ABSTRACT Objective The Explicit Discrimination Scale (EDS) was developed to assess experiences with discrimination in Brazilian epidemiologic surveys. Though previous analyses have demonstrated that ...the EDS has good configural, metric, and scalar properties, its invariance has not yet been investigated. In this study, we examined the factorial invariance of two abridged versions of the EDS, according to skin color/ethnicity, sex, socioeconomic status, and their intersections. Methods: Data from the EpiFloripa Adult Study were used, which include a representative sample of adults residing in a state capital of southern Brazil (n=1,187). Over half of the respondents were women, and around 90% identified as white; the mean age of the participants was 39 years. Two abridged versions of the EDS were analyzed, with seven and eight items, using Multigroup Confirmatory Analysis and the Alignment method. Results: The two versions of the scale may be used to provide estimates of discrimination that are comparable across skin color/ethnicity, sex, socioeconomic status, and their intersections. In the seven-item version of the scale, only one parameter lacked invariance (i.e., threshold of item i13 – called by names you do not like), specifically among black respondents with less than 12 years of formal education. Conclusion: The EDS may provide researchers with valid, reliable, and comparable estimates of discrimination between different segments of the population, including those at the intersections of skin color/ethnicity, sex, and socioeconomic status. However, future research is needed to determine whether the patterns we identified here are consistent in other population domains.
RESUMO Objective A Escala de Discriminação Explícita (EDE) foi desenvolvida para avaliar experiências com discriminação em inquéritos epidemiológicos no Brasil. Embora análises prévias tenham revelado boas propriedades configurais, métricas e escalares do instrumento, nenhum estudo examinou sua invariância. Este trabalho objetivou examinar a invariância fatorial de duas versões abreviadas da EDE, considerando cor/raça, sexo, posição socioeconômica e suas intersecções. Métodos: Utilizaram-se dados do Estudo EpiFloripa Adulto, que encerra uma amostra representativa de residentes de uma capital do sul do Brasil (n=1.187). Cerca de 57% da amostra foi constituída por mulheres e 90% dos entrevistados se declararam brancos; a média de idade dos participantes foi de 39 anos. Duas versões abreviadas da EDE, com sete e oito itens, foram examinadas por meio de Análises Fatoriais Confirmatórias Multigrupo e o método Alignment. Resultados: As duas versões da escala produziram estimativas comparáveis de discriminação entre grupos definidos por cor/raça, sexo, posição socioeconômica e suas intersecções. Na versão reduzida de sete itens, apenas um parâmetro apresentou violação de invariância (limiar do item i13; i.e., chamado por nomes que não gosta), especificamente no grupo de respondentes negros com menos de 12 anos de escolaridade. Conclusão: Os resultados mostraram que a EDE é capaz de produzir estimativas de discriminação válidas, confiáveis e comparáveis entre diversos segmentos da população, incluindo aqueles situados na intersecção de cor/raça, sexo e posição socioeconômica. Contudo, pesquisas futuras são necessárias para verificar se os padrões identificados aqui podem ser confirmados em outros domínios populacionais.
Handgrip strength (HGS) is an indicator of muscle strength, suited for evaluating the aging process. Its use depends on the availability of reliable normative reference values (NRV). The main ...objective of this study is to provide NRV of HGS for Brazilians aged 65 to 90 years.
Participants were from the Frailty in Brazilian Older People research. 2,999 successful aging (SA) participants comprised the development sample. HGS was measured using a hydraulic dynamometer. Obtaining NRV involved regressing HGS on age per sex-height strata, fitting separate fractional polynomial (FP) models for the mean and coefficient of variation. Model fit was assessed via standardized residuals, probability/quantile plots, and comparing observed to normal expected percentages of participants falling within specified centile intervals. For validation, the latter procedure was applied to 2,369 unsuccessfully aging (UA) participants.
Across strata, the best-fitting models for the means were FP of power 1. FP models for the CV indicated age invariance, entailing steady heteroscedastic age decline in SD since coefficients for the means were negative and SD = CV×mean. All models adjusted well. Centiles distributions for the SA and UA populations showed anticipated patterns, respectively falling on and below the normative expected centile references. Results (NRV) are presented in tables and centile charts. Equations are also provided.
NRV/charts may be endorsed for routine use, while still tested further. They would aid professionals caring for older people, not only to identify those at risk and eligible for immediate provisions, but also in planning prevention and rehabilitation measures.
Summary Although there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate ...was 26·8 per 100 000 people and traffic-related mortality was 23·5 per 100 000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Regional differentials are also substantial. Besides the sociocultural determinants, much of the violence in Brazil has been associated with the misuse of alcohol and illicit drugs, and the wide availability of firearms. The high traffic-related morbidity and mortality in Brazil have been linked to the chosen model for the transport system that has given priority to roads and private-car use without offering adequate infrastructure. The system is often poorly equipped to deal with violations of traffic rules. In response to the major problems of violence and injuries, Brazil has greatly advanced in terms of legislation and action plans. The main challenge is to assess these advances to identify, extend, integrate, and continue the successful ones.
Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In ...this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.
O objetivo do artigo foi propor uma sistemática operativa para avaliar o processo de adaptação transcultural de instrumentos desenvolvidos em outros contextos lingüístico sócio-culturais. São feitas ...considerações sobre a necessidade do uso de instrumentos de aferição robustos; a importância de instrumentos "universais" que permitam sintonias transculturais; e a necessidade de partir para adaptação em contraposição ao desenvolvimento de um instrumento novo. Aborda-se a existência de controvérsias e diferentes propostas processuais na literatura e apresenta-se um modelo de adaptação. Essa síntese envolve os passos operativos dos processos de avaliação de equivalência conceitual, de itens, semântica e operacional, e apresenta um roteiro de análise psicométrica que alicerça a avaliação de equivalência de mensuração. Finalmente, reforça-se a necessidade de cuidar da qualidade da informação em estudos epidemiológicos, incluindo meticulosos processos de adaptação transcultural nas agendas de pesquisas.
To evaluate CADRI's configural and metric structures and explore its performance from the perspective of the respondents as perpetrators and victims. In the process, we present shorter versions for ...both roles.
The sample consisted of 561 adolescents aged 15 and 19, enrolled in public and private schools in Rio de Janeiro, Brazil. Initially, confirmatory factor analyzes (CFA) tested the originally proposed dimensional structure. Since this model was rejected, the second step analyzed the data via Exploratory Structural Equation Models (ESEM) to reassess the instrument's structure. Applying a decision algorithm on a new dimensional structure, we proceeded to reduce the number of items to establish separate sets for victimization and perpetration. These final models were then analyzed via CFA to assess their psychometric properties.
The final solutions contained 15 items comprising four and three factors for victimization and perpetration, respectively. Thirteen items were common to both models, but two were unique to their respective sets. Regardless of their small differences, the final solutions fitted adequately, held factorial item pertinence and unambiguity, contained reliable and non-redundant items, and sustained factor-based convergent and discriminant validities.
The four and three-factor models were within the dimensional bounds proposed in the original CADRI, the shorter scales still succeeding in partially capturing what was envisaged in the first version of the instrument. However, the shorter versions suggested here are still tentative, thus requiring further examination.
Objectives
To identify the existing OHRQoL instruments for adults, describe their scope (generic or specific), theoretical background, validation type and cross‐cultural adaptation.
Methods
A ...systematic search was conducted, and articles presenting validation of OHRQoL instruments in adults were included. Data were collected about the validation type: external validation (correlations/associations); or internal validation (factor analysis/principal components analysis, item response theory); and cross‐cultural adaptation.
Results
Of 3730 references identified, 326 were included reporting 392 studies. Forty‐two original instruments were found among 74 different versions, 40 generic and 34 condition‐specific. Locker's theoretical framework was the predominant model. The oral health impact profile (OHIP) presented 20 versions, with OHIP‐14 being the most frequent (26.8%), followed by geriatric oral assessment index (GOHAI) (14.0%), OHIP‐49 (11.7%) and oral impacts on daily performances (OIDP) (9.7%). Most studies focused on external validation (65.3%), while internal validation was reported in 24.8% (n = 26) of OHIP‐14 studies, 50.9% (n = 28) of GOHAI and 21.1% (n = 8) of OIDP studies. Most internal validation studies were conducted in English‐speaking countries (n = 33), and cross‐cultural adaptation was mostly in non‐English‐speaking European countries (n = 40).
Conclusions
Many generic and condition‐specific instruments were found, but few have gone through a rigorous internal validation process or have undergone cross‐cultural adaptation. This, in turn, makes it difficult for researchers to choose an appropriate measure based on known psychometric properties. OHIP‐14, OIDP and GOHAI seem to be the most widely validated instruments. Equalizing measurement properties for comparability are challenging due to theoretical heterogeneity. Future studies should assess psychometric properties, explore the factorial structure and work towards a consensus on critical issues.
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