Perceived health in the Portuguese population aged ? 35

OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and behaviors.

Criteria for the selection of foster families and monitoring of placements.: Comparative study of the application of the Casey Foster Applicant Inventory-Applicant Version (CFAI-A)

Based on a literature review, this article frames different stages of the foster care process, identifying a set of standardized measures in the American and Portuguese contexts which, if implemented, could contribute towards higher levels of foster success. The article continues with the presentation of a comparative study, based on the application of the Casey Foster Applicant Inventory-Applicant Version (CFAI-A) questionnaire, in the aforementioned contexts. Taking a comparative analyses of CFAI-A's psychometric characteristics in four different samples as a starting point, one discovered that despite the fact that the questionnaire was adapted to Portuguese reality, it kept the quality values presented on the American samples. It specifically shows significant values regarding reliability and validity. This questionnaire, which aims to assess the potential of foster families, also supports the technical staff's decision making process regarding the monitoring and support of foster families, while it also promotes a better decision in the placement process towards the child's integration and development.

Cytokines and T-Lymphocute count in patients in the acute and chronic phases of Bartonella bacilliformis infection in an endemic area in peru: a pilot study

Human Bartonellosis has an acute phase characterized by fever and hemolytic anemia, and a chronic phase with bacillary angiomatosis-like lesions. This cross-sectional pilot study evaluated the immunology patterns using pre- and post-treatment samples in patients with Human Bartonellosis. Patients between five and 60 years of age, from endemic areas in Peru, in the acute or chronic phases were included. In patients in the acute phase of Bartonellosis a state of immune peripheral tolerance should be established for persistence of the infection. Our findings were that elevation of the anti-inflammatory cytokine IL-10 and numeric abnormalities of CD4+ and CD8+ T-Lymphocyte counts correlated significantly with an unfavorable immune state. During the chronic phase, the elevated levels of IFN-γ and IL-4 observed in our series correlated with previous findings of endothelial invasion of B. henselae in animal models.

New strategies to detect and understand genotype-by-environment interactions and QTL-by-environment interactions

Dissertação para obtenção do Grau de Doutor em Estatística e Gestão do Risco, especialidade em Estatística

Prevalence of discordant immunologic and virologic responses in patients with AIDS under antiretroviral therapy in a specialized care center in Brazil

Some patients under antiretroviral therapy (ART) do not reach immune recovery when the viral load becomes undetectable. This is called discordant immunologic and virologic responses. Its prevalence varies between 8% and 24%. This study describes its prevalence and the characteristics of the affected subjects in the outpatient clinic of a Brazilian specialized-care center. Of 934 patients on ART, 536 had undetectable viral loads. Prevalence was 51/536 or 9% (95% confidence interval: 6.6% to 11.4%). Median age at the beginning of ART was 37 years (interquartile range - IQR: 31 to 45). Male gender and mixed race predominated (76.5% and 47.1% respectively). AIDS-defining illnesses were absent at the beginning of ART in 60.8%. Fifty-one percent were taking protease inhibitors, 43.2% Efavirenz and 5.8% both. Median time on ART was 36 months (IQR: 17-81 months). Irregular treatment was recorded for 21.6%. ART had been modified for 63% prior to the study, and 15.7% had used monotherapy or double therapy. Median CD4 count was 255 cells/mm³ (IQR: 200-284). Median viral load before ART was 4.7 log10 copies/mL (IQR: 4.5-5.2). Discordant responders were not different from AIDS patients in general, but there was a high frequency of multiple schedules of treatment.

MOLECULAR INVESTIGATION OF HEMOTROPIC MYCOPLASMAS IN HUMAN BEINGS, DOGS AND HORSES IN A RURAL SETTLEMENT IN SOUTHERN BRAZIL

SUMMARY The aims of this study were to determine the prevalence of hemoplasmas in a rural Brazilian settlement's population of human beings, their dogs and horses, highly exposed to tick bites; to identify the tick species parasitizing dogs and horses, and analyze factors associated with their infection. Blood samples from 132 dogs, 16 horses and 100 humans were screened using a pan-hemoplasma SYBR green real-time PCR assay followed by a species-specific TaqMan real-time PCR. A total of 59/132 (44.7%) dog samples were positive for hemoplasmas (21 Mycoplasma haemocanisalone, 12 ' Candidatus Mycoplasma haematoparvum' alone and 21 both). Only 1/100 (1.0%) human sample was positive by qPCR SYBR green, with no successful amplification of 16S rRNA or 23 rRNA genes despite multiple attempts. All horse samples were negative. Dogs >1 year of age were more likely to be positive for hemoplasmas ( p= 0.0014). In conclusion, although canine hemoplasma infection was highly prevalent, cross-species hemoplasma transmission was not observed, and therefore may not frequently occur despite overexposure of agents and vectors.

American Society of Anesthesiologists Score: Still Useful After 60 Years? Results of the EuSOS Study

OBJECTIVE: The European Surgical Outcomes Study described mortality following in-patient surgery. Several factors were identified that were able to predict poor outcomes in a multivariate analysis. These included age, procedure urgency, severity and type and the American Association of Anaesthesia score. This study describes in greater detail the relationship between the American Association of Anaesthesia score and postoperative mortality. METHODS: Patients in this 7-day cohort study were enrolled in April 2011. Consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery with a recorded American Association of Anaesthesia score in 498 hospitals across 28 European nations were included and followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Decision tree analysis with the CHAID (SPSS) system was used to delineate nodes associated with mortality. RESULTS: The study enrolled 46,539 patients. Due to missing values, 873 patients were excluded, resulting in the analysis of 45,666 patients. Increasing American Association of Anaesthesia scores were associated with increased admission rates to intensive care and higher mortality rates. Despite a progressive relationship with mortality, discrimination was poor, with an area under the ROC curve of 0.658 (95% CI 0.642 - 0.6775). Using regression trees (CHAID), we identified four discrete American Association of Anaesthesia nodes associated with mortality, with American Association of Anaesthesia 1 and American Association of Anaesthesia 2 compressed into the same node. CONCLUSION: The American Association of Anaesthesia score can be used to determine higher risk groups of surgical patients, but clinicians cannot use the score to discriminate between grades 1 and 2. Overall, the discriminatory power of the model was less than acceptable for widespread use.

O biofeedback cinemático na realização de exercícios escápulo-torácicos

RESUMO: O Biofeedback cinemático na realização de exercícios escápulo-torácicos Patrícia Ribeiro; Ricardo Matias Desenho do estudo: Estudo quantitativo, experimental, prospetivo de fator único. Objetivos: Determinar a efetividade do biofeedback cinemático tridimensional (3D) em tempo real, como informação de retorno extrínseca, no reconhecimento da zona neutra da omoplata, em indivíduos saudáveis; medir o desempenho temporal, através do tempo que os sujeitos demoram a atingir a posição pretendida, e o desempenho no percurso, através da diferença entre o percurso efetuado e aquele que seria o percurso mais curto, sem Informação de Retorno Extrínseca (IRE), com Informação de Retorno Extrínseca clinica verbal e palpatória (IRE-VP) e com informação de retorno extrínseca visual cinemática (IRE-VC). Enquadramento: Reconhecer aquela que deve ser a posição adequada da omoplata e tomar consciência da importância dessa posição para a estabilidade e correto funcionamento da articulação gleno-umeral é uma tarefa difícil, pois a grande maioria do indivíduos não têm os conhecimentos necessários. É reconhecido o contributo que a IRE tem na reaprendizagem motora, em especial na primeira fase da aprendizagem motora – a consciencialização. Vários estudos se têm debruçado em avaliar a influencia da IRE na reabilitação de indivíduos com disfunção do ombro, tendo-se limitado ao formato electromiográfico. No sentido de encontrar novas estratégias para facilitar o processo de reaprendizagem motora nestes indivíduos, foi escolhido biofeedback cinemático tridimensional. Métodos: Participaram no estudo 60 sujeitos, sem queixas de dor no ombro, com idades compreendidas entre os 18 e os 54 anos, com um valor médio de 21,66 anos (±5.89), divididos aleatoriamente em três grupos com uma tarefa comum: o reconhecimento da zona neutra da omoplata. Um grupo não recebeu qualquer tipo de IRE - Grupo Controlo (GC), outro grupo recebeu IRE-VP e outro recebeu IRE-VC. Para efeitos de análise da performance foram consideradas duas variáveis: tempo e qualidade da execução. A abordagem estatística destas variáveis consistiu numa análise de variância simples e num teste de comparações múltiplas. Resultados: Observámos que o grupo controlo e o grupo IRE-VC efetuaram a tarefa pedida em menos tempo que o grupo IRE-VP (p<0.01) e que o grupo IRE-VC obteve melhores resultados no que respeita à qualidade da execução da tarefa do que o GC e o grupo IRE-VP (p<0.01). Conclusão: Pelos resultados obtidos, na tarefa de reconhecimento da zona neutra da omoplata, podemos concluir que o biofeedback cinemático é mais efetivo na facilitação da obtenção de melhor qualidade de execução da tarefa do que o feedback clinico ou a inexistência de feedback e igualmente efetivo à inexistência de IRE no que respeita ao tempo demorado a reconhecer essa posição. -------------- ABSTRACT:Study Design: Single factor experimental design. Objectives: To determine the effectiveness of real time cinematic biofeedback as extrinsic information in the recognition of the neutral zone of the scapula in healthy subjects; to measure the temporal performance and quality of the execution without extrinsic feedback, with clinical feedback and with cinematic feedback. Background: To recognize the proper scapula position and to be aware of the importance of this position to the stability and correct function of the gleno-umeral joint is a difficult task, because most people don’t have the necessary knowledge. It is known that extrinsic feedback is effective in motor learning, specially in the early stages. There are several studies that evaluated the influence of extrinsic feedback in rehabilitation of shoulder dysfunctions, but only in the electromyography format. Material and Methods: Sixty healthy subjects were randomly divided into 3 groups that received no feedback (group 1 – control group), verbal and palpatory feedback (group 2) and real time cinematic feedback (group 3). The performance variables considered – time and quality of execution - were statistically analyzed with ANOVA one-way and multiple comparisons test. Results: Control group and group 3 executed the task in less time that group 2 (p<0.01) and group 3 executed the task with better quality than control group and group 2 (p<0.01). Conclusions: From the results of this study we conclude that in the studied task, the cinematic feedback is more effective to facilitate a better quality of execution than no feedback or clinical feedback and, regarding to time taken to attain the requested position, equally effective to no feedback.

Attachment style impacts behavior and early oculomotor response to positive, but not negative, pictures

The present study investigated whether oculomotor behavior is influenced by attachment styles. The Relationship Scales Questionnaire was used to assess attachment styles of forty-eight voluntary university students and to classify them into attachment groups (secure, preoccupied, fearful, and dismissing). Eye-tracking was recorded while participants engaged in a 3-seconds free visual exploration of stimuli presenting either a positive or a negative picture together with a neutral picture, all depicting social interactions. The task consisted in identifying whether the two pictures depicted the same emotion. Results showed that the processing of negative pictures was impermeable to attachment style, while the processing of positive pictures was significantly influenced by individual differences in insecure attachment. The groups highly avoidant regarding to attachment (dismissing and fearful) showed reduced accuracy, suggesting a higher threshold for recognizing positive emotions compared to the secure group. The groups with higher attachment anxiety (preoccupied and fearful) showed differences in automatic capture of attention, in particular an increased delay preceding the first fixation to a picture of positive emotional valence. Despite lenient statistical thresholds induced by the limited sample size of some groups (p < 0.05 uncorrected for multiple comparisons), the current findings suggest that the processing of positive emotions is affected by attachment styles. These results are discussed within a broader evolutionary framework.

Cerebral perfusion and automated individual analysis using SPECT among an obsessive-compulsive population

OBJECTIVE: To make individual assessments using automated quantification methodology in order to screen for perfusion abnormalities in cerebral SPECT examinations among a sample of subjects with OCD. METHODS: Statistical parametric mapping (SPM) was used to compare 26 brain SPECT images from patients with OCD individually with an image bank of 32 normal subjects, using the statistical threshold of p < 0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). The maps were analyzed, and regions presenting voxels that remained above this threshold were sought. RESULTS: Six patients from a sample of 26 OCD images showed abnormalities at cluster or voxel level, considering the criteria described above, which represented 23.07%. However, seven images from the normal group of 32 were also indicated as cases of perfusional abnormality, representing 21.8% of the sample. CONCLUSION: The automated quantification method was not considered to be a useful tool for clinical practice, for analyses complementary to visual inspection.

Minu, Startu and all that:- Pitfalls in estimating the sensitivity of a worker’s wage to aggregate unemployment

In this paper we show that the inclusion of unemployment-tenure interaction variates in Mincer wage equations is subject to serious pitfalls. These variates were designed to test whether or not the sensitivity to the business cycle of a worker’s wage varies according to her tenure. We show that three canonical variates used in the literature - the minimum unemployment rate during a worker’s time at the firm(min u), the unemployment rate at the start of her tenure(Su) and the current unemployment rate interacted with a new hire dummy(δu) - can all be significant and "correctly" signed even when each worker in the firm receives the same wage, regardless of tenure (equal treatment). In matched data the problem can be resolved by the inclusion in the panel of firm-year interaction dummies. In unmatched data where this is not possible, we propose a solution for min u and Su based on Solon, Barsky and Parker’s(1994) two step method. This method is sub-optimal because it ignores a large amount of cross tenure variation in average wages and is only valid when the scaled covariances of firm wages and firm employment are acyclical. Unfortunately δu cannot be identified in unmatched data because a differential wage response to unemployment of new hires and incumbents will appear under both equal treatment and unequal treatment.

(No)competition in the Spanish retailing gasoline market: a variance filter approach

Various methodologies in economic literature have been used to analyse the international hydrocarbon retail sector. Nevertheless at a Spanish level these studies are much more recent and most conclude that generally there is no effective competition present in this market, regardless of the approach used. In this paper, in order to analyse the price levels in the Spanish petrol market, our starting hypothesis is that in uncompetitive markets the prices are higher and the standard deviation is lower. We use weekly retail petrol price data from the ten biggest Spanish cities, and apply Markov chains to fill the missing values for petrol 95 and diesel, and we also employ a variance filter. We conclude that this market demonstrates reduced price dispersion, regardless of brand or city.

Sub-cortical and brainstem sites associated with chemo-stimulated increases in ventilation in humans.

We investigated the neural basis for spontaneous chemo-stimulated increases in ventilation in awake, healthy humans. Blood oxygen level dependent (BOLD) functional MRI was performed in nine healthy subjects using T2 weighted echo planar imaging. Brain volumes (52 transverse slices, cortex to high spinal cord) were acquired every 3.9 s. The 30 min paradigm consisted of six, 5-min cycles, each cycle comprising 45 s of hypoxic-isocapnia, 45 s of isooxic-hypercapnia and 45 s of hypoxic-hypercapnia, with 55 s of non-stimulatory hyperoxic-isocapnia (control) separating each stimulus period. Ventilation was significantly (p<0.001) increased during hypoxic-isocapnia, isooxic-hypercapnia and hypoxic-hypercapnia (17.0, 13.8, 24.9 L/min respectively) vs. control (8.4 L/min) and was associated with significant (p<0.05, corrected for multiple comparisons) signal increases within a bilateral network that included the basal ganglia, thalamus, red nucleus, cerebellum, parietal cortex, cingulate and superior mid pons. The neuroanatomical structures identified provide evidence for the spontaneous control of breathing to be mediated by higher brain centres, as well as respiratory nuclei in the brainstem.

Parasites in rodent coprolites from the historical archaeological site Alero Mazquiarán, Chubut Province, Argentina

The aim of this study was to examine the parasitic remains that were found in rodent coprolites collected from the archaeological site Alero Mazquiarán (Chubut Province, 45º44'15"S, 70°25'9"W), which is assigned to the interface of the Araucanian and Tehuelche cultures, dated at 212 ± 35 years B.P. The faecal material from two unidentified rodent species (X-10 and X-11) was collected from one human pelvic cavity found in a multiple burial. The faecal samples were processed and examined using paleoparasitological procedures. The X-10 coprolites were positive for eggs of Monoecocestus sp. (Cestoda: Anoplocephalidae) and the X-11 faeces were positive for Pterygodermatites sp. (Nematoda: Rictulariidae), Trichosomoides sp. (Nematoda: Trichosomoididae) and Monoecocestus sp. In this study, we discuss parasitic life cycles, the zoonotic importance of parasites and the behaviour of the aboriginal people.

Compositional Data Analysis with R

R from http://www.r-project.org/ is ‘GNU S’ – a language and environment for statistical computingand graphics. The environment in which many classical and modern statistical techniques havebeen implemented, but many are supplied as packages. There are 8 standard packages and many moreare available through the cran family of Internet sites http://cran.r-project.org .We started to develop a library of functions in R to support the analysis of mixtures and our goal isa MixeR package for compositional data analysis that provides support foroperations on compositions: perturbation and power multiplication, subcomposition with or withoutresiduals, centering of the data, computing Aitchison’s, Euclidean, Bhattacharyya distances,compositional Kullback-Leibler divergence etc.graphical presentation of compositions in ternary diagrams and tetrahedrons with additional features:barycenter, geometric mean of the data set, the percentiles lines, marking and coloring ofsubsets of the data set, theirs geometric means, notation of individual data in the set . . .dealing with zeros and missing values in compositional data sets with R procedures for simpleand multiplicative replacement strategy,the time series analysis of compositional data.We’ll present the current status of MixeR development and illustrate its use on selected data sets