The mediator role of psychological morbidity in patients with chronic low back pain in differentiated treatments

This study analyzed the mediating role of psychological morbidity and the variables that discriminated low versus high disability, in patients receiving physiotherapy and acupuncture. A total of 203 patients answered measures of illness and medication representations, coping, depression, anxiety, quality of life, and functional disability. Morbidity was a mediator between functional disability and quality of life. Treatment consequences and quality of life, in the acupuncture group, and emotional representations, quality of life, depression, anxiety, and active strategies for pain relief, in the physiotherapy group, discriminated patients with low versus high disability. These results have important implications for identifying high-risk patients.

Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships

Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.

Experimental procedures for the identification of material properties of intervertebal disc - a contribution for the development of biomimetic substitutes for the nucleus pulposus

Tese de Doutoramento em Engenharia Mecânica.

Tunnel engineering – influence of the type and the quantity of measurements in the back analysis of geomechanical parameters

The monitoring data collected during tunnel excavation can be used in inverse analysis procedures in order to identify more realistic geomechanical parameters that can increase the knowledge about the interested formations. These more realistic parameters can be used in real time to adapt the project to the real structure in situ behaviour. However, monitoring plans are normally designed for safety assessment and not especially for the purpose of inverse analysis. In fact, there is a lack of knowledge about what types and quantity of measurements are needed to succeed in identifying the parameters of interest. Also, the optimisation algorithm chosen for the identification procedure may be important for this matter. In this work, this problem is addressed using a theoretical case with which a thorough parametric study was carried out using two optimisation algorithms based on different calculation paradigms, namely a conventional gradient-based algorithm and an evolution strategy algorithm. Calculations were carried for different sets of parameters to identify several combinations of types and amount of monitoring data. The results clearly show the high importance of the available monitoring data and the chosen algorithm for the success rate of the inverse analysis process.

Postcolonial co-ordinary literature and the Web 2.0/3.0: "Thinking Back" within transmediatic knowledge

Pedro Andrade destaca o papel que as literacias híbridas preenchem numa redefinição pós-colonial da Europa. Em sua opinião, as literacias híbridas constituem uma condição necessária para a desconstrução do discurso colonial e a posterior reconstrução de literacias e literaturas pós-coloniais. Como parte deste processo, o autor argumenta a necessidade de vários tipos de competências que enfatizem a leitura e escrita não apenas dentro de sua própria cultura, mas também nas culturas dos outros. A literacia digital desempenha um papel particularmente importante neste processo, o que nos permite enfatizar as multivocalidades desta alteridade, igualmente na interação entre diferentes tradições de literacia: Ocidental e Oriental, nacional e transnacional, verbal e mediática. Andrade exemplifica o conceito de literatura transmediática com uma série de projetos em que esteve envolvido, por exemplo a Web 3.0 Novel enquanto modalidade daquilo que ele nomeia "GeoNeoLogic Novel". Este género de novel experimental mistura a narrativa com a teoria e a recolha de dados no campo empírico, promovendo uma abordagem que se apresenta simultaneamente regional e global. Em suma, o autor sugere diversos conceitos em primeira mão que classifica de ‘origem Lusófona’, e que representam diversas estratégias pós-coloniais globais também visíveis na área social, política e cultural da Lusofonia: o ‘pensamento-réplica’ (thinking back); o 'conhecimento transmediático' (transmediatic knowledge); a ‘sociedade da escrita comum’ (common writing society); as ‘redes comuns de conflito/significado’ (common webs of conflict and meaning); a literatura co-ordinária (co-ordinary literature).

Hemispheric dorsolateral prefrontal cortex lateralization in the regulation of empathy for pain

The dorsolateral prefrontal cortex (DLPFC) is involved in the cognitive appraisal and modulation of the pain experience. In this sham-controlled study, with healthy volunteers, we used bi-hemispheric transcranial direct current stimulation (tDCS) over the DLPFC to assess emotional reactions elicited by pain observation. Left-cathodal/right-anodal tDCS decreased valence and arousal evaluations compared to other tDCS conditions. Compared to sham condition, both left-cathodal/right-anodal and left-anodal/right-cathodal tDCS decreased hostility, sadness and self-pain perception. These decreased sensations after both active tDCS suggest a common role for left and right DLPFC in personal distress modulation. However, the differences in arousal and valence evaluations point to distinct roles of lateralized DLPFC in cognitive empathy, probably through distinct emotion regulation mechanisms.

Epigastric pain: incarceration or rotation?

Introduction: Acute intrathoracic gastric volvulus occurs when the stomach has a twist mesenteroaxial/organoaxial or chest cavity resulting in a dilatation or rupture of the diaphragmatic hiatus or diaphragmatic hernia. The purpose of this work is to show a interesting case of gastric volvulus in a patient with several comorbidities. Case Report: A 77-year-old female with past history of hiatal hernia and mental disease associated with diabetes and atrial fibrillation. Patient went to the emergency department due to vomiting associated with blood. Analytical parameters (WBC, HGB, PCR, metabolic panel and liver function), showed no significant alterations. Thoracic X-ray revealed an enlarged mediastinum due to herniation of the stomach. A computed tomography (CT) scan confirmed intrathoracic localization of the gastric antrum with twist. Patient’s symptoms were relieved by nasogastric intubation and analgesia. After six months, the patient is still asymptomatic. Conclusion: In general, the treatment of an acute gastric volvulus requires an emergent surgical repair. In patients who are not surgical candidates (with comorbidities or an inability to tolerate anesthesia), endoscopic reduction should be attempted. Chronic gastric volvulus may be treated non-emergently, and surgical treatment is increasingly being performed using a laparoscopic approach. In this case, it is a chronic form that was solved with the placement of the nasogastric tube. A nasogastric decompression is an option in the chronic form of hiatal hernia associated to gastric volvulus in patients with serious comorbidities.

Differential predictors of acute post-surgical pain intensity after abdominal hysterectomy and major joint arthroplasty

Author's personal copy

Relaxamento, correção postural e respiração na prática da flauta transversal: aplicação de exercícios de Técnica de Alexander

Relatório de estágio de mestrado em Ensino de Música

Psychological approach to endometriosis: Women's pain experience and quality of life improvement

Endometriosis is a chronic condition affecting 10 to15% of women in childbearing age. Understanding the impact of this disease on women’s well-being is still a challenge, namely to intervene. Pain is the most current and troublesome symptom. Although medical treatments for pain relief are effective, recurrence rate remains significant, calling for a better understanding and development of new approaches for pain management. A group Cognitive Behavioral Therapy (CBT) for management of associated co-morbidities is suggested, paying special attention to Chronic Pelvic Pain (CPP). CBT design can be grounded on information collected from focus groups and a one-group exploratory trial. Evaluation of therapy effectiveness is possible to be performed by comparing group CBT to Usual Care (UC) and Support Group (SG) in a randomized controlled trial. Research in this area could represent an important step in providing a solution to the management of endometriosis and, to the best of our knowledge, the first national psychological approach for its understanding and treatment.