Depressive symptoms and harmful alcohol use in hepatitis C patients: prevalence and correlates

Introduction It is important to understand the characteristics and vulnerabilities of people who have hepatitis C because this disease is currently an important public health problem. The objective of this study was to estimate the prevalence of depressive symptoms and harmful alcohol use in patients with hepatitis C and to study the association between these outcomes and demographic, psychosocial and clinical variables. Methods This cross-sectional, descriptive and analytical study involved 82 hepatitis C patients who were being treated with pegylated interferon and ribavirin at a public university hospital. The primary assessments used in the study were the Alcohol Use Disorders Identification Test and the Beck Depression Inventory. Bivariate analyses were followed by logistic regression. Results The prevalence of depressive symptoms was 30.5% (n=25), and that of harmful alcohol use was 34.2% (n=28). Logistic regression analysis showed that individuals who were dissatisfied with their social support (OR=4.41; CI=1.00-19.33) and were unemployed (OR=6.31; CI=1.44-27.70) were at a higher risk for depressive symptoms, whereas harmful alcohol use was associated with the male sex (OR=6.78; CI=1.38-33.19) and the use of illicit substances (OR=7.42; CI=1.12-49.00). Conclusions High prevalence rates of depressive symptoms and harmful alcohol use were verified, indicating vulnerabilities that must be properly monitored and treated to reduce emotional suffering in this population.

A saúde mental global, a depressão, a ansiedade e os comportamentos de risco nos estudantes do ensino superior : estudo de prevalência e correlação

RESUMO: A saúde mental é influenciada pelos comportamentos tanto como estes são influenciados pela saúde mental. Por isso é importante compreender quer a saúde mental quer os comportamentos adoptados pelo indivíduo em qualquer momento do seu ciclo vital para melhor poder actuar quando e sempre que necessário. Nos estudantes universitários, não sendo uma população de risco, a saúde mental e os comportamentos de risco afectam não só o próprio estudante e quem com ele convive mas também as próprias instituições que o acolhem. O presente estudo teve como objectivos: nos estudantes universitários 1) caracterizar a saúde mental global; 2) caracterizar os níveis de sintomatologia depressiva e ansiosa; 3) identificar os padrões de comportamentos de risco; 4) analisar a relação entre saúde mental global, depressão, ansiedade e comportamentos de risco. Para tal realizou-se um estudo quantitativo, descritivo, correlacional, transversal e exploratório com 1968 estudantes do 1º ciclo da Universidade da Beira Interior e dos Institutos Politécnicos da Guarda, Castelo Branco e Portalegre. Foram utilizados como instrumentos de investigação uma ficha de Caracterização Socio-Demográfica; o Mental Health Inventory-5; o Patient Health Questionnaire-9; Generalized Anxiety Disorder-7; e o Questionário de Comportamentos de Risco em Estudantes Universitários. Os principais resultados mostraram que 18,3% (n=360) apresentavam saúde mental negativa; 17,7% sintomatologia depressiva moderada a severa; 15,6% sintomatologia ansiosa moderada a severa; e que apenas 15% dos que apresentavam saúde mental global negativa recorreu a ajuda profissional. As mulheres, os alunos de 1ª e 4º ano, e os alunos dos cursos de Artes e Letras apresentavam níveis de saúde mental global inferiores. O Consumo de álcool foi superior nos homens, nos estudantes das áreas de Ciências e Ciências da Saúde e nos estudantes deslocados. Os estudantes com mais de 3 unidades curriculares em atraso apresentavam maior sintomatologia depressiva e ansiosa. Os resultados mostraram ainda que quanto mais positiva a saúde mental global maior o consumo de bebidas alcoólicas e menor a sintomatologia depressiva e ansiosa. As variáveis Curso e Sexo influenciam significativamente a saúde mental global, a depressão e a ansiedade. Apesar de a maioria dos estudantes inquiridos não revelar problemas de saúde mental nem apresentar comportamentos de risco, as principais conclusões apontam para a necessidade de programas de educação para a saúde assim como de programas de literacia de saúde mental para as instituições poderem identificar precocemente as situações problemáticas e ajudar os próprios estudantes a reconhecer em si o sofrimento psicológico e a necessidade de procurar apoio profissional.---------------------------------- ABSTRACT: Mental health is influenced by behaviours as much as behaviours are influenced by mental health. Thus, it is important to understand not only the mental health but also the behaviours adopted by an individual at any stage of its vital cycle in order to accurately intervene whenever and always deemed necessary. Regarding college students, despite not being deemed as a population at risk, mental health and risk behaviours affect not only the student itself and whoever interacts with him but also the institutions that host them. The main purposes of this study were regarding college students 1) characterize the overall mental health; 2) characterize the levels of depression and anxiety symptoms; 3) identify the risk behaviours patterns; and 4) analyse the relation between overall mental health, depression, anxiety and risk behaviours. With that scope a quantitative, descriptive, correlated, transversal and exploratory study has been conducted with 1968 students of the 1st cycle of the University of Beira Interior and of the Polytechnic Institutions of Guarda, Castelo Branco and Portalegre. The investigation instruments used were a chart of Socio-Demographic Characterization; the Mental Health Inventory-5; the Patient Health Questionnaire-9; the Generalized Anxiety Disorder-7; and one Questionnaire of Risk Behaviours in College Students. The main results showed that 18.3% (n=360) revealed negative mental health; 17.7% moderated to severe depression symptoms; 15.6% moderated to severe anxiety symptoms; and that only 15% of those revealing negative overall mental health have seek for professional help. Females, students of the 1st and 4th years and students of the Artes and Letras courses revealed inferior levels of overall mental health. Alcohol consumption is higher in males, in the Sciences and Health Sciences’ students and on displaced students. Students with more than 3 curricular units in delay revealed higher depression and anxiety symptoms. The results also showed that the more positive overall mental health the higher alcohol consumption and the lower depression and anxiety symptoms. The Course and Sex variations significantly influence the overall mental health, the depression and the anxiety. Although the majority of the enquired students did not reveal mental health issues or present risk behaviours, the main conclusions indicate the need to implement health education and mental health literacy programmes in order to enable the institutions to prematurely identify problematic situations and help students to recognize the psychological suffering and the need to seek for professional help.

The stigma and prejudice of leprosy: influence on the human condition

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

Low blood glucose levels and other complications during growth hormone supplementation in sepsis

Blood glucose levels in the high normal range or even moderate hyperglycemia is the expected profile in septic postoperative patients receiving high-calorie enteral alimentation. The addition of growth hormone as an anabolic agent should additionally reinforce this tendency. In a cancer patient undergoing partial gastrectomy with lymphadenectomy and suffering from postoperative subphrenic abscess and prolonged sepsis, tube feeding (38.3 kcal/kg/day) and growth hormone (0.17 IU/kg/day) were simultaneously administered for 25 days. Blood glucose levels were in the lower limits of the normal range before growth hormone introduction, and continued with a similar tendency during most of the therapeutic period. Two additional complications, namely heart arrest and peripheral edema, were documented during the same period. It is concluded that sepsis was the most likely mechanism for low glucose values, and that high-calorie enteral diet and growth hormone supplementation did not prevent that result. It is uncertain whether heart arrest was due to the drug, but its association with peripheral edema is well documented in clinical series.

Primary biliary cirrhosis and myopathy: an uncommon association

Primary biliary cirrhosis (PBC) is a cholestatic liver disease, which is characterized by a chronic inflammatory destruction of intrahepatic bile ducts. It is a rare disorder whose precise etiology is still to be elucidated. Even though the liver is the principal target of PBC, other organ systems also might be affected. Muscular involvement has rarely been described in this disease, and in the majority of cases, muscular weakness has been interpreted as polymyositis. We report the case of a 48-year-old woman suffering from classic PBC, in association with a myopathy whose histological features are distinct from the cases reported before. We also performed a MEDLINE research for PBC and concomitant muscular diseases.

The consumption of beauty products on famale young adults in Portugal. Recommenrations for the brand Lancôme to improve its store trafic

This project aims to explore the Portuguese Beauty and Cosmetics market, and to discuss the usage and purchase behaviour of young female adults, between 18 and 26 years old. After a market analysis based on secondary data, it evaluates the results of qualitative and quantitative research based on 9 interviews and 126 online questionnaires to explore the consumers’ reasoning when choosing products from this category – fragrances, skin care or make-up – as well as their attitude towards brands, with a special focus on the premium cosmetics brand Lancôme. Contrary to our expectations there was no statistically significant positive influence of the online touchpoints within this age segment’s purchase intention. However, results indicate that Lancôme is already being perceived by some as young and modern, but is still suffering the threat of Mass Market brands that are valued by this target, mainly due to a price sensitivity towards premium beauty brands.

Promoting sustainability as a strategy to mitigate the effects of economic downturn on the construction industry

During the recent years followed by the Global Financial Crisis (GFC), most of business and industries around the globe have been hardly hit to the limit that it still struggling to survive, suffering from the crisis financial consequences. For instance, in the construction industry; many construction projects have been suspended or totally cancelled. Nevertheless, among this dilemma, a call has been raised to use the sustainable practices to mitigate the effects of the GFC on construction industry. For the first look, it seems that there is contradiction since the sustainable solutions are often associated with an increase in the initial cost, undoubtedly, the sustainable practices have many advantages in both economic and environment aspects, however, the question which needs to be addressed here is, to what extent using such sustainable practices can mitigate the negative effects of the economic downturn on construction industry. Therefore, it is a challenging argument for using such sustainable construction from its economic perspective, however, this paper is aiming to present the economical benefits of sustainable practices in construction industry, and trying to clear the doubt of the high initial costs of the sustainable construction through studying the life cycle benefit of green building.

Assistive locomotion strategies for active lower limb devices

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Eletrónica Médica)

Postpartum depression in Recife - Brazil: prevalence and association with bio-socio-demographic factors

OBJECTIVE:To use a semi-structured interview to detect depression in postpartum women according to the criteria proposed by the DSM in child health care clinics in the city of Recife, together with the proper association of this disorder to bio-socio-demographic data. METHODS: The study used a cross-section method and contained a convenience sample of 400 women that were between 2 and 26 weeks of postpartum in child health care clinics. A bio-socio-demographic questionnaire and the Portuguese version of the Structured Clinical Interview for DSM-IV Axis I Disorders were used. RESULTS: Twenty nine of the mothers (7.2%) were diagnosed as suffering from postpartum depression. Women with a past history of psychiatric disorders, a family history of psychiatric disorder and some sort of clinical complication presented a higher prevalence of depression. The same happened to those with a past history of spontaneous abortion, those who had a transpelvic birth and those over 8 weeks of puerperium. CONCLUSION: The rate of postpartum depression in this sample, 7.2%, was lower than that reported by other Brazilian studies. It probably occurred because the other researchers used screening scales to assess this estimate instead of a clinical interview.

A prevenção de Lesões por Esforço Repetitivo (LER) nas aulas de saxofone

Relatório de estágio de mestrado em Ensino de Música

Application of receptive music therapy in internal medicine and cardiology

OBJECTIVE: To investigate the effects of receptive music therapy in clinical practice. METHODS: Receptive music therapy was individually applied via musical auditions, including five stages: musical stimulation, sensation, situation, reflection, and behavioral alteration. Following anamnesis and obtainment of consent, patients answered a first questionnaire on health risk evaluation (Q1), and after participating in 16 weekly music therapy sessions, answered a second one (Q2). RESULTS: Two men and 8 women, aged above 18 years, referred to us due to symptoms of stress, emotional suffering, and the need to change lifestyles (health risk behavior) were studied between August 1998 and December 1999. Comparison between answers to Q1 and Q2, showed a trend (P=0.059) for reduction of ingestion of cholesterol-rich foods and for increased prospects in life with a tendency towards improvement, and also of increased intake of fiber-rich food (55.6%), increased levels of personal satisfaction (44.5%), and decreased levels of stress (66.7%). CONCLUSION: The study demonstrated decreased stress levels and increased personal satisfaction, higher consumption of fiber-rich food, lower cholesterol intake, and a better perspective on life, suggesting that receptive music therapy may be applied in clinical practice as an auxiliary therapeutic intervention for the treatment of behavioral health risks.

Avaliação de desempenho das organizações desportivas sem fins lucrativos através do Balanced Scorecard : estudo de caso do Conselho de Arbitragem da Federação Portuguesa de Futebol

A realização deste estudo junta duas áreas distintas: a arbitragem de futsal e o Balanced Scorecard (BSC). Nos últimos anos, devido ao crescimento acentuado da modalidade de Futsal, a mesma tem sido alvo de várias mudanças, nomeadamente no número de competições realizadas ao longo de uma época desportiva. Inerente ao elevado nível de competitividade alcançado, surge a necessidade de melhorar a gestão de uma área fundamental do jogo de futsal, a arbitragem. A arbitragem de futsal a nível nacional é gerida pelo Conselho de Arbitragem da Federação Portuguesa de Futebol (FPF). O Balanced Scorecard é uma metodologia de gestão estratégica, desenvolvida por Robert Kaplan e David Norton em 1992, que pode ser aplicada quer em organizações com fins lucrativos quer em organizações sem fins lucrativos, como é o caso do Conselho de Arbitragem da FPF. Desta forma, para colmatar a necessidade de melhorar a gestão da arbitragem de futsal, o presente estudo propõem-se aplicar a metodologia Balanced Scorecar ao Conselho de Arbitragem da Federação Portuguesa de Futebol na vertente futsal. Assim, irá ser apresentada uma análise do ambiente externo e interno, a definição de posicionamento e planeamento estratégico, o mapa estratégico e os objetivos definidos para cada perspetiva. Por fim, será feita uma reflexão quanto ao problema e aos objetivos do estudo, bem como, uma apresentação de algumas recomendações para futuros estudos.

Meta-Analysis of Ultrafiltration versus Diuretics Treatment Option for Overload Volume Reduction in Patients with Acute Decompensated Heart Failure

Introduction: Although diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF), inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF) as an alternative strategy for reducing volume overloads in patients with ADHF. Objective: The aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality) were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome. Results: A total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI): −2.65 to −0.91 kg; p < 0.001) more than those who received standard diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = −0.25 mg/dL; 95% CI: −0.56 to 0.06 mg/dL; p = 0.112). The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64–1.56; p = 0.993). Conclusion: Compared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.

Estudos químico-agrícolas sôbre o enxofre

1. Analyses of soluble sulphates in 2 N ammonium chloride extracts of 24 samples of soils of the state of São Paulo, Brazil, S. A., showed a sulphur content varying from 0,0013 g per 100 g (found in the b layer of a genuine "terra roxa") to 0,007 g per 100 g of soil (b layer of a soil of depression without definite characteristics). (The results are expressed as elemental sulphur). Determinations of total sulphur in 56 samples of soils of the same state using the method of fusion with sodium carbonate and sodium nitrate revealed 0.007 g of elemental S per 100 g of soil as the lowest value (found in several soil types) and 0.096 g as the highest one (found in the b layer of an ar-quean soil). Apparently soluble sulphates accumulate in the upper layers and total sulphur does the opposite. It was found a strong correlation between total S and carbon content. 2. Under laboratory conditions, in a compost of fresh soil, powdered sulphur and apatite, it was verified after a three months period of incubation that the pH value lowered from 6.30 to 3.23; the citric acid solubility of apatite increased to 271.1 per cent of the original one. Lupinus sp. grown in soil manured with sulphur and apatite has showed fresh and dry weights higher than the plants in control pots; the results are significant at 5% level of probability; phosphorus content is also higher in the manured plants. It was observed a net influence of the apatite plus sulphur treatment on the weight of root nodosities that was four times greater than in the control plants. 3. Nearly five hundred determinations of S, N and P were carried out in 35 species of plants cultivated in the state of São Paulo. A great variation in the amounts of these elements was observed. As a general rule, the leaves contain more sulphur than the stems and roots show the lowest percentages. The conjunct roots and stem of guar (Cyamopsis psoraloides) revealed only 0.019 per cent sulphur; the leaves of kale showed the highest sulphur content, i. e., 2.114%. Apparently there is no correlation between the amounts of S, N and P. The ratio S/N increases from 0.006 (guar) to 0.485 (kale). The ratio S/P, always higher than the corresponding S/N, increases from 0.082 (guar) to 6.381 (older leaves of tomato plants). It is interesting to mention that several among the most important crops in the state of São Paulo namely, cotton, rice, coffee and sugar cane contain more sulphur than phosphorus. 4. Tomato plants cultivated in nutrient solution lacking sulphur showed the following visual symptons of deficiency : chlorosis first in the younger leaves and afterwards in all the leaves; anthocyanin pigments in the petioles and stems; absence of fruits; primary roots stunted and secondary ones longer than in the control plants; stems slender, hard, woody. The histological study of petioles suffering from sulphur deficiency revealed anthocyanin in the parenchyme layer instead of clo-rophyll pigments observed in normal petioles; in the chlorotic leaves the large chloroplasts present only the stroma but the small ones have a little amount of green pigments. Chemical analysis revealed in the abnormal plants : less sulphur and an increased proportion of phosphorus; older leaves contain more sulphur and less phosphorus than the younger ones probably due to physiological difficulties in translocation of sulphur bearing material; increased amount of total N attributed to accumulation of nitrates; marked decrease in ash, sugars and starch; increased proportion of crude fiber and dry material. In the plants suffering from sulphur deficiency photosyntetic rate decreased 34 per cent. 5. Tomato plants were succesfully cultivated in nutrient solution in absence of mineral sulphur but in presence of cysteine. The plants absorbed sulphur, under that form and were able to grow up quite well; the fruiting was normal. In this way rested cleary demonstrated the possibility of absorption of organic sulphur without previous mineralization and its utilization in the building up of protein molecules.