Abstract Background The area of self-regulated learning integrates the fields of metacognition and self-regulation and assumes that the student is an active processor of information capable of self-regulating his learning by putting together the cognitive, metacognitive, and motivational components. The Motivated Strategies for Learning Questionnaire (MSLQ) is a benchmark for the measurement of self-regulated learning. However, the field of study does not show adequate evidence of its structural validity. The vast majority of studies involving this question present serious methodological mistakes, compromising the evidence of validity. Objective Our study investigates the structural validity of MSLQ including all 15 scales and corrects relevant mistakes in the previous studies. Method We tested different models through item confirmatory factor analysis in a convenience sample of 670 college students (M = 22.8 years, SD = 5.2) from a public Brazilian university in the technological area. The models with the ML, MLR, MLM and WLMSV estimators. Results Only WLSMV produced models with acceptable fit. The final model has a bi-factor structure with a general factor (self-regulated learning), 15 components as first-order factors, and four broad components as second-order factors. Twelve first-order components, all second-order components and the general factor had acceptable reliability. The components’ elaboration, intrinsic goal orientation and metacognitive self-regulation, did not show acceptable reliability, in terms of McDonald's omega. Conclusion Considering the worldwide importance of the MSLQ, we do not recommend the use of the measurement of these components for clinical practice and psychoeducational diagnosis until new studies show that this low reliability only occurs in our sample. Our study shows new evidence, correcting many previous methodological mistakes and producing initial evidence favorable to the factor structure of the MSLQ.

ABSTRACT The expansion of higher education is associated with the progressive diversification of student’s profiles, such as the increasing number of older, working and female students. The transition to higher education poses challenges for students entering it, generating expectations that can impact academic adaptation. This study compared academic expectations by gender and work situation in two cohorts of first-year students from a Brazilian public university, involving 13,336 participants. The Brazilian Scale of Academic Expectations for First-Year University Students was administered. Non-working and female students had higher academic expectations in both cohorts. The findings provide subsidies to higher education institutions to develop support programs and policies targeting first-year students.

RESUMO A expansão da educação superior está associada à progressiva diversificação dos perfis discentes, tais como aumento do número de estudantes mais velhos, trabalhadores e mulheres. A transição para o ensino superior comporta desafios para os estudantes que nele ingressam, gerando expectativas que podem impactar a adaptação acadêmica. Este estudo comparou as expectativas acadêmicas por gênero e situação de trabalho em dois coortes de estudantes ingressantes em uma universidade pública brasileira, envolvendo 13.336 participantes. Utilizou-se a Escala Brasileira de Expectativas Acadêmicas para Estudantes Ingressantes na Educação Superior. Estudantes mulheres e não trabalhadores apresentaram maiores expectativas acadêmicas em ambas as coortes. Os resultados fornecem subsídios às instituições de ensino superior para desenvolvimento de programas de apoio e políticas voltadas aos estudantes ingressantes.

Abstract Background It is known that around 30% of patients have higher blood pressure (BP) values when examined at the office than at home. Worldwide, only 35% of patients with hypertension undergoing treatment have reached their BP targets. Objective To provide epidemiological data on BP control in the offices of a sample of Brazilian cardiologists, considering office and home BP measurement. Methods This is a cross-sectional analysis of patients with a hypertension diagnosis and undergoing antihypertensive treatment, with controlled BP or not. BP was assayed in the office by a medical professional and at home using home BP monitoring (HBPM). The association between categorical variables was verified using the chi-square test (p<0.05). Results The study included 2540 patients, with a mean age of 59.7 ± 15.2 years. Most patients were women (62%; n=1575). Prevalence rates of 15% (n=382) for uncontrolled white coat hypertension and 10% (n=253) for uncontrolled masked hypertension were observed. The rate of BP control in the office was 56.3% and at home, 61%. Meanwhile, 46.4% of the patients had controlled BP in and outside of the office. Greater control was observed in women and in the 49-61 years age group. Considering the new DBHA 2020 threshold for home BP control, the control rate was 42.4%. Conclusion BP control in the offices of a sample of Brazilian cardiologists was 56.3%; this rate was 61% when BP was measured at home and 46.4% when considering both the office and home.

Resumo Fundamento Sabe-se que em torno de 30% dos pacientes apresentam valores de pressão arterial (PA) mais elevados quando examinados no consultório do que em suas residências. No mundo, admite-se que apenas 35% dos hipertensos já tratados tenham alcançado meta pressórica. Objetivo Fornecer dados epidemiológicos sobre o controle da PA nos consultórios, em uma amostra de cardiologistas brasileiros, avaliado pela medida de consultório e monitorização residencial da pressão arterial (MRPA). Métodos Análise transversal. Observou-se pacientes com diagnóstico de hipertensão arterial, em tratamento anti-hipertensivo, podendo ou não estar com a PA controlada. A PA foi verificada no consultório por profissional médico, e no domicílio através da MRPA. A associação entre variáveis categóricas se deu por meio do teste do qui-quadrado (p < 0,05). Resultados Foram incluídos 2.540 pacientes, com idade média 59,7 ± 15,2 anos. A maioria dos pacientes eram mulheres (62%; n = 1.575). O estudo mostrou uma prevalência de 15% (n = 382) de hipertensão do avental branco não controlada, e 10% (n = 253) de hipertensão mascarada não controlada. A taxa de controle da PA no consultório foi 56,3%, e no domicílio, de 61%; 46,4% dos pacientes tiveram PA controlada no consultório e fora dele. Observou-se maior controle no sexo feminino e na faixa etária 49-61 anos. Observando o controle domiciliar com o novo ponto de corte das Diretrizes Brasileiras de Hipertensão Arterial de 2020, a taxa de controle foi de 42,4%. Conclusão O controle pressórico nos consultórios em uma amostra de cardiologistas brasileiros foi de 56,3%; 61% quando a PA foi obtida no domicílio, e 46,4% quando o controle foi observado tanto no consultório como no domicílio.

Abstract Meta-analyses show that the correlations of approaches to learning with academic achievement are low. However, only one study has controlled these correlations in the presence of intelligence. Our study investigates the incremental validity of the surface and deep approaches taking cognitive abilities as control and applied the multiple linear regression and CART regression tree method in a diversified sample of high school students from Minas Gerais, Brazil. We found a prediction of 20.37% and 35.20% of the outcome variance, through the linear regression and CART, respectively. Our results show that although cognitive abilities are more important than students’ approaches, the approaches have incremental validity and important roles as predictors of academic achievement.

Résumé Méta-analyses montrent que les corrélations entre les approches de l’apprentissage et le rendement scolaire sont faibles. Cependant, une seule étude a contrôlé ces corrélations en présence d’intelligence. Notre étude examine la validité incrémentielle des approches superficielles et profondes en prenant les capacités cognitives comme contrôle et en appliquant la régression linéaire multiple et la méthode de l’arbre de régression CART à un échantillon diversifié d’élèves du secondaire de Minas Gerais, au Brésil. Nous avons trouvé une prédiction de 20,37% et 35,20% de la variance des résultats, grâce à la régression linéaire et au CART, respectivement. Nos résultats montrent que bien que les capacités cognitives soient plus importantes que les approches des étudiants, les approches ont une validité incrémentale et des rôles importants en tant que prédicteurs du rendement scolaire.

Resumen El meta-análisis revela que las correlaciones entre las aproximaciones al aprendizaje y el rendimiento académico son bajas. Sin embargo, solo un estudio ha controlado estas correlaciones en presencia de la inteligencia. El presente estudio investiga la validez incremental de los enfoques superficiales y profundos tomando las habilidades cognitivas como variable control, y aplicando la regresión lineal múltiple y el método del árbol de regresión CART en una muestra diversificada de estudiantes de secundaria de Minas Gerais, Brasil. Encontramos una predicción de 20.37% y 35.20% de la varianza del resultado, mediante la regresión lineal y CART, respectivamente. Nuestros resultados muestran que, aunque las habilidades cognitivas son más importantes que los enfoques de los estudiantes, los enfoques tienen una validez incremental y roles importantes como predictores del rendimiento académico.

Resumo Meta-análises mostram que as correlações das abordagens da aprendizagem com o desempenho acadêmico são baixas. No entanto, apenas um estudo controlou essas correlações na presença de inteligência. Nosso estudo investiga a validade incremental das abordagens superficial e profunda tomando habilidades cognitivas como controle e aplicou a regressão linear múltipla e o método de regressão em árvore CART em uma amostra diversificada de estudantes do ensino médio de Minas Gerais, Brasil. Encontramos uma previsão de 20,37% e 35,20% da variância do desfecho, por meio da regressão linear e CART, respectivamente. Nossos resultados mostram que, embora as habilidades cognitivas sejam mais importantes do que as abordagens dos alunos, as abordagens têm validade incremental e papéis importantes como preditoras do desempenho acadêmico.

Resumo Qualquer método quantitativo é formatado por certas regras ou postulados que constituem a sua própria racionalidade. Não fortuitamente, esses postulados determinam as condições e constrangimentos segundo os quais as evidências podem ser construídas. Neste artigo, argumentamos por que a racionalidade do Método de Regressão em Árvore é mais apropriada do que a do Modelo Linear Geral para analisar dados educacionais complexos. Ademais, aplicamos o algoritmo CART do Método de Regressão em Árvore, assim como a Regressão Linear Múltipla, num modelo com 53 preditores, tomando como desfecho as pontuações dos estudantes em leitura da edição de 2011 do Exame Nacional do Ensino Médio (ENEM; N = 3.670.089), o qual é um dado educacional complexo. Esta comparação empírica ilustra como o Método de Regressão em Árvore é superior ao Modelo Linear Geral para fornecer evidências sobre relações não lineares, assim como para lidar com variáveis nominais com muitas categorias, e variáveis ordinais. Concluímos que o Método de Regressão em Árvore constrói melhores evidências sobre as relações entre os preditores e o desfecho em dados complexos.

Resumen Cualquier método cuantitativo está conformado por ciertas reglas o postulados que constituyen su propia racionalidad. No por casualidad, estos postulados determinan las condiciones y restricciones sobre las cuales se puede construir la evidencia En este artículo, argumentamos por qué la racionalidad del Método de Árbol de Regresión es más apropiada que el Modelo Lineal General para analizar datos educativos complejos. Además, se aplicó el algoritmo CART del Método de Regresión de Árbol, así como la Regresión Linear Múltiple, en un modelo con 53 predictores, tomando como variable de respuesta el desempeño de los estudiantes en lectura de la edición 2011 del Examen Nacional de Educación Secundaria (ENEM; N = 3.670.089), que es un dato educativo complejo. Esta comparación empírica ilustra cómo el Método de Árbol de Regresión es superior al Modelo Linear General al proporcionar evidencia de relaciones no lineales, así como al tratar con variables nominales con muchas categorías y variables ordinales. Llegamos a la conclusión de que el Método de Árbol de Regresión genera mejores evidencias sobre las relaciones entre los predictores y el variable de respuesta en datos complejos.

Abstract Any quantitative method is shaped by certain rules or assumptions which constitute its own rationale. It is not by chance that these assumptions determine the conditions and constraints which permit the evidence to be constructed. In this article, we argue why the Regression Tree Method’s rationale is more suitable than General Linear Model to analyze complex educational datasets. Furthermore, we apply the CART algorithm of Regression Tree Method and the Multiple Linear Regression in a model with 53 predictors, taking as outcome the students’ scores in reading of the 2011’s edition of the National Exam of Upper Secondary Education (ENEM; N = 3,670,089), which is a complex educational dataset. This empirical comparison illustrates how the Regression Tree Method is better suitable than General Linear Model for furnishing evidence about non-linear relationships, as well as, to deal with nominal variables with many categories and ordinal variables. We conclude that the Regression Tree Method constructs better evidence about the relationships between the predictors and the outcome in complex datasets.

ABSTRACT Overactive bladder is a symptom complex consisting of bothersome storage urinary symptoms that is highly prevalent among both sexes and has a significant impact on quality of life. Various antimuscarinic agents and the beta-3 agonists mirabegron and vibegron are currently available for the treatment of OAB. Each drug has specific pharmacologic properties, dosing schedule and tolerability profile, making it essential to individualize the medical treatment for the patient's characteristics and expectations. In this manuscript, we review the most important factors involved in the contemporary pharmacological treatment of OAB.

Resumo Há uma hegemonia dos métodos de autorrelato e thinkaloud para avaliar metacognição. Isso é problemático, pois eles geram substanciais vieses do respondente e confirmatório, trazendo prejuízo à medida. O Teste de Monitoramento Metacognitivo (TMC) foi criado para avaliar a metacognição mediante o desempenho e eliminar os vieses supramencionados. Há evidências de validade convergente, divergente, estrutural, preditiva e incremental do TMC. Este artigo amplia os estudos de validade e analisa a invariância configural, métrica e escalar do TMC, em relação ao sexo, nacionalidade, e nível educacional. A amostra do estudo é composta por brasileiros e hondurenhos, e estudantes da 6ª à 12ª séries da educação básicae ensino superior. Os resultados indicam invariância configural, métrica e escalar para a variável sexo, assim como invariância configural e invariância parcial métrica e escalar para nacionalidade e nível educacional. Conclui-se que o TMC permite comparar médias da variável latente mensurada nos grupos analisados.

Abstract Metacognition is predominantly measured by the self-report and think-aloud methods. This is problematic since they produce considerable both respondent and confirmatory biases, which implies damage to the measurement. The Metacognitive Monitoring Test (MMT) was created to evaluate metacognition through performance and eliminate the aforementioned biases. There is evidence of MMT convergent, divergent, structural, predictive and incremental validity. This article expands the validity studies about the MMT by analyzing the configural, metric and scalar invariance of MMT across sex, nationality, and educational level variables. The sample is composed of Brazilian and Honduran subjects, as well as 6st to 12st grades and higher education students. Results indicate configural, metric and scalar invariance for the sex variable, as well as configural invariance and metric and scalar partial invariance for nationality and educational level. It is concluded that the MMT allows comparing means of the latent variable measured in the analyzed groups.

Resumen Hay un predominio de métodos de auto-reporte e think aloud para evaluar la metacognición. Esto es problemático, ya que dichos métodos producen un considerable sesgo de respuesta y confirmación, lo que implica un perjuicio en la medición. La Prueba de Monitoreo Metacognitivo (PMM) fue diseñada para evaluar la metacognición por medio del desempeño y eliminar los sesgos mencionados anteriormente. Hay evidencia de validez convergente, divergente, estructural, predictiva e incremental de la PMM. Este artículo amplía los estudios de validez sobre la PMM, analizando la invarianza configural, métrica y escalar de la PMM con respecto a las variables sexo, nacionalidad y nivel educativo. La muestra del estudio está formada por brasileños y hondureños, y estudiantes de 6º a 12º grado de educación básica y educación superior. Los resultados indican invarianza configural, métrica y escalar para la variable sexo así como invarianza configural e invarianza parcial escalar y métrica para nacionalidad y nivel educativo. Se concluye que la PMM permite comparar medias de la variable latente medida en los grupos analizados.

ABSTRACT Objectives: To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. Materials and Methods: A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE). Results: Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. Conclusions: COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.

ABSTRACT Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p <0.0001). The Bland-Altman analyzes demonstrate good agreement between the two questionnaires (bias=5.6%). LUTS-V demonstrated excellent diagnostic accuracy in detecting the most serious cases with an area under the ROC curve of 83% [78-87%] 95% CI. p <0.001). LUTS-V >4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.

ABSTRACT Objectives To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists’ clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 – 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions COVID-19 produced massive disturbances in Brazilian urologists’ practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians’ income, health and personal lives. These findings are probably applicable to other medical specialties.