BackgroundTransplant recipients are expected to adhere to a lifelong immunosuppressant therapeutic regimen. However, nonadherence to treatment is an underestimated problem for which no properly validated measurement tool is available for Portuguese-speaking patients. We aimed to initially validate the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS®) to accurately estimate immunosuppressant nonadherence in Brazilian transplant patients.MethodsThe BAASIS® (English version) was transculturally adapted and its psychometric properties were assessed. The transcultural adaptation was performed using the Guillemin protocol. Psychometric testing included reliability (intraobserver and interobserver reproducibility, agreement, Kappa coefficient, and the Cronbach’s alpha) and validity (content, criterion, and construct validities).ResultsThe final version of the transculturally adapted BAASIS® was pretested, and no difficulties in understanding its content were found. The intraobserver and interobserver reproducibility variances (0.007 and 0.003, respectively), the Cronbach’s alpha (0.7), Kappa coefficient (0.88) and the agreement (95.2%) suggest accuracy, preciseness and reliability. For construct validity, exploratory factorial analysis demonstrated unidimensionality of the first three questions (r = 0.76, r = 0.80, and r = 0.68). For criterion validity, the adapted BAASIS® was correlated with another self-report instrument, the Measure of Adherence to Treatment, and showed good congruence (r = 0.65).ConclusionsThe BAASIS® has adequate psychometric properties and may be employed in advance to measure adherence to posttransplant immunosuppressant treatments. This instrument will be the first one validated to use in this specific transplant population and in the Portuguese language.

BackgroundPatients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers.MethodThis cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015. We included patients aged over 18 years, with at least 6 months on dialysis treatment, and caregivers who were family members. The participants’ social, demographic, clinical, laboratory, and psychological variables were evaluated. A descriptive analysis and an examination of the association between patients and caregivers were performed.ResultsAmong patients, we observed that 38.1% had symptoms that indicated anxiety and depression. The average score for practical social support was 3.15 ± 0.769 and that for emotional social support was 3.16 ± 0.79. As for fatigue, 14.3% of patients reported being ‘extremely tired’ and 14.3% reported that they engaged in all the activities they usually performed before the illness. Further, 57.1% presented stress, and of these, 66.7% were at the resistance stage, with predominance of psychological symptoms in 60.0%. The quality of life domain in terms of functional capacity (FC) presented a correlation with haemoglobin level (r = 0.581, p = 0.006) and non-anaemic patients presented better FC. Among caregivers, we observed symptoms that indicated anxiety and depression in 33.3% of the sample. Caregivers exhibited an average score of 2.88 ± 0.77 for practical social support and 3.0 ± 0.72 for emotional social support. Further, 14.3% reported being ‘extremely tired’ and 28.8% reported that they engaged in all activities that they usually performed before the patient’s illness. When comparing the two groups (patients vs. caregivers), we observed that they presented similar results for the presence of anxiety, depression, and fatigue. Caregivers received less social support than patients did. Both groups presented similar predominance of stress levels; however, patients presented more predominance of psychological symptoms. With reference to quality of life, patients and caregivers presented similar results on the social aspects, vitality, mental health, and mental domains.ConclusionThe mental health characteristics of patients and caregivers were similar, and within the context of dialysis for renal disease, both must undergo specific interventions.

This paper's aim was to identify the main factors influencing secondary education dropout. The data are based on a historical series developed by the National Household Sample Survey (PNAD) and a large survey conducted in Minas Gerais, Brazil, which collected diverse information from 3,418 interviewees (including students and dropouts). Cox proportional hazards regression models were estimated to identify potential correlations between intra and extra-school factors and early dropout. Another model used PNAD database, for which a Logit model was estimated, to verify nondropout rates in high schools in Minas Gerais. Some significant factors are highlighted in the results explaining dropout, such as: difficulties faced with subjects, desire for a different school, perception of better job opportunities if studies are completed, and importance assigned to school choice.

The prevalence of patients outside the target for iPTH was 50.5%. There was a high prevalence of hyperphosphatemia (35.8%), and the minority of patients were using active vitamin D, vitamin D analogs, selective vitamin D receptor activators, and cinacalcet. These data indicate the need for better compliance with clinical guidelines and public policies on the supply of drugs associated with CKD-MBD.

Resumo -Este trabalho enfoca dois aspectos fundamentais na interação professor-aluno: a sintonia entre o professor e sua turma, e a expectativa do professor quanto ao desempenho dos alunos. Cruzando-se informações de diferentes instrumentos contextuais, aplicados aos professores e alunos, com os resultados dos testes cognitivos dos alunos, pôde-se identificar os fatores que distorcem a percepção do professor acerca da turma e influenciam sua expectativa. Constatou-se que a expectativa do professor é influenciada por suas percepções em relação ao ambiente escolar e pelas características sociodemográficas dos alunos. Observou-se que a expectativa do professor provoca um impacto positivo na proficiência do aluno, mesmo considerandose o efeito de variáveis sociodemográficas tradicionalmente associadas ao desempenho. Essas conclusões foram obtidas a partir da construção de modelos hierárquicos.Palavras-chave: avaliação educacional; expectativa do professor; desempenho do aluno; modelos de regressão hierárquicos. Teacher's Expectation and Students' PerformanceABSTRACT -This work focus on two basic aspects on teacher-student interaction: the tune between teacher and their class, and teacher's expectation with regard to students' performance. When cross analyzing the information of different contextual instruments, applied to teachers and students, with results of the students' cognitive tests, it was possible to identify the factors that distort the teacher's perception about the class and influence his/her expectation. It was noticed that the teacher's expectation is influenced by his/her perceptions in relation to the school environment and the students' social-demographic characteristics. It was observed that the teacher's expectation provokes a positive impact on the student's proficiency, even when it is considered the effect of social-demographic variables, which are traditionally associated to the performance. All these conclusions were obtained by constructing hierarchical models.

Resumo A partir da pesquisa longitudinal Geres, o estudo propõe a comparação de diferentes modelos estatísticos com graus variados de complexidade para determinar a eficácia de escolas de Ensino Fundamental. O propósito da comparação é o de determinar se um grau maior de complexidade se justifica em termos de maior precisão e se há diferenças entre os modelos na sua consistência e capacidade de retratar de modo estável o desempenho da escola. Os dois modelos mais simples da contribuição da escola para a proficiência do aluno, denominados modelos de Status, incorporam ou uma medida do nível socioeconômico médio da escola, ou uma medida da condição socioeconômica de cada aluno como proxy para a proficiência prévia. Os outros dois, denominados de modelos de Valor Agregado (VA), incorporam medidas da proficiência prévia, o que os tornam modelos em condições de descrever o ganho de aprendizagem atribuível à escola no período em estudo. O estudo indica alta correlação entre os modelos de VA, mas baixa correlação deles com os modelos de Status, mostrando que é pequeno o ganho de precisão com a adição de uma medida da condição socioeconômica de cada aluno. Descobre-se que cerca de 80% das escolas apresentam estabilidade para as diferentes medidas temporais de VA, sugerindo que a eficácia seja, de fato, uma característica razoavelmente estável no tempo, e que o VA pode contribuir para a comparação das escolas e a definição de intervenções, pelo menos no primeiro segmento do Ensino Fundamental.

Este artigo compara duas abordagens de valor agregado para dados oriundos do survey educacional de recorte longitudinal, chamado GERES -Estudo Longitudinal da Geração Escolar 2005, que acompanhou uma coorte de alunos de mais de 300 escolas públicas e privadas ao longo dos primeiros quatro anos do Ensino Fundamental. Ambas as abordagens utilizam modelos lineares hierárquicos, permitindo o agrupamento natural dos dados educacionais provenientes dos três níveis: aluno, turma e escola. Na primeira abordagem de valor agregado, constroem-se modelos cuja variável dependente é a proficiência do aluno em cada ano avaliado. Com um modelo distinto para cada ano é possível detectar fatores do aluno, da turma e da escola associados ao desempenho dos alunos. A segunda abordagem cria modelos para mostrar o efeito das covariáveis de aluno, turma e escola nas curvas de evolução da proficiência ao longo do período do estudo. Quando comparados os dois tipos de modelos de valor agregado, o primeiro foi o mais eficiente em diagnosticar os efeitos do ambiente e da prática pedagógica do professor, mas somente em determinados anos. Já o segundo tipo de modelo foi capaz de identificar curvas de evolução de proficiência de formatos distintos de acordo com determinadas características das escolas e dos alunos, mas foi menos sensível na identificação de variáveis associadas ao processo de formação de grupos e à prática pedagógica do professor. Os dois tipos de modelos de valor agregado oferecem indicações de processos de aprendizagem diferenciados para as disciplinas Língua Portuguesa e Matemática que mereceriam estudos adicionais. Palavras-chaveEstudo longitudinal -Avaliação educacional -Valor agregado -GERES -Modelos lineares hierárquicos.

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