Stress e adaptação no processo de luto materno : um estudo exploratório

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicologia Clínica Sistémica), Universidade de Lisboa, Faculdade de Psicologia, 2014

Avaliação do stress oxidativo na disfunção erétil

As sequelas fisiopatológicas do stress oxidativo são difíceis de quantificar. Apesar dos obstáculos, a relevância médica do stress oxidativo tem vindo a ser cada vez mais reconhecida, sendo hoje em dia encarado como um componente chave de virtualmente todas as doenças. A disfunção erétil (DE) surge neste contexto como uma espécie de barómetro da função endotelial e do dano oxidativo. A quantificação de biomarcadores de stress oxidativo poderá apresentar um enorme impacto na avaliação de pacientes com DE. O rácio glutationa reduzida/oxidada (GSH/GSSG) e a nitrotirosina (3-NT) têm vindo a demonstrar relevância clínica. A consideração de polimorfismos genéticos constitui ainda uma abordagem promissora na avaliação destas relações no futuro. Um método altamente sensível de cromatografia líquida de alta performance (HPLC) foi desenvolvido para a determinação de 3-NT em plasma humano. As concentrações de 3-NT medidos em indivíduos com DE foram 6,6±2,1μM (média±S.D., n = 46). A medição da concentração plasmática de 3-NT poderá revelar-se útil como marcador de dano oxidativo dependente do óxido nítrico (NO). O nível de stress oxidativo pode também ser quantificado através da medição do decréscimo do rácio GSH/GSSG, que tem mostrado alterações numa miríade de patologias, como a DE e a diabetes mellitus. O método proposto para a quantificação do rácio GSH/GSSG em HPLC apresenta a vantagem de avaliação concomitante dos dois parâmetros em apenas uma corrida. O valor do rácio GSH/GSSG obtido a partir de sangue de indivíduos com DE foi 11,9±9,8 (média±S.D., n = 49). Os resultados estatísticos revelaram diferenças significativas (p<0,001) entre ambos a concentração plasmática de 3-NT e o rácio GSH/GSSG de sangue de indivíduos com DE e as respetivas medições em indivíduos saudáveis. Observaram-se ainda diferenças estatisticamente significativas (p≈0,027) entre o rácio GSH/GSSG do sangue de pacientes apenas com diagnóstico de DE e a medição respetiva em indivíduos com DE e comorbilidades cardiovasculares. Estes resultados enfatizam o papel do dano oxidativo na biopatologia da DE, elucidado com o auxílio destas duas metodologias, que poderão ter um amplo campo de aplicação no futuro, dado que se mostraram simples, não dispendiosas e rápidas, podendo eventualmente adequar-se a estudos de rastreio em larga escala.

Psychological impact of diagnostic exams

Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognized anxiety may lead to exam repetition, and impedance of exam performance. Objective: The aim of the study was to examine the anxiety levels of patients who are to undergo diagnostic exams related to cancer diagnostic: PET/CT and mammography. Methods: Two hundred and thirty two patients who undergo PET/CT and one hundred thirteen women who undergo mammography filled out one questionnaire after the procedure to determine their concerns, expectations and perceptions of anxiety. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself and fear of the results. Patients who suffered from greater anxiety were those who were scanned during the initial stage of an oncological disease. On the other hand, the diagnostic is the main cause of anxiety in women who are requiring a mammography. 28% of the women reported having experienced pain or intense pain. Conclusions: The performance of diagnostic exams related to cancer diagnostic like a PET/CT and a mammography are important and statistically generators of anxiety. Patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. These results provide expertise that can be used in the development of future training programs to integrate post-graduate courses of health professionals.

Use of a fluorescence-based approach to assess short-term responses of the alga Pseudokirchneriella subcapitata to metal stress

This work explores the use of fluorescent probes to evaluate the responses of the green alga Pseudokirchneriella subcapitata to the action of three nominal concentrations of Cd(II), Cr(VI), Cu(II) and Zn(II) for a short time (6 h). The toxic effect of the metals on algal cells was monitored using the fluorochromes SYTOX Green (SG, membrane integrity), fluorescein diacetate (FDA, esterase activity) and rhodamine 123 (Rh123, mitochondrial membrane potential). The impact of metals on chlorophyll a (Chl a) autofluorescence was also evaluated. Esterase activity was the most sensitive parameter. At the concentrations studied, all metals induced the loss of esterase activity. SG could be used to effectively detect the loss of membrane integrity in algal cells exposed to 0.32 or 1.3 μmol L−1 Cu(II). Rh123 revealed a decrease in the mitochondrial membrane potential of algal cells exposed to 0.32 and 1.3 μmol L−1 Cu(II), indicating that mitochondrial activity was compromised. Chl a autofluorescence was also affected by the presence of Cr(VI) and Cu(II), suggesting perturbation of photosynthesis. In conclusion, the fluorescence-based approach was useful for detecting the disturbance of specific cellular characteristics. Fluorescent probes are a useful diagnostic tool for the assessment of the impact of toxicants on specific targets of P. subcapitata algal cells.

Regulation of autoimmune neuroinflammation by stress-responsive genes

Dissertation presented to obtain the Ph.D degree in Biology

Fiscal policy under financial stress: A threshold VAR approach

The purpose of the project is to measure the impact of fiscal policy on the Portuguese GDP and how it may vary according to the state of the financial market. A Threshold VAR model is presented in which the two regimes are found using a financial stress index that divides the economy into a situation of financial stress and financial stability.

The impact of job insecurity on adaptive performance via burnout

Difficult and unpredictable times, due to economic instability, lead employees to feel high job insecurity. Organizations’ only way to subsistence is to search innovative ways of solving problems and find creative solutions. This study focuses on the impact that job insecurity has on adaptive performance, a recent measure integrating the response of creativity, reactivity in the face of emergencies, interpersonal adaptability, training effort, and handling work stress, and, mediated by burnout. From the responses of two questionnaires (????????1=252; ????????2=145), we conclude that job insecurity leads to exhaustion, but not to disengagement. In turn, it is the latter that demonstrates to have negative relations with some measures of adaptive performance. Thus, it is crucial to understand how organizations can minimize the inherent process.

Endocrine response and perceived stress test during an experimental challenge task in adult survivors of a childhood cancer.

BACKGROUND: Although long-term implications of cancer in childhood or adolescence with regard to medical conditions are well documented, the impact on mental health and on response to stress, which may be an indicator of psychological vulnerability, is not yet well understood. In this study, psychological and physiological responses to stress were examined.¦PROCEDURE: Fifty-three participants aged 18-39 years (n = 25 survivors of childhood or adolescence cancer, n = 28 controls) underwent an experimental stress test, the Trier Social Stress Test (TSST). Participants were asked to provide repeated evaluations of perceived stress on visual-analogical scales and blood samples were collected before and after the TSST to measure plasma cortisol.¦RESULTS: The psychological perception of stress was not different between the two groups. However, the cancer survivors group showed a higher global plasma cortisol level as well as higher amplitude in the response to the TSST. The global cortisol level in cancer survivors was increased when depression symptoms were present. The subjective perception of stress and the plasma cortisol levels were only marginally correlated in both groups.¦CONCLUSIONS: It is suggested that the exposure to a life-threatening experience in childhood/adolescence increases the endocrine response to stress, and that the presence of depressive symptoms is associated with an elevation of plasma cortisol levels. A better knowledge of these mechanisms is important given that the dysregulations of the stress responses may cause psychological vulnerability. Pediatr Blood Cancer 2012; 59: 138-143. © 2011 Wiley Periodicals, Inc.

Linking of stress offset score (SOS), work satisfaction, and organizational commitment to intentions to quit

The purpose of this study was to identify the impact of stressors and offsetting satistiers, measured in this study with Stress Offset Score (SOS), on intentions to quit and examine the mediating and moderating effects of three facets of work satisfaction (job satisfaction, pay satisfaction, and satisfaction with supervisor) and two facets of organizational commitment (affective and nonnative commitment) on this relationship. The sample was composed of 2990 employees from 21 public and private organizations. The interaction of each type of work satisfaction and organizational commitment, with SOS, was tested using Ordinary Least Squares (OLS) procedures. Intentions to quit was the dependent variable. The research questions were determine: (1) Does SOS predict intentions to quit? (2) Does work satisfaction mediate the predictive relationship of SOS on intentions to quit? (3) Does organizational commitment mediate the predictive relationship of SOS on intent to quit? (4) Does work satisfaction moderate the predictive relationship of SOS on intentions to quit? and (5) Does organizational commitment moderate the predictive relationship of SOS on intentions to quit? The results indicated that SOS was negatively correlated with intentions to quit. Each of the types of work satisfaction and organizational commitment variables showed a partial mediated relationship with SOS and each relationship was highly significant, while normative commitment explained more of the relationship then other mediators. The study also tested for interactions but no statistical significant relationships where established between any of the interaction terms (e.g., SOSxJob Satisfaction and SOSxAffcctive Commitment) and intentions to quit.

A constructivist grounded theory of firefighter perceptions of stress, coping and the relationship to health

This qualitative research was a constructivist grounded theory designed to develop an understanding of how firefighters perceive and cope with stressful situations and the impact this has on their perceptions of health. This study was framed in a social ecological perspective with the community of firefighting providing the environment within which to explore stress and coping. Of particular concern here are the stressors associated with firefighting. Prior research with firefighters has often been epidemiological and statistical in nature, focusing on measures of cardiovascular disease, cancer, and depression (Baker & Williams, 2001 ; Brown et al., 2002; Murphy et al.,1999; Regehr et al., 2002; Regehr et al., 2003). Qualitative research examining the perception of stress among firefighters that includes personal stories allows firefighters the opportunity to describe what it is like to be met with physically and mentally challenging situations on a daily basis. Twelve in-depth, semi-structured, face-to-face interviews with a brief questionnaire were conducted with firefighters from a Southern Ontario Fire Department. Four main themes emerged describing the persona of the firefighter, the stressors of firefighters, coping strategies of firefighters, and firefighters' perceptions of health. Stressors include requirements of the job, traumatic calls, tensions with co-workers, the struggle between the family at home and the family at work, political stressors with the City, and the inner struggle. Avoidance coping, approach coping, and gaining perspective emerged as the three coping styles of firefighters. Health was defined as including physical, mental, social and spiritual aspects. A model of the findings is provided that depicts the cyclical nature of the stress-coping-health relationship among firefighters.

Posttraumatic stress disorder symptoms might be destroying your intimacy : a test of mediational models in a community sample of couples

The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of selfpreservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy. Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. I t is possible that the Tend-andBefriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary.

Impact of different irrigation strategies on grapes and wine quality of four grapevine cultivars (Vitis sp.) in cool climate conditions. An investigation into the relationships among ABA, water status, grape cultivar and wine quality

Niagara Peninsula of Ontario is the largest viticultural area in Canada. Although it is considered to be a cool and wet region, in the last decade many water stress events occurred during the growing seasons with negative effects on grape and wine quality. This study was initiated to understand and develop the best strategies for water management in vineyards and those that might contribute to grape maturity advancement. The irrigation trials investigated the impact of time of initiation (fruit set, lag phase and veraison), water replacement level based on theoretical loss through crop evapotranspiration (ETc; 100,50 and 25%) and different irrigation strategies [partial root zone drying (PRD) versus regulated deficit irrigation (RD!)] on grape composition and wine sensory profiles. The irrigation experiments were conducted in a commercial vineyard (Lambert Vineyards Inc.) located in Niagara-on-the-Lake, Ontario, from 2005 through 2009. The two experiments that tested the combination of different water regimes and irrigation time initiation were set up in a randomized block design as follows: Baco noir - three replicates x 10 treatments [(25%, 50% and 100% of ETc) x (initiation at fruit set, lag phase and veraison) + control]; Chardonnay - three replicates x seven treatments [(25%, 50% and 100% of ETc) x (initiation at fruit set and veraison) + control]. The experiments that tested different irrigation strategies were set up on two cultivars as follows: Sauvignon blanc - four replicates x four treatments [control, fully irrigated (100% ETc), PRD (100% ETc) and RDI (25% ETc)]; Cabemet Sauvignon - four replicates x five treatments [control, fully irrigated (100% ETc), PRD (100% ETc), RDI (50% ETc) and RDI (25% ETc)]. The controls in each experiment were nonirrigated. The irrigation treatments were compared for many variables related to soil water status, vine physiology, berry composition, wine sensory profile, and hormone composition [(abscisic acid (ABA) and its catabolites]. Soil moisture profile was mostly affected by irrigation treatments between 20 and 60 em depth depending on the grapevine cultivar and the regime of water applied. Overall soil moisture was consistently higher throughout the season in 100 and 50% ETc compare to the control. Transpiration rates and leaf temperature as well as shoot growth rate were the most sensitive variables to soil water status. Drip irrigation associated with RDI treatments (50% ETc and 25% ETc) had the most beneficial effects on vine physiology, fruit composition and wine varietal typicity, mainly by maintaining a balance between vegetative and reproductive parts of the vine. Neither the control nor the 100 ETc had overall a positive effect on grape composition and wine sensory typicity. The time of irrigation initiation affected the vine physiology and grape quality, the most positive effect was found in treatments initiated at lag phase and veraison. RDI treatments were overall more consistent in their positive effect on grape composition and wine varietal typicity comparing to PRD treatment. The greatest difference between non-irrigated and irrigated vines in most of the variables studied was found in 2007, the driest and hottest season of the experimental period. Soil water status had a greater and more consistent effect on red grapevine cultivars rather than on white winegrape cultivars. To understand the relationships among soil and plant water status, plant physiology and the hormonal profiles associated with it, abscisic acid (ABA) and its catabolites [phaseic acid (PA), dihydrophaseic acid (DPA), 7-hydroxy-ABA (TOH-ABA), 8' -hydroxy-ABA, neophaseic acid and abscisic acid glucose ester (ABA-GE)] were analyzed in leaves and berries from the Baco noir and Chardonnay irrigation trials over two growing seasons. ABA and some of its catabolites accurately described the water status in the vines. Endogenous ABA and some of its catabolites were strongly affected in Baco noir and Chardonnay by both the water regime (i.e. ET level) and timing of irrigation initiation. Chardonnay grapevines produced less ABA in both leaves and berries compared to Baco noir, which indicated that ABA synthesis is also cultivar dependant. ABA-GE was the main catabolite in treatments with high water deficits, while PA and DPA were higher in treatments with high water status, suggesting that the vine produced more ABA-GE under water deficits to maintain rapid control of the stomata. These differences between irrigation treatments with respect to ABA and catabolites were particularly noticeable in the dry 2007 season. Two trials using exogenous ABA investigated the effect of different concentrations of ABA and organs targeted for spraying, on grape maturation and berry composition of Cabemet Sauvignon grapevines, in two cool and wet seasons (2008-2009). The fIrst experiment consisted of three replicates x three treatments [(150 and 300 mg/L, both applications only on clusters) + untreated control] while the second experiment consisted in three replicates x four treatments [(full canopy, only clusters, and only leaves sprayed with 300 ppm ABA) + untreated control]. Exogenous ABA was effective in hastening veraison, and improving the composition of Cabemet Sauvignon. Ability of ABA to control the timing of grape berry maturation was dependant on both solution concentration and the target organ. ABA affected not only fruit composition but also yield components. Berries treated with ABA had lower weight and higher skin dry mass, which constitutes qualitative aspects desired in the wine grapes. Temporal advancement of ripening through hormonal control can lead to earlier fruit maturation, which is a distinct advantage in cooler areas or areas with a high risk of early frost occurrence. Exogenous ABA could provide considerable benefits to wine industry in terms of grape composition, wine style and schedule activities in the winery, particularly in wet and cool years. These trials provide the ftrst comprehensive data in eastern North America on the response of important hybrid and Vitis vinifera winegrape cultivars to irrigation management. Results from this study additionally might be a forward step in understanding the ABA metabolism, and its relationship with water status. Future research should be focused on ftnding the ABA threshold required to trigger the ripening process, and how this process could be controlled in cool climates.

Importance du stress oxydant dans le diabète secondaire à la fibrose kystique

Introduction : La fibrose kystique (FK) est une maladie génétique mortelle qui touche principalement les poumons et l’appareil digestif. Elle est causée par des mutations sur le gène codant la protéine du CFTR, un canal chlore exprimé à la surface des organes à sécrétions exocrines. Les fonctions principales du CFTR sont les suivantes: 1) la régulation de l’homéostasie ionique des sécrétions; 2) le maintien de la fluidité des sécrétions et; 3) le transport du glutathion. Le dysfonctionnement de la protéine du CFTR rend les sécrétions visqueuses et épaisses, avec des phénomènes obstructifs qui sont responsables de l’apparition de fibrose au sein des divers organes. Dans le poumon, l’accumulation du mucus épais rend difficile l’élimination des bactéries inhalées, ces dernières établissent alors des cycles d’infection qui endommagent les tissus pulmonaires à travers des processus inflammatoires. Dans le tube digestif, le mucus épais entrave l’absorption d’une quantité suffisante d’éléments nutritifs incluant les principaux antioxydants. L’infection et l’inflammation des poumons favorisent l’apparition d’un stress oxydant qui détruit davantage le tissu pulmonaire. Le déficit en glutathion, probablement lié au dysfonctionnement de la proteine du CFTR, et la malabsorption des antioxydants favorisent l’augmentation du stress oxydant. Une augmentation du stress oxydant a été démontrée au cours du diabète et les produits dérivés du stress oxydant ont été mis en évidence dans la pathogenèse des complications associées au diabète. Une augmentation du stress oxydant a également été montrée durant la FK, mais sans pour autant expliquer la survenue du diabète secondaire à la FK dont la prévalence augmente sans cesse. Objectifs : Notre étude consiste à évaluer l’impact du stress oxydant dans les anomalies du métabolisme du glucose durant la FK, et à étudier son rôle dans les mécanismes de sécrétion d’insuline induite par le glucose. Pour ce faire, nous avons déterminé l’impact de la peroxydation lipidique sur la tolérance au glucose et la défense antioxydante globale, in vivo, chez des patients FK présentant une altération du métabolisme du glucose. De plus, nous avons évalué le rôle du stress oxydatif sur la synthèse et la sécrétion d’insuline, in vitro, dans les cellules pancréatiques βTC-tet. Résultats : Dans l’étude in vivo, nous avons démontré que l’intolérance au glucose et le diabète étaient associés à une augmentation de la peroxydation lipidique, traduite par la hausse des niveaux sanguins de 4-hydroxynonenal lié aux protéines (HNE-P). La défense antioxydante évaluée par la mesure du glutathion sanguin démontre que les niveaux de glutathion oxydé restent également élevés avec l’intolérance au glucose. Dans l’étude in vitro, nos résultats ont mis en évidence que l’exposition de la cellule βTC-tet au stress oxydant: 1) induit un processus de peroxydation lipidique; 2) augmente la sécrétion basale d’insuline; 3) diminue la réponse de la sécrétion d’insuline induite par le glucose; et 4) n’affecte que légèrement la synthèse de novo de l’insuline. Nous avons aussi démontré que les cellules pancréatiques βTC-tet résistaient au stress oxydant en augmentant leur synthèse en glutathion tandis que la présence d’un antioxydant exogène pouvait restaurer la fonction sécrétoire de ces cellules. Conclusion : Le stress oxydant affecte le fonctionnement de la cellule pancréatique β de plusieurs manières : 1) il inhibe le métabolisme du glucose dont les dérivés sont nécessaires à la sécrétion d’insuline; 2) il active la voie de signalisation impliquant les gènes pro-inflammatoires et; 3) il affecte l’intégrité membranaire en induisant le processus de peroxydation lipidique.

Impact de facteurs sanguins et d'agents thérapeutiques sur la survie de fibroblastes de sujets atteints de la forme canadienne-française du syndrome de Leigh (LSFC)

La forme canadienne-française du syndrome de Leigh (LSFC) est une maladie métabolique associée à une déficience en cytochrome oxydase (COX) et caractérisée par des crises d’acidose lactique, menant à une mort prématurée. Les mécanismes qui sous-tendent l’induction des crises restent inconnus et il n’existe aucune thérapie efficace pour les prévenir. Cette étude vise à caractériser l'effet de facteurs métaboliques périphériques potentiellement altérés chez les patients LSFC sur la mort de lignées cellulaires issues de ces patients et de témoins puis, à identifier des agents thérapeutiques pouvant la prévenir. Nous postulons que (i) ces facteurs métaboliques induiront une mort prématurée des cellules de patients et que (ii) les interventions susceptibles de la prévenir pallieront les conséquences de la déficience en COX, soit la diminution des taux d’adénosine triphosphate (ATP) et l’augmentation du stress oxydant, du nicotinamide adénine dinucléotide (NADH) et des lipides toxiques. Un criblage de 8 facteurs sanguins et 10 agents thérapeutiques a été réalisé. Les paramètres mesurés incluent la nécrose, l’apoptose, l’ATP et l’activité de la COX. Les fibroblastes LSFC sont plus susceptibles à la mort par nécrose (39±6%) induite par du palmitate plus lactate, un effet associé à des niveaux d’ATP diminués (53±8%). La mort cellulaire est réduite de moitié par l’ajout combiné d’agents ciblant le NADH, l’ATP et les lipides toxiques, alors que l’ajout d’antioxydants l’augmente. Ainsi, un excès de nutriments pourrait induire la mort prématurée des cellules LSFC et, pour atténuer cette mort, il serait important de combiner plusieurs interventions ciblant différents mécanismes.

Relation entre la structure et la fonction des artères cérébrales dans l’athérosclérose : impact des traitements cardioprotecteurs

Thèse réalisée en cotutelle avec Dre Christine Des Rosiers