The Portuguese short version of the postpartum depression screening scale

Introduction

Screening for perinatal depression is essential. The Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is a self-report instrument, composed of 35 items. The Portuguese version of the PDSS revealed to be a valid instrument to screen for perinatal depression (Pereira et al., 2010a,b).

Objectives

To develop PDSS short version and to determine its cut-off points and associated conditional probabilities to screen for depression according to DSM-IV and ICD-10 criteria.

Methods

Participants were 452 women in their third month post-partum (M = 13.07 weeks post-partum; SD = 1.808). All women completed the Portuguese PDSS and were interviewed using the Mood Disorders Section/Diagnostic Interview for Genetic Studies. To select items for the short version the items that showed the highest correlations with their respective seven dimension scores were retained. ROC analysis was applied and both cut-off points and associated conditional probabilities adjusted to the real prevalence were determined.

Results

For major depression/DSM-IV the cut-off point of 15, resulted in sensitivity of 77.8%, specificity of 88.9%, positive predictive value (PPV) of 21.7% and negative predictive value (NPV) of 98.9%; for depressive disorder/ICD-10 the cut-off point of 14 determined sensitivity 77.3%, specificity 84.0%, PPV 19.7%, NPV 98.6%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 the cut-off point of 18 was associated to sensitivity 91.7%, specificity 94.5%, PPV 31.4% and NPV 99.8%.

Conclusions

The Portuguese short version of PDSS is a good alternative to the 35-items version, equally valid and precise, but more economic, faster and easier.

Improved objectivity of grading of T(A,1) transitional cell carcinomas of the urinary bladder by quantitative nuclear and proliferation related features

AIM

To analyse whether the mean nuclear area of the 10 largest nuclei (MNA-10), the mitotic activity index (MAI), and Ki-67 immunoquantitative features have additional value to discriminate different grades of T(A,1) transitional cell carcinoma (TCC) of the urinary bladder.

MATERIALS/METHODS

One hundred and fifty of 200 consecutive cases (75%) showing interobserver agreement on duplicate blind grade assessment by independent pathologists were studied. Using random numbers, the 150 cases were divided into sets for learning (n = 75) and testing (n = 75). Single and multivariate analyses were applied to discriminate the different grades in the learning set. The multivariate classifier developed in this way was evaluated in the test set (n = 75).

RESULTS

With the MNA-10 alone, using the classification MNA-10 < 80 microm(2) = grade 1, 80 microm(2) < MNA-10 < 130 microm(2) = grade 2, MNA-10 > 130 microm(2) = grade 3, 71% of all 150 cases were correctly classified (69% of grade 1 v grade 2 and 76% of grade 2 v grade 3). With multivariate analysis, the best discriminating features in the learning set (17 grade 1, 30 grade 2, and 28 grade 3) between grades 1 and 2 were MNA-10 and MAI, and between grades 2 and 3 MAI and Ki-67. With these features, 94% of grade 1 v grade 2 and 97% of grade 2 v grade 3 were correctly classified in the learning set (overall, 95% correct, none of the grade 3 cases misclassified). In the test set the classification results were similar. When the three grades were entered at the same time for discrimination, Ki-67 area % and MAI was the best discriminating combination, both in the sets for learning and testing. Overall correct classification results in the sets for learning and testing were slightly lower, but still 94% and 92%. Most importantly, none of the grade 3 cases was misclassified; the classification shifts all occurred between grades 1 and 2.

CONCLUSIONS

The combination of MNA-10, MAI, and Ki-67 gives much better discrimination between grades 1, 2, and 3 in T(A,1) TCC of the urinary bladder than MNA-10 alone. The similarity of the classification results of the learning set and test set are encouraging and this quantitative pathological grading model should be applied in a prospective study.

Structural evidence for Ta-tetramerization displacements in the charge-density-wave compound (TaSe4)2I from x-ray anomalous diffraction

We use the anomalous x-ray diffraction technique to investigate the nature of the tantalum displacement pattern in the modulated phase of the charge-density-wave compound (TaSe4)2I. In addition to the known acousticlike modulation, we find the first direct evidence for the condensation of opticlike Ta displacements along the metallic chains corresponding to an LLSS pattern of long and short in-chain Ta-Ta distances (Ta-tetramerization modes). This result confirms a previous model in which the interaction of the electronically coupled optic modes with long-wavelength acoustic shear modes leads to the condensation of a modulation of mixed character.

Integration procedure for the quantitative analysis of dispersive anomalous diffraction

The development of the energy/angular dispersive diffraction setup, which can be used for anomalous diffraction, allows the collection of diffracted intensities around an absorption edge, either over a continuous energy range [for DAFS (diffraction anomalous fine structure) studies], or at discrete energies [for simultaneous MAD (multiwavelength anomalous diffraction) studies]. Used with a large two-dimensional detector and an oscillating single crystal, this setup allows simultaneous collection of many reflections for a given energy range. An integration procedure has been developed along with a program,DAD(dispersive anomalous diffraction), for the collection and analysis of the raw images, to yield finally data in the formI(h, k, l, λ) for all reflections. Wavelength calibration and intensity corrections are made during the integration process, and parameters that may be needed in later stages of the analysis are extracted and referenced within the integrated data. A general procedure to calculate the positions of diffracted reflections, for a monochromatic oscillation scan with a two-dimensional detector, when the incident beam is not perpendicular to the oscillation axis, is also described.

Perceived Benefits of Peer Leadership as Described by Junior Baccalaureate Nursing Students

Nursing students often do not get the chance to practice the skills they need as nurses prior to graduation. Many of the required skills are difficult to teach using traditional classroom or clinical teaching methods. Peer leadership is one teaching method that may provide alternative learning opportunities for enhancing these professional nursing skills, and it encompasses the notions of peer teaching and peer supervision simultaneously. The purpose of this study was to describe what junior baccalaureate nursing students perceived as the benefits of a peer leadership experience, using Loving's Competence Validation Model as the theoretical framework. Twelve junior nursing students participated during their adult medical-surgical rotation and completed self-evaluations following the peer leadership experience. From analysis of these self-evaluations, responses were categorized into five perceived benefits: practice in prioritizing, enhancement of critical thinking skills, enhancement of technical skills, realization of peers as resources, and development of management skills.