Background The ChAdOx1 nCoV-19 (AZD1222) vaccine has been approved for emergency use by the UK regulatory authority, Medicines and Healthcare products Regulatory Agency, with a regimen of two standard doses given with an interval of 4–12 weeks. The planned roll-out in the UK will involve vaccinating people in high-risk categories with their first dose immediately, and delivering the second dose 12 weeks later. Here, we provide both a further prespecified pooled analysis of trials of ChAdOx1 nCoV-19 and exploratory analyses of the impact on immunogenicity and efficacy of extending the interval between priming and booster doses. In addition, we show the immunogenicity and protection afforded by the first dose, before a booster dose has been offered. Methods We present data from three single-blind randomised controlled trials—one phase 1/2 study in the UK (COV001), one phase 2/3 study in the UK (COV002), and a phase 3 study in Brazil (COV003)—and one double-blind phase 1/2 study in South Africa (COV005). As previously described, individuals 18 years and older were randomly assigned 1:1 to receive two standard doses of ChAdOx1 nCoV-19 (5 × 10 10 viral particles) or a control vaccine or saline placebo. In the UK trial, a subset of participants received a lower dose (2·2 × 10 10 viral particles) of the ChAdOx1 nCoV-19 for the first dose. The primary outcome was virologically confirmed symptomatic COVID-19 disease, defined as a nucleic acid amplification test (NAAT)-positive swab combined with at least one qualifying symptom (fever ≥37·8°C, cough, shortness of breath, or anosmia or ageusia) more than 14 days after the second dose. Secondary efficacy analyses included cases occuring at least 22 days after the first dose. Antibody responses measured by immunoassay and by pseudovirus neutralisation were exploratory outcomes. All cases of COVID-19 with a NAAT-positive swab were adjudicated for inclusion in the analysis by a masked independent endpoint review committee. The primary analysis included all participants who were SARS-CoV-2 N protein seronegative at baseline, had had at least 14 days of follow-up after the second dose, and had no evidence of previous SARS-CoV-2 infection from NAAT swabs. Safety was assessed in all participants who received at least one dose. The four trials are registered at ISRCTN89951424 (COV003) and ClinicalTrials.gov , NCT04324606 (COV001), NCT04400838 (COV002), and NCT04444674 (COV005). Findings Between April 23 and Dec 6, 2020, 24 422 participants were recruited and vaccinated across the four studies, of whom 17 178 were included in the primary analysis (8597 receiving ChAdOx1 nCoV-19 and 8581 receiving control vaccine). The data cutoff for these analyses was Dec 7, 2020. 332 NAAT-positive infections met the primary endpoint of symptomatic infection more t...

Abstract:The adaptation of psychological instruments is a complex process that requires a high methodological rigor. Because there is no consensus in the literature about its steps, this article discuss some essential aspects regarding the crosscultural adaptation of psychological instruments and proposes guidelines to the researchers about the different steps of this process. Some considerations regarding the validation of the adapted instrument are also presented. In this stage, we discuss some aspects regarding the factorial structure of the instrument, which might be evaluated through statistical procedures, such as exploratory and confi rmatory factor analysis. More than that, the authors provide some guidelines to the validation of psychological instruments in different cultures.Keywords: translating, adaptation, psychological testing, psychometrics Adaptação e Validação de Instrumentos Psicológicos entre Culturas: Algumas ConsideraçõesResumo: A adaptação de instrumentos psicológicos é um processo complexo que requer elevado rigor metodológico. Por não haver consenso na literatura sobre suas etapas, o presente artigo discute alguns aspectos essenciais concernentes à adaptação transcultural de instrumentos psicológicos e propõe diretrizes aos pesquisadores sobre os diferentes passos desse processo. São apresentadas, também, algumas considerações referentes à validação do instrumento adaptado. Nesta etapa, são discutidos os aspectos referentes à estrutura fatorial do instrumento, a qual requer avaliação por meio de procedimentos estatísticos, como análises fatoriais exploratórias e confi rmatórias, sendo fornecidas algumas diretrizes gerais para a validação de instrumentos psicológicos em diferentes culturas. Palavras-chave: tradução, adaptação, testes psicológicos, psicometria Adaptación y Validación de Instrumentos Psicológicos entre Culturas: Algunas ConsideracionesResumen: La adaptación de instrumentos psicológicos es un proceso complejo que requiere bastante rigor metodológico. Ya que no hay consenso sobre sus etapas, el presente artículo discute algunos aspectos esenciales sobre la adaptación transcultural de instrumentos psicológicos y propone directrices a los investigadores sobre los diferentes pasos de este proceso. Son presentadas, también, algunas consideraciones referentes a la validación del instrumento adaptado. En esta etapa, son discutidos aspectos referentes a la estructura factorial del instrumentos, la cual debe ser evaluada mediante procedimientos estadísticos como el análisis factorial exploratorio y confi rmatorio. Además, se incluyen algunas directrices para la validación de instrumentos psicológicos en culturas diversas. Palabras clave: traducción, adaptación, testes psicológicos, psicometríaThe adaptation of psychological instruments is a complex task that requires careful planning regarding its content maintenance, psychometric properties, and general validity for the intended population (Cassepp-Borges, Balbinotti, & Teodoro, 2010). During this process, one must provide both the e...

History of cancer and smoking, psychiatric disorders, negative future perception, moderate to intense depressive symptoms, high trait-anxiety, moderate to intense pain, medium surgery, female gender, ASA category III, up to 12 years of education and more than 12 years of education constituted independent risk factors for preoperative state-anxiety. Previous surgery reduced the risk for preoperative anxiety.

The identification of predictive factors for intense acute postoperative pain may be useful for designing specific preventive interventions to relieve patient suffering. Especially because few of these variables are accessible for medical intervention, which would improve the clinical outcomes and quality of life of patients at risk of moderate to intense acute postoperative pain.

O conceito de coping tem sido descrito como o conjunto das estratégias utilizadas pelas pessoas para adaptarem-se a circunstâncias adversas ou estressantes. O presente artigo apresenta os modelos de coping de Folkman e Lazarus, e de Rudolph, Denning e Weisz, bem como suas diferentes posições teóricas e metodológicas. As definições de estilos e estratégias de coping, sua eficácia e possíveis relações com traços de personalidade são discutidas. É salientada a necessidade de uma teoria de stress-coping específica para crianças, tendo em vista as mudanças cognitivas que ocorrem no curso de seu desenvolvimento. Este artigo apresenta também questões controversas sobre o tema e aponta a necessidade de pesquisas sobre coping no Brasil, para auxiliar na compreensão e desenvolvimento deste conceito.

RESUMO. O coping religioso-espiritual (CRE), que descreve o modo como os indivíduos utilizam sua fé para lidar com o estresse, tem se mostrado associado com melhores índices de qualidade de vida e saúde física e mental. O objetivo deste artigo foi relatar a elaboração e o processo de validação de construto da Escala de Coping Religioso-Espiritual (Escala CRE), primeiro instrumento de avaliação de CRE do Brasil, com base na escala norte-americana RCOPE (Pargament, Koenig & Perez, 2000). O estudo foi realizado em duas fases: (1) tradução, adaptação e teste piloto (N=50), (2) teste de campo (N=616) e validação de construto. Análises fatoriais, de consistência interna e de correlação indicaram que a Escala CRE é válida e fidedigna, avaliando aspectos positivos e negativos do uso da religião/espiritualidade para manejo do estresse e constituindo-se em um instrumento compreensivo, teórica e empiricamente embasado, funcionalmente orientado, clinicamente significativo e útil a várias áreas da pesquisa científica. Palavras-chave: psicologia da religião, avaliação psicológica, coping religioso-espiritual.

ResumoContexto: O coping religioso/espiritual (CRE), pouco estudado no Brasil, está associado à saúde e à qualidade de vida (QV). Objetivo: Apresentar revisão de literatura sobre CRE, enfocando sua base teórica, avaliação e aplicação na prática clínica. Método: Pesquisa nas bases de dados Medline, PsycINFO, Scielo e Bireme/BVS entre 1979 e 2006. Resultados: O CRE é o uso da religião, espiritualidade ou fé para lidar com o estresse. Estratégias de CRE, conforme conseqüências que trazem para quem as utiliza, podem ser classificadas como positivas ou negativas, estando geralmente associadas, respectivamente, a melhores ou piores resultados de saúde física/mental e QV. Evidências apontam que as pessoas utilizam CRE especialmente em situações de crise e, também, mais CRE positivo que negativo. Existem cinco estilos de CRE: autodireção, colaboração, delegação, súplica e renúncia. Conclusões: Instrumentos como RCOPE e Escala CRE podem ajudar na avaliação espiritual do paciente, na pesquisa e no planejamento de intervenções psicoespirituais enfocando o processo de CRE. Estas podem ser efetivas, ajudando os pacientes a mais bem utilizar um importante recurso disponível, com significativo impacto na saúde e na QV populacional, e reduzindos custos de intervenção em termos de saúde pública. Assim, o estudo do CRE mereceria ser incluído na formação dos profissionais da saúde. Bandeira, D.R. / Rev. Psiq. Clín. 34, supl 1; 126-135, 2007 Palavras-chave: Coping religioso espiritual, enfrentamento, saúde, qualidade de vida, prática clínica. Panzini AbstractBackground: Spiritual/religious coping (SRC), little studied in Brazil, is associated to health and quality of life (QoL). Objectives: To present a literature review about spiritual/religious coping, focusing its theoretical background, assessment and clinical applications. Methods: Research on Medline, PsycINFO, Scielo and Bireme/BVS databases between 1979-2006. Results: The SRC is the use of religion, spirituality or faith to cope with stress. SRC methods, depending on the consequences that bring to those who use them, can be classified into positive or negative, generally associated to better or worse physical/mental health and QoL outcomes, respectively. Evidences show that people use SRC especially in crisis situations, and also, they use more positive than negative SRC. There are five SRC styles: self-directing, collaborative, deferring, pleading and surrender. Conclusions: Instruments as RCOPE and SRCOPE Scale can be helpful to patient's spiritual evaluation, to researches and for planning psychospiritual interventions focused on the SRC process. Those can be effective in helping patients to better use an important available resource, with high impact on population's health and QoL, and potential to reduce public health costs. So, SRC studies would deserve to be included in health professionals graduate courses.

Periodontitis and its relationship with psycho-neuro-immunological variables, such as psychological stress and cortisol, have been little explored. The objective of this study was to evaluate the extent and severity of chronic periodontitis and its association with the levels of salivary cortisol and the scores obtained with a stress questionnaire in a population aged 50 years and over. We studied 235 individuals in a cross-sectional study. They answered the Lipp's Inventory of Stress Symptoms for Adults, were instructed to collect three saliva samples for cortisol analysis, and were examined for evaluation for periodontitis. Based on logistic regression, cortisol levels were positively associated with the following outcomes: means of clinical attachment level (CAL) > = 4 mm [OR = 5.1, 95%CI (1.2, 20.7)]; 30% of sites with CAL > = 5 mm [OR = 6.9, 95%CI (1.7, 27.1)]; and 26% of sites with probing depth > = 4 mm [OR = 10.7, 95%CI (1.9, 54.1)] after adjustment for confounding variables. The results suggest that cortisol levels were positively associated with the extent and severity of periodontitis.