Coping Style and Depressive Symptomatology during Pregnancy in a Private Setting Sample

Aim: to evaluate the association of antenatal depressive symptomatology (AD) with life events and coping styles, the hypothesis was that certain coping strategies are associated to depressive symptomatology. Methods: we performed a cross sectional study of 312 women attending a private clinic in the city of Osasco, Sao Paulo from 27/05/1998 to 13/05/2002. The following instruments were used: Beck Depression Inventory (BDI), Holmes and Rahe Schedule of Recent Events (SSRS), Folkman and Lazarus Ways of Coping Questionnaire and questionnaire with social-demographic and obstetric data. Inclusion criteria: women with 110 past history of depression, psychiatric treatment, alcohol or drug abuse and no clinical-obstetrical complications. Odds ratios and 95% CI were used to examine the association between AD (according to BDI) and exposures variables. Hypothesis testing was done with chi(2) tests and a p value < .05. Results: AD occurred in 21.1% of pregnant women. By the univariate analyses, education, number of pregnancies, previous abortion, husband income, situation of marriage and score of SSRS were associated with AD. All coping styles were associated with AD, except seeking support and positive reappraisal. By the multivariate analyses, four coping styles were kept in the final model: confront (p = .039), accepting responsibility (p < .001), escape-avoidance (p = .002), problem-solving (p = .005). Conclusions: AD was highly prevalent and was associated with maladaptive coping styles.

RNA interference-mediated knockdown of CD49e (α5 integrin chain) in human thymic epithelial cells modulates the expression of multiple genes and decreases thymocyte adhesion

Abstract Background The thymus is a central lymphoid organ, in which bone marrow-derived T cell precursors undergo a complex process of maturation. Developing thymocytes interact with thymic microenvironment in a defined spatial order. A component of thymic microenvironment, the thymic epithelial cells, is crucial for the maturation of T-lymphocytes through cell-cell contact, cell matrix interactions and secretory of cytokines/chemokines. There is evidence that extracellular matrix molecules play a fundamental role in guiding differentiating thymocytes in both cortical and medullary regions of the thymic lobules. The interaction between the integrin α5β1 (CD49e/CD29; VLA-5) and fibronectin is relevant for thymocyte adhesion and migration within the thymic tissue. Our previous results have shown that adhesion of thymocytes to cultured TEC line is enhanced in the presence of fibronectin, and can be blocked with anti-VLA-5 antibody. Results Herein, we studied the role of CD49e expressed by the human thymic epithelium. For this purpose we knocked down the CD49e by means of RNA interference. This procedure resulted in the modulation of more than 100 genes, some of them coding for other proteins also involved in adhesion of thymocytes; others related to signaling pathways triggered after integrin activation, or even involved in the control of F-actin stress fiber formation. Functionally, we demonstrated that disruption of VLA-5 in human TEC by CD49e-siRNA-induced gene knockdown decreased the ability of TEC to promote thymocyte adhesion. Such a decrease comprised all CD4/CD8-defined thymocyte subsets. Conclusion Conceptually, our findings unravel the complexity of gene regulation, as regards key genes involved in the heterocellular cell adhesion between developing thymocytes and the major component of the thymic microenvironment, an interaction that is a mandatory event for proper intrathymic T cell differentiation.

Echocardiographic and hemodynamic determinants of right coronary artery flow reserve and phasic flow pattern in advanced non-ischemic cardiomyopathy

Abstract Background In patients with advanced non-ischemic cardiomyopathy (NIC), right-sided cardiac disturbances has prognostic implications. Right coronary artery (RCA) flow pattern and flow reserve (CFR) are not well known in this setting. The purpose of this study was to assess, in human advanced NIC, the RCA phasic flow pattern and CFR, also under right-sided cardiac disturbances, and compare with left coronary circulation. As well as to investigate any correlation between the cardiac structural, mechanical and hemodynamic parameters with RCA phasic flow pattern or CFR. Methods Twenty four patients with dilated severe NIC were evaluated non-invasively, even by echocardiography, and also by cardiac catheterization, inclusive with Swan-Ganz catheter. Intracoronary Doppler (Flowire) data was obtained in RCA and left anterior descendent coronary artery (LAD) before and after adenosine. Resting RCA phasic pattern (diastolic/systolic) was compared between subgroups with and without pulmonary hypertension, and with and without right ventricular (RV) dysfunction; and also with LAD. RCA-CFR was compared with LAD, as well as in those subgroups. Pearson's correlation analysis was accomplished among echocardiographic (including LV fractional shortening, mass index, end systolic wall stress) more hemodynamic parameters with RCA phasic flow pattern or RCA-CFR. Results LV fractional shortening and end diastolic diameter were 15.3 ± 3.5 % and 69.4 ± 12.2 mm. Resting RCA phasic pattern had no difference comparing subgroups with vs. without pulmonary hypertension (1.45 vs. 1.29, p = NS) either with vs. without RV dysfunction (1.47 vs. 1.23, p = NS); RCA vs. LAD was 1.35 vs. 2.85 (p < 0.001). It had no significant correlation among any cardiac mechanical or hemodynamic parameter with RCA-CFR or RCA flow pattern. RCA-CFR had no difference compared with LAD (3.38 vs. 3.34, p = NS), as well as in pulmonary hypertension (3.09 vs. 3.10, p = NS) either in RV dysfunction (3.06 vs. 3.22, p = NS) subgroups. Conclusion In patients with chronic advanced NIC, RCA phasic flow pattern has a mild diastolic predominance, less marked than in LAD, with no effects from pulmonary artery hypertension or RV dysfunction. There is no significant correlation between any cardiac mechanical-structural or hemodynamic parameter with RCA-CFR or RCA phasic flow pattern. RCA flow reserve is still similar to LAD, independently of those right-sided cardiac disturbances.

Demographic and clinical predictors of depressive symptoms among incarcerated women

Abstract Background Imprisonment may lead to the development of mental illness, especially depression. This study examines the clinical and sociodemographic profiles of imprisoned women, identifies indicative signs of depression, and relates these indicators to other variables. Methods This study took the form of descriptive exploratory research with a psychometric evaluation. A total of 100 of 300 women in a female penitentiary were interviewed. A questionnaire with sociodemographic, clinical and penal situation information was used, along with the Beck Depression Inventory. The authors performed bivariate and multivariate analysis regarding depression. Results In all, 82 women presented signs of depression (light = 33, mild = 29 and severe = 20). Comorbidities, lack of religious practice, absence of visitors and presence of eating disorders were risk factors for depression (P = 0.03, 0.03, 0.02, 0.04, and 0.01). Being older was a protection factor against severe depression; for women over 30, the risk of depression was multiplied by 0.12. The rate of depression among women prisoners was high. Conclusions Comorbidities, the lack of religious practice, not having visitors and eating disorders are significant risk factors for depression, while age is a protective factor, among incarcerated women.

Are cats (Felis catus) from multi-cat households more stressed? Evidence from assessment of fecal glucocorticoid metabolite analysis

Given the social and territorial features described in feral cats, it is commonly assumed that life in multi-cat households is stressful for domestic cats and suggested that cats kept as single pets are likely to have better welfare. On the other hand, it has been hypothesized that under high densities cats can organize themselves socially thus preventing stress when spatial dispersion is unavailable. This study was aimed at comparing the general arousal underpinning emotional distress in single housed cats and in cats from multi-cat households (2 and 3–4 cats) on the basis of fecal glucocorticoid metabolites (GCM) measured via enzyme immunoassay (EIA). GCM did not significantly vary as a function of living style (single, double or group-housing); highly stressed individuals were equally likely in the three groups. Young cats in multi-cat households had lower GCM, and overall cats that tolerate (as opposed to dislike) petting by the owners tended to have higher GCM levels. Other environmental aspects within cat houses (e.g. relationship with humans, resource availability) may play a more important role in day to day feline arousal levels than the number of cats per se

Portal de Busca Integrada

O SIBiUSP lançou em março de 2012 uma nova ferramenta de busca de conteúdos acadêmicos/científicos, o nome dado foi Portal de Busca Integrada. Esta ferramenta pertence à uma categoria de softwares intitulada de “Web Scale Discovery”, que permitem a integração de diversas e dispersas fontes de dados em uma única interface de busca e entrega de resultados. Dessa forma, apresentam-se aqui os processos de seleção e implantação desta solução.

Incapacidade relacionada à dor lombar crônica: prevalência e fatores associados

A incapacidade relacionada à dor lombar crônica (DLC) é um fenômeno complexo e multifatorial. O objetivo desse estudo foi identificar a prevalência e os fatores associados à incapacidade em pacientes com dor lombar crônica. Estudo transversal com amostra composta por 177 pacientes com DLC, de três serviços de saúde; que responderam ao formulário com dados demográficos, ao Inventário de Depressão de Beck, às Escalas Oswestry Disability Index, de autoeficácia para dor crônica, Tampa de Cinesiofobia e de Fadiga de Piper. A prevalência de incapacidade foi de 65% (IC95%: 57,5 - 72,0) e era de moderada a grave em 80,7% dos pacientes. O modelo de regressão múltipla identificou três fatores independentemente associados à incapacidade: ausência de trabalho remunerado, autoeficácia baixa e depressão. Os fatores associados à incapacidade identificados são modificáveis. Intervenções como recolocação no trabalho, tratamento para a depressão e reconceitualização da crença de autoeficácia podem ter um impacto importante na prevenção e redução de incapacidade.

Aspectos cognitivos do falar em público: validação de uma escala de autoavaliação para universitários brasileiros

CONTEXTO: O falar em público é o medo mais prevalente na população geral e no Transtorno de Ansiedade Social (TAS). Assim sendo, estudos que dimensionem essa situação específica são necessários. OBJETIVOS: Validar a Self Statements during Public Speaking (SSPS) em amostra da população geral de estudantes universitários (PG - n = 2.314), casos (C - n = 88) e não casos de TAS (NC - n = 90) do Brasil. MÉTODOS: Conduziu-se o estudo em duas fases: a) preenchimento dos questionários autoaplicados em sala de aula; b) participação em entrevista telefônica e ao vivo. RESULTADOS: Evidenciaram-se correlações baixas/moderadas entre SSPS e Inventário de Fobia Social (PG = 0,22-0,65; C = 0,28-0,32; NC = 0,21-0,30), Inventário de Ansiedade de Beck (PG = 0,18-0,53; C = 0,25-0,33; NC = 0,22-0,25) e Escala Breve de Fobia Social (C = não significativa, NC = 0,23-0,31) nas diferentes amostras, especialmente para a PG. A análise fatorial apontou a presença de dois fatores, associados à autoavaliação positiva e negativa. O estudo da validade discriminativa evidenciou a capacidade da SSPS de discriminar os casos dos não casos de TAS. CONCLUSÃO: A SSPS é adequada para uso no contexto brasileiro, sendo que a subescala autoavaliação positiva parece ser mais efetiva para a avaliação de amostras identificadas ou suspeitas de TAS e a subescala autoavaliação negativa ter uma característica mais rastreadora quando aplicada em amostras da população geral.

Perfil de cuidadores de idosos com doença de Alzheimer associado à resiliência

Estudo exploratório-descritivo que objetivou descrever variáveis sociodemográficas e de saúde dos cuidadores de idosos com Alzheimer, associando os cuidados realizados à resiliência. Participaram do estudo 101 cuidadores, maiores de 18 anos, que acompanhavam os idosos em unidade básica e em hospital público, no ano 2009. Foram aplicados questionários para perfil, Inventário de Depressão de Beck e Escala de Resiliência. Realizada análise estatística dos dados. A maioria dos cuidadores eram mulheres, sem depressão, recebia ajuda de outras pessoas para cuidar e possuía alto grau de resiliência. Houve associação significativa da resiliência com as variáveis: grau de parentesco, tratamento médico, uso de medicamentos, cansaço, esgotamento, desânimo e saúde mental do cuidador. Saúde física foi associada, significativamente, à experiência no cuidado, sendo que 82 idosos tinham prejuízos cognitivos graves. O idoso no contexto familiar pode ser beneficiado quando o cuidador é mais resiliente.

Imagem corporal, ansiedade e depressão em pacientes obesos submetidos à cirurgia bariátrica

Pacientes obesos mórbidos têm recorrido à cirurgia bariátrica como um recurso eficaz para perder peso. Entretanto, este procedimento pode causar alterações comportamentais significativas. O objetivo deste trabalho foi investigar os níveis de ansiedade e depressão, assim como as mudanças sofridas na percepção da imagem corporal em pacientes obesos submetidos à cirurgia bariátrica em três momentos: pré-operatório, 6 meses e 12 meses após a cirurgia. Trata-se de um estudo do tipo prospectivo longitudinal, de abordagem quantitativa. No estudo foram aplicados os Inventários de Depressão e Ansiedade de Beck e a Escala Brasileira de Figuras de Silhuetas para Adultos. A cirurgia diminuiu significativamente tanto o índice de massa corporal dos pacientes quanto a insatisfação com a sua imagem corporal. Essa perda de peso e diminuição da insatisfação com a imagem corporal foi acompanhada de redução nos níveis de ansiedade e depressão, o que sugere que estes são fatores importantes no quadro obesidade.

Tracing latitudinal gradient, river discharge and water masses along the subtropical South American coast using benthic Foraminifera assemblages

More than 30% of Buccella peruviana (D'Orbigny), Globocassidulina crassa porrecta (Earland & Heron-Allen), Cibicides mackannai (Galloway & Wissler) and C. refulgens (Montfort) indicate the presence of cold Sub Antarctic Shelf Water in winter, from 33.5 to 38.3º S, deeper than 100 m, in the southern part of the study area. In summer, the abundance of this association decreases to less than 15% around 37.5-38.9º S where two species (Globocassidulina subglobosa (Brady), Uvigerina peregrina (Cushman) take over. G. subglobosa, U. peregrina, and Hanzawaia boueana (D'Orbigny) are found at 27-33º S in both seasons in less than 55 m deep in the northern part, and are linked with warm Subtropical Shelf Water and Tropical Water. Freshwater influence was signalized by high silicate concentration and by the presence of Pseudononion atlanticum (Cushman), Bolivina striatula (Cushman), Buliminella elegantissima (D'Orbigny), Bulimina elongata (D'Orbigny), Elphidium excavatum (Terquem), E. poeyanum (D'Orbigny), Ammobaculites exiguus (Cushman & Brönnimann), Arenoparrella mexicana (Kornfeld), Gaudryina exillis (Cushman & Brönnimann), Textularia earlandi (Parker) and thecamoebians in four sectors of the shelf. The presence of Bulimina marginata (D'Orbigny) between 34.1-32.8º S in the winter and 34.2-32.7º S in the summer indicates that the influence of the Subtropical Shelf Front on the sediment does not change seasonally, otherwise, the presence of Angulogerina angulosa (Williamson) in the winter, only in Mar del Plata (38.9º S), show that Malvinas currents are not influencing the sediment in the summer.

Reliability-based design optimization strategies based on FORM: a review

In deterministic optimization, the uncertainties of the structural system (i.e. dimension, model, material, loads, etc) are not explicitly taken into account. Hence, resulting optimal solutions may lead to reduced reliability levels. The objective of reliability based design optimization (RBDO) is to optimize structures guaranteeing that a minimum level of reliability, chosen a priori by the designer, is maintained. Since reliability analysis using the First Order Reliability Method (FORM) is an optimization procedure itself, RBDO (in its classical version) is a double-loop strategy: the reliability analysis (inner loop) and the structural optimization (outer loop). The coupling of these two loops leads to very high computational costs. To reduce the computational burden of RBDO based on FORM, several authors propose decoupling the structural optimization and the reliability analysis. These procedures may be divided in two groups: (i) serial single loop methods and (ii) unilevel methods. The basic idea of serial single loop methods is to decouple the two loops and solve them sequentially, until some convergence criterion is achieved. On the other hand, uni-level methods employ different strategies to obtain a single loop of optimization to solve the RBDO problem. This paper presents a review of such RBDO strategies. A comparison of the performance (computational cost) of the main strategies is presented for several variants of two benchmark problems from the literature and for a structure modeled using the finite element method.

Modeling random corrosion processes via polynomial chaos expansion

Polynomial Chaos Expansion (PCE) is widely recognized as a flexible tool to represent different types of random variables/processes. However, applications to real, experimental data are still limited. In this article, PCE is used to represent the random time-evolution of metal corrosion growth in marine environments. The PCE coefficients are determined in order to represent data of 45 corrosion coupons tested by Jeffrey and Melchers (2001) at Taylors Beach, Australia. Accuracy of the representation and possibilities for model extrapolation are considered in the study. Results show that reasonably accurate smooth representations of the corrosion process can be obtained. The representation is not better because a smooth model is used to represent non-smooth corrosion data. Random corrosion leads to time-variant reliability problems, due to resistance degradation over time. Time variant reliability problems are not trivial to solve, especially under random process loading. Two example problems are solved herein, showing how the developed PCE representations can be employed in reliability analysis of structures subject to marine corrosion. Monte Carlo Simulation is used to solve the resulting time-variant reliability problems. However, an accurate and more computationally efficient solution is also presented.

Reliability of buildings in service limit state for maximum horizontal displacements

Brazilian design code ABNT NBR6118:2003 - Design of Concrete Structures - Procedures - [1] proposes the use of simplified models for the consideration of non-linear material behavior in the evaluation of horizontal displacements in buildings. These models penalize stiffness of columns and beams, representing the effects of concrete cracking and avoiding costly physical non-linear analyses. The objectives of the present paper are to investigate the accuracy and uncertainty of these simplified models, as well as to evaluate the reliabilities of structures designed following ABNT NBR6118:2003[1&] in the service limit state for horizontal displacements. Model error statistics are obtained from 42 representative plane frames. The reliabilities of three typical (4, 8 and 12 floor) buildings are evaluated, using the simplified models and a rigorous, physical and geometrical non-linear analysis. Results show that the 70/70 (column/beam stiffness reduction) model is more accurate and less conservative than the 80/40 model. Results also show that ABNT NBR6118:2003 [1] design criteria for horizontal displacement limit states (masonry damage according to ACI 435.3R-68(1984) [10]) are conservative, and result in reliability indexes which are larger than those recommended in EUROCODE [2] for irreversible service limit states.