This study evaluates whether the integration of pharmacists into health-care teams through the delivery of pharmaceutical care-based medication therapy management (MTM) services can improve the clinical outcomes of patients with chronic health conditions in the primary health-care setting. A retrospective descriptive study of 92 outpatients assisted by MTM pharmacists in primary health-care units was carried out over 28 months (median follow-up: 05 months). Patients were followed up by MTM pharmacists, with a total of 359 encounters and a ratio of 3.9 encounters per patient. The prevalence of hypertension, diabetes mellitus and dyslipidaemia was 29.5%, 22.0% and 19.4%, respectively. There was a high prevalence of drug-related problems with a ratio of 3.4 per patient. Pharmacists performed a total of 307 interventions to prevent or resolve drug-related problems. With regard to control of the most prevalent chronic medical conditions, a high percentage of patients reached their therapy goals by the last encounter with the pharmacist: 90.0% for hypertension, 72.3% for diabetes mellitus and 90.3% for dyslipidaemia. MTM services provided by pharmacists resolved drug therapy problems and improved patients' clinical outcomes. This study provides evidence for health-care managers of the need to expand the clinical role of pharmacists within the Brazilian public health-care system. Uniterms: Pharmaceutical care/primary care. Medication therapy management. Chronic health/ conditions. Pharmacists/professional practice/Brazil
This publication from the National Initiative for Cybersecurity Education (NICE) describes the Workforce Framework for Cybersecurity (NICE Framework), a fundamental reference for describing and sharing information about cybersecurity work. It expresses that work as Task statements and describes Knowledge and Skill statements that provide a foundation for learners including students, job seekers, and employees. The use of these statements helps students to develop skills, job seekers to demonstrate competencies, and employees to accomplish tasks. As a common, consistent lexicon that categorizes and describes cybersecurity work, the NICE Framework improves communication about how to identify, recruit, develop, and retain cybersecurity talent. The NICE Framework is a reference source from which organizations or sectors can develop additional publications or tools that meet their needs to define or provide guidance on different aspects of cybersecurity education, training, and workforce development.
Among the main factors that affect patients' quality of life, fatigue is a significant symptom experienced by children during treatment. Despite the high incidence, there has been no validated scale to evaluate fatigue in children with cancer in Brazil. The purpose of this study was to examine the psychometric properties of the PedsQL™ Multidimensional Fatigue Scale, using self-reports of Brazilian children, 8 to 18 years of age, and proxy reports. A cross-sectional method was used to collect data from 216 subjects over an 18-month period. Reliability ranged from .70 to .90 except for sleep/rest fatigue, self-report (α = .55). No floor or ceiling effects were found in any dimension. Convergent validity was higher than .40 and divergent validity had 100% adjustment. The root mean square error of approximation was acceptable. The comparative fit index was lower than expected. The agreement between self and proxy responses was weak and moderate. The results demonstrate the reliability and validity of the Brazilian version in children with cancer. This is the first validated scale that assesses fatigue in Brazilian children and adolescents with cancer.
The aim of this study was to estimate the prevalence and factors associated with the occurrence of incidents related to medication, registered in the medical records of patients admitted to a Surgical Clinic, in 2010. This is a cross-sectional study, conducted at a university hospital, with a sample of 735 hospitalizations. Was performed the categorization of types of incidents, multivariate analysis of regression logistic and calculated the prevalence. The prevalence of drug-related incidents was estimated at 48.0% and were identified, as factors related to the occurrence of these incidents: length of hospitalization more than four days, prescribed three or more medications per day and realization of surgery intervention. It is expected to have contributed for the professionals and area managers can identify risky situations and rethink their actions.
OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS® - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, São Paulo, Paraná, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbach's Alpha statistics, Pearson's Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbach's Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS® - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.
OBJECTIVE:To assess preliminary psychometric properties of the Brazilian Portuguese version of a questionnaire for measuring health-related quality of life in children and adolescents with atopic dermatitis. METHODS:Cross-sectional study with a sample consisting of 52 children and adolescents aged 8 to 18 diagnosed with atopic dermatitis, and their parents or caregivers, selected at the dermatology department of a university hospital in the city of São Paulo, Southeast Brazil, in 2009. Construct validity, internal consistency and agreement between the responses of children and adolescents and their parents or caregivers were assessed in the Brazilian Portuguese version of the DISABKIDS ® -Atopic Dermatitis Module (ADM). RESULTS:Adequate internal consistency was found with Cronbach's alpha coeffi cients of 0.7024/0.8124 and 0.7239/0.8604. The multitrait multimethod analysis for assessing convergent validity showed measures higher than 0.30 for all items. The analysis showed good discriminant validity. Agreement between child self-report and parent proxy-report was evaluated using intraclass correlation with measures impact and social stigma of disease of 0.8173 and 0.7629, respectively. CONCLUSIONS:The study results showed that the DISABKIDS ® -ADM can be used by Brazilian researchers after its complete validation as it showed adequate preliminary psychometric properties and can be considered a valid, reliable instrument.
RESUMOEste estudo objetivou adaptar culturalmente e descrever as propriedades psicométricas iniciais do instrumento de mensuração de qualidade de vida relacionada à saú-de DISABKIDS® − Cystic Fibrosis Module para crianças e adolescentes e seus pais/ cuidadores. Estudo metodológico de desenvolvimento sequencial, incluindo 126 participantes em quatro estados brasileiros. Envolveu tradução e retrotradução dos itens, equivalência conceitual e semântica, validade de face e descrição das propriedades psicométricas iniciais relacionadas ao construto e fidedignidade. Para equivalência semântica da versão adaptada houve ajustes na redação de um item. O instrumento apresentou consistência interna satisfatória com valores de alfa de Cronbach entre 0,70 e 0,85, validade convergente com valores de correlação acima 0,40 em 85% dos itens e validade divergente com valores de ajuste superiores a 75%. A versão brasileira do DISABKIDS® -CFM certamente se constituirá em um instrumento válido e confiável para a mensuração da qualidade de vida de crianças e adolescentes brasileiros com fibrose cística. DESCRITORES RESUMENEste estudio tuvo como objetivo adaptar culturalmente y describir las propiedades psicométricas iniciales del instrumento de medida de la calidad de vida relacionada a la salud, DISABKIDS® -Cystic Fibrosis Module para niños/adolescentes y sus padres/cuidadores. Estudio metodológico de desarrollo secuencial, incluyendo 126 participantes en cuatro estados brasileños. Envolvió la traducción y retro-traducción de los ítems, la equivalencia conceptual y semántica, la validez externa y la descripción de las propiedades psicométricas iniciales con relación al constructo y la confiabilidad. Para la equivalencia semántica de la versión adaptada hubo ajustes en la redacción de un ítem. El instrumento presentó consistencia interna satisfactoria con valores de alfa de Cronbach entre 0,70 y 0,85, validez convergente con valores de correlación superiores a 0,40 en 85% de los ítems y validez divergente con valores de ajuste superiores a 75%. La versión brasileña del DISABKIDS® -CFM ciertamente será un instrumento válido y confiable para medir la Calidad de Vida de niños y adolescentes con fibrosis quística.
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