Cross-cultural adaptation, validity, and reliability of the Child and Adolescent Behavior Inventory (CABI) for use in Brazil

Formononetin Alleviates the Inflammatory Response Induced by Carotid Balloon Injury in Rats via the PP2A/MAPK Axis

BACKGROUND

Carotid arteriosclerosis is common, with interventional therapy being the primary treatment. However, postoperative restenosis and poor stent patency, related to vascular inflammation involving MAPK and PP2A, limit success. Formononetin (FOR) may offer a novel approach by activating PP2A and inhibiting MAPK, reducing inflammation and improving outcomes.

METHODS

Rats were divided into sham and carotid artery balloon injury (CABI) groups, with the latter receiving various concentrations of FOR. Vascular damage and inflammation were assessed using HE staining, ELISA, Western blot, and immunohistochemistry. HUVECs were treated with Ox-LDL to induce injury, followed by FOR (10-40 μM) and the MAPK inhibitor U0126. PP2A and MAPK expression were analyzed via Western blot and immunofluorescence.   .

RESULTS

HE staining showed carotid lumen narrowing and tissue damage in the model group, which improved with FOR treatment. ELISA revealed reduced IL-6 and TNF-α levels post-CABI with FOR. FOR also reversed the decrease of PP2A and increased MAPK expression, along with reduced ERK1/2 phosphorylation. Conclusion FOR reduces vascular damage and inflammation after CABI via the PP2A/MAPK axis, enhancing vascular remodeling and restoring protein expression. FOR shows promise as a therapeutic agent for vascular injuries.

CONCLUSION

FOR can effectively reduce vascular damage and inflammation after coronary artery bypass grafting through the PP2A/MAPK axis, enhance vascular remodeling, and restore protein expression profiles. These findings suggest FOR as a promising therapeutic agent for vascular injuries.

Translation, cross-cultural adaptation and validation of the Short Screening Instrument for Psychological Problems in Enuresis for use in Brazil (SSIPPE-Br)

OBJECTIVE

Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br).

METHODS

Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used.

RESULTS

Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains.

CONCLUSION

The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.

Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial

Background

Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5% of children and 2.5% of adults worldwide. Comorbidities are frequent, and Oppositional Defiant Disorder (ODD) reaches 50%. Family environment is crucial for the severity of behaviors and for prognosis. In middle-income countries, access to treatment is challenging, with more untreated children than those under treatment. Face-to-face behavioral parent training (PT) is a well-established intervention to improve child behavior and parenting.

Method

A clinical trial was designed to compare PT-online and face-to-face effects to a waiting list group. Outcomes were the ADHD and ODD symptoms, parental stress and styles, and quality of life. Families were allocated into three groups: standard treatment (ST), ST + PT online, and ST + Face-to-Face PT. We used repeated measures ANOVA for pre × post treatment analysis corrected for multiple comparisons.

Results and discussion

Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000). The combination of ST and PT was also associated with better quality of life in the physical domain for patients (p = 0.009) and their parents (p = 0.050). In addition to preliminary data, online intervention seems effective for parenting and improving social acceptance of children. The potential to reach many by an online strategy with a self-directed platform may imply effectiveness with a low cost for public health to support parents' symptoms management.