Mapping non-suicidal self-injury in adolescence: Development and confirmatory factor analysis of the impulse, self-harm and sucidal ideation questionnaire for adolescents (ISSIQ-A)

Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.

Diferenciais intra-urbanos de peso ao nascer no município de São Paulo

OBJETIVO: Identificar diferenciais intra-urbanos e fatores de risco na prevalência de baixo peso ao nascer. MÉTODOS: Foram utilizadas as informações das declarações de nascido vivo de mães residentes no município de São Paulo, obtidos do Sistema de Informação de Nascidos Vivos e Fundação Seade, para o período de 2002 e 2003, totalizando 368.980 nascidos vivos. Os endereços foram geo-referenciados em setores censitários e classificados em seis grupos de vulnerabilidade segundo o Índice Paulista de Vulnerabilidade Social. Para identificação dos possíveis fatores de risco empregou-se análise de regressão logística. RESULTADOS: Observou-se tendência de crescimento da prevalência de baixo peso ao nascer com aumento da vulnerabilidade (de 6,8% a 8,1%). Houve diferenças significativas entre os grupos quanto às características maternas, assistência pré-natal e da proporção de nascimentos de não pré-termo de baixo peso. No grupo de baixo peso não pré-termo, proxy da presença de retardo do crescimento intra-uterino, residir em áreas vulneráveis (1,29;1,17-1,43) e características socioeconômicas maternas desaforáveis, como mães adolescentes (1,13;1,04-1,22), baixa escolaridade (1,26;1,17-1,35) e elevada paridade (1,10;1,01-1,20) foram fatores de risco, assim como mães idosas (1,38;1,30-1,47), e sem companheiro (1,15;1,11-1,20). A ausência de pré-natal apresentou o maior risco de baixo peso para nascimentos de pré-termo (3,39;2,86-4,02) e não pré-termo (2,12;1,87-2,41). Houve redução de risco de baixo peso com o aumento de consultas de pré-natal para nascimentos de pré-termo e não pré-termo. CONCLUSÕES: Há diferenças de prevalência de baixo peso ao nascer segundo grupos de vulnerabilidade. A assistência pré-natal mostrou-se desigual segundo grupos de vulnerabilidade e seu elevado risco para o baixo peso ao nascer indica a importância de ampliar o acesso e qualidade dos serviços de saúde.

Performance of a Brazilian population on the test of functional health literacy in adults

OBJECTIVE: To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS: The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS: The mean age of the sample was 47.3 years(sd=16.8) and the mean education was 9.7 years(sd=5; range: 1 - 17). A total of 32.4% of the sample showed literacy/numeracy deficits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; p<0.01) and a negative correlation between age and the scores (r=-0.259; p<0.01). The correlation between the scores and age was not significant when the effects of education were held constant (rp=-0.031, p=0.584). A significant association (B=3.877, Beta =0.733; p<0.001) was found between schooling and scores. Age was not a significant predictor in this model (B=-0.035, Beta=-0.22; p=0.584). CONCLUSIONS: The short version of the Test of Functional Health Literacy in Adults was a suitable tool to assess health literacy in the study population. The high number of individuals classified as functional illiterates in this test highlights the importance of special assistance to help them properly understand directions for healthcare.

Exposição ocupacional a mercúrio: associação com a atividade da paraoxonase humana e vitaminas A e E

Mestrado em Segurança e Higiene no Trabalho

Indicadores prognósticos na hipertensão pulmonar

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Intervenção Cardiovascular

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

High risk of recurrence/progression bladder tumours is treated with Bacillus Calmette-Guérin (BCG) immunotherapy after complete resection of the tumour. Approximately 75% of these tumours express the uncommon carbohydrate antigen sialyl-Tn (Tn), a surrogate biomarker of tumour aggressiveness. Such changes in the glycosylation of cell-surface proteins influence tumour microenvironment and immune responses that may modulate treatment outcome and the course of disease. The aim of this work is to determine the efficiency of BCG immunotherapy against tumours expressing sTn and sTn-related antigen sialyl-6-T (s6T). METHODS: In a retrospective design, 94 tumours from patients treated with BCG were screened for sTn and s6T expression. In vitro studies were conducted to determine the interaction of BCG with high-grade bladder cancer cell line overexpressing sTn. RESULTS: From the 94 cases evaluated, 36 had recurrence after BCG treatment (38.3%). Treatment outcome was influenced by age over 65 years (HR=2.668; (1.344-5.254); P=0.005), maintenance schedule (HR=0.480; (0.246-0.936); P=0.031) and multifocality (HR=2.065; (1.033-4.126); P=0.040). sTn or s6T expression was associated with BCG response (P=0.024; P<0.0001) and with increased recurrence-free survival (P=0.001). Multivariate analyses showed that sTn and/or s6T were independent predictive markers of recurrence after BCG immunotherapy (HR=0.296; (0.148-0.594); P=0.001). In vitro studies demonstrated higher adhesion and internalisation of the bacillus to cells expressing sTn, promoting cell death. CONCLUSION: s6T is described for the first time in bladder tumours. Our data strongly suggest that BCG immunotherapy is efficient against sTn- and s6T-positive tumours. Furthermore, sTn and s6T expression are independent predictive markers of BCG treatment response and may be useful in the identification of patients who could benefit more from this immunotherapy.

Evolução do consumo de crack em coorte com histórico de tratamento

OBJETIVO: Analisar a evolução do consumo entre usuários de crack com histórico de tratamento. MÉTODOS: Uma coorte de, originalmente, 131 dependentes de crack admitidos em uma enfermaria de desintoxicação em São Paulo, SP, entre 1992 e 1994, foi re-entrevistada em três ocasiões: 1995-1996, 1998-1999 e 2005-2006. As variáveis averiguadas foram: dados demográficos, comportamento sexual de risco, padrões de consumo de crack e outras substâncias, prisões, desaparecimentos e óbitos. Na análise estatística empregou-se o teste de qui-quadrado, a regressão logística multinomial e regressão de Cox. RESULTADOS: Dos pacientes avaliados, 43 estavam abstinentes do crack (12 meses ou mais), 22 eram usuários, 13 estavam presos, dois desaparecidos e 27 estavam mortos. Foram identificados três grupos com trajetórias distintas de consumo pós-alta. Comportamento seguro com uso de preservativo foi identificado como fator relacionado ao grupo de abstinentes estáveis (p = 0,001). Teste HIV positivo na internação (p = 0,046); consumo de cocaína aspirada no último ano (p = 0,001) e tempo de uso de cocaína aspirada na vida (mais de 132 meses) (p = 0,000) foram fatores relacionados a uso de longo termo. Uso pregresso de cocaína endovenosa aumentou em 2,5 vezes as chances de óbito em 12 anos (p = 0,031) (IC95%: 1,08; 5,79). CONCLUSÕES: A recorrência e persistência do consumo nos anos pós-alta de tratamento refletem novas modalidades de uso do crack. Por outro lado, padrões de abstinência estável apontam a viabilidade dos processos de recuperação relativos ao uso de crack.

Common genetic polymorphisms in the ABCB1 gene are associated with risk of major depressive disorder in male Portuguese individuals

Major depressive disorder (MDD) is a highly prevalent disorder, which has been associated with an abnormal response of the hypothalamus–pituitary–adrenal (HPA) axis. Reports have argued that an abnormal HPA axis response can be due to an altered P-Glycoprotein (P-GP) function. This argument suggests that genetic polymorphisms in ABCB1 may have an effect on the HPA axis activity; however, it is still not clear if this influences the risk of MDD. Our study aims to evaluate the effect of ABCB1 C1236T, G2677TA and C3435T genetic polymorphisms on MDD risk in a subset of Portuguese patients. DNA samples from 80 MDD patients and 160 control subjects were genotyped using TaqMan SNP Genotyping assays. A significant protection for MDD males carrying the T allele was observed (C1236T: odds ratio (OR) = 0.360, 95% confidence interval [CI]: [0.140– 0.950], p = 0.022; C3435T: OR= 0.306, 95% CI: [0.096–0.980], p = 0.042; and G2677TA: OR= 0.300, 95% CI: [0.100– 0.870], p = 0.013). Male Portuguese individuals carrying the 1236T/2677T/3435T haplotype had nearly 70% less risk of developing MDD (OR = 0.313, 95% CI: [0.118–0.832], p = 0.016, FDR p = 0.032). No significant differences were observed regarding the overall subjects. Our results suggest that genetic variability of the ABCB1 is associated with MDD development in male Portuguese patients. To the best of our knowledge, this is the first report in Caucasian samples to analyze the effect of these ABCB1 genetic polymorphisms on MDD risk.

Growth and Raman scattering characterization of Cu2ZnSnS4 thin films

In the present work we report the results of the growth, morphological and structural characterization of Cu2ZnSnS4 (CZTS) thin films prepared by sulfurization of DC magnetron sputtered Cu/Zn/Sn precursor layers. The adjustment of the thicknesses and the properties of the precursors were used to control the final composition of the films. Its properties were studied by SEM/EDS, XRD and Raman scattering. The influence of the sulfurization temperature on the morphology, composition and structure of the films has been studied. With the presented method we have been able to prepare CZTS thin films with the kesterite structure.

Mixed integer non linear programming and artificial neural network based approach to ancillary services dispatch in competitive electricity markets

Ancillary services represent a good business opportunity that must be considered by market players. This paper presents a new methodology for ancillary services market dispatch. The method considers the bids submitted to the market and includes a market clearing mechanism based on deterministic optimization. An Artificial Neural Network is used for day-ahead prediction of Regulation Down, regulation-up, Spin Reserve and Non-Spin Reserve requirements. Two test cases based on California Independent System Operator data concerning dispatch of Regulation Down, Regulation Up, Spin Reserve and Non-Spin Reserve services are included in this paper to illustrate the application of the proposed method: (1) dispatch considering simple bids; (2) dispatch considering complex bids.

Growth and characterization of Cu2ZnSn(S,Se)4 thin films for solar cells

Cu2ZnSnS4 (CZTS) and Cu2ZnSnSe4 (CZTSe) with their band gap energies around 1.45 eV and 1.0 eV, respectively, can be used as the absorber layer in thin film solar cells. By using a mixture of both compounds, Cu2ZnSn(S,Se)4 (CZTSSe), a band gap tuning may be possible. The latter material has already shown promising results such as solar cell efficiencies up to 10.1%. In this work, CZTSSe thin films were grown in order to study its structure and to establish the best growth precursors. SEM micrographs reveal an open columnar structure for most samples and EDS composition profiling of the cross sections show different selenium gradients. X-ray diffractograms show different shifts of the kesterite/stannite (1 1 2) peak, which indicate the presence of CZTSSe. From Raman scattering analysis, it was concluded that all samples had traces of CZTS and CZTSSe. The composition of the CZTSSe layer was estimated using X-ray diffraction and Raman scattering and both results were compared. It was concluded that Se diffused more easily in precursors with ternary Cu–Sn–S phases and metallic Zn than in precursors with ZnS and/or CZTS already formed. It was also showed that a combination of X-ray diffraction and Raman scattering can be used to estimate the ratio of S per Se in CZTSSe samples.

Ambiente familiar e transtorno de déficit de atenção e hiperatividade

OBJETIVO: Analisar fatores associados a transtorno de déficit de atenção e hiperatividade em crianças. MÉTODOS: Estudo longitudinal sobre problemas de comportamento em crianças escolares de São Gonçalo, RJ, em 2005. Foram analisados 479 escolares da rede pública selecionados por amostragem por conglomerados em três estágios. Foi utilizada a escala Child Behavior Checklist para medição do desfecho. Foi aplicado um questionário para pais/responsáveis acerca dos fatores de exposição analisados: perfil da criança e da família, variáveis de relacionamento familiar, violências físicas e psicológicas. O modelo regressão log-binomial com enfoque hierarquizado foi empregado para a análise. RESULTADOS: Quociente de inteligência mais alto associou-se inversamente à frequência do transtorno (RP = 0,980 [IC95% 0,963;0,998]). A prevalência de transtorno nas crianças foi maior quando havia disfunção familiar do que entre famílias com melhor forma de se relacionar (RP = 2,538 [IC95% 1,572;4,099]). Crianças que sofriam agressão verbal pela mãe apresentaram prevalência 3,7 vezes maior do que aquelas não expostas a essa situação no último ano (RP = 4,7 [IC95% 1,254;17,636]). CONCLUSÕES: Relações familiares negativas estão associadas aos sintomas de transtorno de déficit de atenção e hiperatividade. Sua associação com quociente de inteligência reitera a importância da base genética e ambiental na origem do transtorno.

Risk factors of HIV-related oral lesions in adults

OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005). CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

Analysis of temperature time-series: embedding dynamics into the MDS method

Global warming and the associated climate changes are being the subject of intensive research due to their major impact on social, economic and health aspects of the human life. Surface temperature time-series characterise Earth as a slow dynamics spatiotemporal system, evidencing long memory behaviour, typical of fractional order systems. Such phenomena are difficult to model and analyse, demanding for alternative approaches. This paper studies the complex correlations between global temperature time-series using the Multidimensional scaling (MDS) approach. MDS provides a graphical representation of the pattern of climatic similarities between regions around the globe. The similarities are quantified through two mathematical indices that correlate the monthly average temperatures observed in meteorological stations, over a given period of time. Furthermore, time dynamics is analysed by performing the MDS analysis over slices sampling the time series. MDS generates maps describing the stations’ locus in the perspective that, if they are perceived to be similar to each other, then they are placed on the map forming clusters. We show that MDS provides an intuitive and useful visual representation of the complex relationships that are present among temperature time-series, which are not perceived on traditional geographic maps. Moreover, MDS avoids sensitivity to the irregular distribution density of the meteorological stations.

Hybrid adaptive control of a dragonfly model

Dragonflies show unique and superior flight performances than most of other insect species and birds. They are equipped with two pairs of independently controlled wings granting an unmatchable flying performance and robustness. In this paper, it is presented an adaptive scheme controlling a nonlinear model inspired in a dragonfly-like robot. It is proposed a hybrid adaptive (HA) law for adjusting the parameters analyzing the tracking error. At the current stage of the project it is considered essential the development of computational simulation models based in the dynamics to test whether strategies or algorithms of control, parts of the system (such as different wing configurations, tail) as well as the complete system. The performance analysis proves the superiority of the HA law over the direct adaptive (DA) method in terms of faster and improved tracking and parameter convergence.