileira. Concluiu-se que a versao traduzida e semântica e conceitualmente equivalente aos originais.The Patient-Reported Outcome Measurement Information System (PROMIS), structured in Itens Banks, provides a new tool for evaluating results that apply to various chronic diseases through advanced statistical techniques (TRI) and computerized adaptive testing (CAT). The aim of this study was to culturally adapt the Items Banks of Anxiety and Depression of PROMIS to the Portuguese language. The process followed the recommendations of PROMIS through the advanced translation, reconciliation, back-translation, FACIT review, independent review, finalization, pre-test, and incorporation of the results from the pre-test. The translated version was pre-tested in ten patients, and items 3, 46, and 53 of the Bank of Anxiety and item 46 of the bank of Depression had to be changed. Changes affected equivalence of meaning, and the final version was consistent with the Brazilian populations linguistic and cultural skills. In conclusion, for the Brazilian population the translated version proved semantically and conceptually equivalent to the original.