Estudo das diferenças de género nas cognições antecipatórias, estratégias de coping e depressão em adultos

RESUMO: A presente dissertação tem o objectivo de estudar a relação das diferenças de género nas cognições antecipatórias, estratégias de coping e depressão. Para o efeito, constituiu-se duas amostras, uma de indivíduos do género feminino (n=224) de 57,9% (com uma média de idades de 36,2 e um DP=10,5), e outra por indivíduos do género masculino (n=163), perfazendo uma percentagem de 42,1% (com uma média de idades de 41,1 e um DP=12,5). Foi elaborado um protocolo de investigação composto por: Questionário de dados sócio-demográficos, Questionário de Cognições Antecipatórias (QCA), de Figueira & Ramos, 1995, o Questionário de Modos de Lidar com os Acontecimentos (QMLA), de J. Pais Ribeiro, C. Santos, 2001 e o Inventário de Avaliação Clínica da Depressão (IACLIDE), de A, Vaz Serra, 1995. Os resultados demonstraram que não existem diferenças estatisticamente significativas entre géneros nas cognições antecipatórias (p=0,594). Em relação às estratégias de coping, os resultados foram estatisticamente significativos, com as mulheres a recorrerem mais à procura de suporte social (p=0,042) e à fuga-evitamento (p=0,006). O índice de depressão mostra, de forma estatisticamente significativa, que o género feminino apresenta valores mais elevados (p=0,038). A escala de depressão permitiu ainda verificar de forma estatisticamente significativa que as mulheres revelam mais dificuldades no desempenho das tarefas associadas a queixas biológicas e cognitivas (p=0,003), tal como nas dimensões biológica (p=0,002) e de desempenho da tarefa (p=0,007). A relação entre as três variáveis, permite concluir que o índice global da escala de depressão está relacionado positivamente com as Cognições Antecipatórias (p=,000), e nas estratégias de coping, as dimensões fuga-evitamento (p=,002), resolução planeada do problema (p=,000) e a reavaliação positiva (p=,034) também estão relacionadas com esta escala da depressão de forma estatisticamente significativa. ABSTRACT: This dissertation aims to study the relationship of gender differences in anticipatory cognitions, coping strategies and depression. For this purpose, it was constituted two samples, one for female gender (n = 224) 57.9% (with a mean age of 36.2 and a SD=10.5), and other of male gender (n = 163), giving a percentage of 42.1% (with an average age of 41.1 and a SD=12.5). It was prepared a research protocol composed of data questionnaire included social-demographic, Anticipatory Cognitions Questionnaire (QCA), Figueira & Ramos, 1995, the Ways of Coping Questionnaire (WCQ), J. Pais Ribeiro, C. Santos, 2001, and the Inventory and Evaluation of Clinical Depression (IACLIDE) A, Vaz Serra, 1995. The results have shown no statistically significant differences between genders in anticipatory cognitions (p= 0.594). In the coping strategies, the results were statistically significant, with women looking to take more advantage of social support (p= 0.042) and escape-avoidance (p= 0.006). The rate of depression shows a statistically significant with females having higher values (p=0.038). The depression scale allowed us to verify statistically significant that women shows more difficulty in performing tasks associated with biological and cognitive complaints (p=0,003), as in the biological (p=0,002) and task performance (p=0,007). The relationship between the three variables, shows that the overall rate of depression scale is positively related to the Anticipatory Cognitions (p =, 000), and strategies for coping, escape-avoidance dimensions (p =, 002), resolution of the planned problem (p =, 000) and positive reappraisal (p =, 034) are also related to the scale of depression and were also statistically significant.

The influence of geometric factors on the wall shear stress distribution in realistic human coronary arteries

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para a obtenção do grau de Mestre em Engenharia Biomédica. A presente dissertação foi desenvolvida no Erasmus Medical Center em Roterdão, Holanda

A importância da política regional comunitária para o desenvolvimento de Portugal e da Irlanda: uma comparação

Dissertação de mestrado Universidade do Minho

Qual o erro da angiografia na definição de isquemia miocárdica durante intervenções coronarianas percutâneas?

FUNDAMENTO: A angiografia vem sendo utilizada como padrão de referência para definição de doença arterial coronariana (DAC), embora suas limitações sejam conhecidas. O valor da medida do fluxo fracionado de reserva do miocárdio (FFR) na avaliação da DAC está bem estabelecido. OBJETIVO: O objetivo deste estudo é avaliar a acurácia da angiografia em definir as lesões isquêmicas e sua correlação com o FFR. MÉTODOS: Duzentos e cinqüenta pacientes foram incluídos no estudo (471 vasos). Todas as estenoses > 50% pela estimativa visual da angiografia (EVA) foram avaliadas medindo-se o FFR. Se o FFR <0,75 a lesão foi tratada, se o FFR >0,75 a lesão não foi tratada. As lesões foram divididas em moderadas (<70% - 327) e graves (125) pela QCA. Foram determinados o coeficiente de correlação entre o grau de estenose (%DE), o FFR e a acurácia da EVA em definir se uma lesão era ou não isquêmica. RESULTADOS: Foi possível obter o FFR em 96% das lesões. %DE e FFR médios de 56±8% e 0,74 e 76±6% e 0,48 para as lesões moderadas e graves respectivamente. Notou-se pobre correlação entre o %DE e o FFR, especialmente nas lesões moderadas (Spearman rho = - 0.33, p<0,0001). A acurácia da EVA comparada com FFR foi de 57% e 96% nas lesões moderadas versus graves. CONCLUSÃO: A angiografia coronária não é adequada para avaliar a importância funcional das lesões coronarianas, sendo necessário associá-la a um método funcional capaz de fazê-lo, especialmente nas lesões moderadas.

Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block

Abstract Background: Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). Objective: To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis ≥ 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy. Methods: Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution’s ethics committee. Results: The patients’ mean age was 62 ± 10 years. The mean dose of radiation for the tomography protocol was 9.3 ± 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001). Conclusion: The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB.

Assessment of coronary stenosis, plaque burden and remodeling by multidetector computed tomography in patients referred for suspected coronary artery disease.

Aims To compare multidetector computed tomography (MDCT) with intravascular ultrasound (IVUS) and invasive quantitative coronary angiography (QCA) for assessment of coronary lesions in patients referred for suspected coronary artery disease (CAD). Methods and results We studied 57 patients (48 men; mean age: 63 +/- 10 years) who underwent 64-slice MDCT because of atypical chest pain, stable angina, or ECG abnormalities and were diagnosed with CAD. All patients subsequently underwent QCA and IVUS. We analyzed 102 coronary lesions using the three techniques. Measurements of luminal area stenosis and cross-sectional area by MDCT (72.9 +/- 7.0% and 4.5 +/- 1.8 mm(2), respectively) were in good agreement with those by IVUS [72.7 +/- 6.7% and 4.5 +/- 1.6 mm(2), respectively; Lin's concordance correlation coefficient r = 0.847; 95% confidence interval (CI) = 0.792-0.902 and r = 0.931; 95% CI = 0.906-0.956, respectively] but not QCA (r = 0.115; 95% CI = 0.040-0.189 and r = 0.433; 95% CI = 0.291-0.576, respectively). Plaque cross-sectional area and plaque volume measured by MDCT (12.4 +/- 3.8 mm(2) and 104.7 +/- 52.8 mu l, respectively) were in good agreement with those by IVUS (12.2 +/- 3.7 mm(2) and 102.8 +/- 54.1 mu l; r = 0.913; 95% CI = 0.880-0.945 and r = 0.979; 95% CI = 0.969-0.990, respectively). Remodeling index measurements by MDCT (1.22 +/- 0.22) were in good agreement with those by IVUS (r = 0.876; 95% CI = 0.831-0.922). Positive remodeling occurred in 63% of stenoses. Conclusion MDCT allows accurate noninvasive assessment of coronary stenosis, plaque burden and remodeling in patients referred for suspected CAD. Positive remodeling is a frequent finding in stable lesions. J Cardiovasc Med 12:122-130 (C) 2011 Italian Federation of Cardiology.

Estruturas de governança interna e a capacidade de inovação em pequenas firmas brasileiras de torrefação e moagem de café

Na pesquisa relatada neste artigo são investigadas quais as combinações de estruturas de governança interna (mercado, burocrática e comunitária) que possibilitam mais capacidade de inovação de produto nas pequenas firmas. Neste estudo, inspirado nos trabalhos de Grandori e Furnari (2008; 2010), tem-se como hipótese que a capacidade de inovação ocorre de modo mais consistente nas firmas que adotam uma estrutura de governança interna multimodal. Essa hipótese foi testada por meio de um survey com 80 indústrias brasileiras de torrefação e moagem de café(1). Para encontrar as combinações de estruturas, foi utilizada a análise comparativa qualitativa (QCA) no software fs/QCA versão 2.0 (RAGIN, 2008). Como resultado, verificou-se que a estrutura de governança interna multimodal - que combina práticas de incentivos monetários, burocráticas e comunitárias - apresentou resultados mais consistentes para a inovação das pequenas firmas de torrefação. Esses resultados, ao permitirem identificar os requisitos organizacionais que produzem mais possibilidades de inovação, podem ajudar a traçar ações de políticas públicas e privadas para as empresas brasileiras, de modo a melhorar sua taxa de inovação e a competitividade em seus mercados.

Avaliação nutricional de lactentes hospitalizados

Investigou-se a evolução ponderal, conforme o valor das quotas calóricas de dietas prescritas (QCP) e aceitas (QCA) de lactentes internados por diarréia ou broncopnemonia no Instituto Materno Infantil de Pernambuco, Brasil. A proporção de crianças que ganharam ou não ganharam peso foi avaliada em função das QCP E QCA que atingiram as quotas calóricas ideais (QCI) durante o internamento, verificando-se que 46% das crianças perderam ou mantiveram o peso nos dois primeiros dias. Houve maior freqüência de ganho de peso associado às QCP e QCA que atingiram as QCI, bem como entre as crianças amamentadas. Concluiu-se existir deficiente evolução ponderal relacionada às baixas quotas calóricas oferecidas ou aceitas durante a hospitalização.

Myocardial flow reserve by Rb-82 cardiac PET improves the selection of patients eligible for invasive coronary angiography

Aim: We asked whether myocardial flow reserve (MFR) by Rb-82 cardiac PET improve the selection of patients eligible for invasive coronary angiography (ICA). Material and Methods: We enrolled 26 consecutive patients with suspected or known coronary artery disease who performed dynamic Rb-82 PET/CT and (ICA) within 60 days; 4 patients who underwent revascularization or had any cardiovascular events between PET and ICA were excluded. Myocardial blood flow at rest (rMBF), at stress with adenosine (sMBF) and myocardial flow reserve (MFR=sMBF/rMBF) were estimated using the 1-compartment Lortie model (FlowQuant) for each coronary arteries territories. Stenosis severity was assessed using computer-based automated edge detection (QCA). MFR was divided in 3 groups: G1:MFR<1.5, G2:1.5≤MFR<2 and G3:2≤MFR. Stenosis severity was graded as non-significant (<50% or FFR ≥0.8), intermediate (50%≤stenosis<70%) and severe (≥70%). Correlation between MFR and percentage of stenosis were assessed using a non-parametric Spearman test. Results: In G1 (44 vessels), 17 vessels (39%) had a severe stenosis, 11 (25%) an intermediate one, and 16 (36%) no significant stenosis. In G2 (13 vessels), 2 (15%) vessels presented a severe stenosis, 7 (54%) an intermediate one, and 4 (31%) no significant stenosis. In G3 (9 vessels), 0 vessel presented a severe stenosis, 1 (11%) an intermediate one, and 8 (89%) no significant stenosis. Of note, among 11 patients with 3-vessel low MFR<1.5 (G1), 9/11 (82%) had at least one severe stenosis and 2/11 (18%) had at least one intermediate stenosis. There was a significant inverse correlation between stenosis severity and MFR among all 66 territories analyzed (rho= -0.38, p=0.002). Conclusion: Patients with MFR>2 could avoid ICA. Low MFR (G1, G2) on a vessel-based analysis seems to be a poor predictor of severe stenosis severity. Patients with 3-vessel low MFR would benefit from ICA as they are likely to present a significant stenosis in at least one vessel.

Does gender really matter in cathlab

Purpose: Results of some PCI clinical trials indicated more procedure related complications and worse clinical outcomes in women than men, but due to a lower representation of female patients this question still remains open. We aimed toinvestigate characteristics and early and late clinical outcomes in female patients as compared to male when treated in a real life setting with a new generation DES.Methods: Among 3069 consecutive patients treated with Nobori DES, and enrolled in NOBORI 2 study, 675 were female. The primary endpoint of the study is target lesion failure (TLF), a composite of cardiac death, MI and target lesion revascularization (TLR) at 12 months. Data are entered in an electronic database; all adverse events are adjudicated by an independent clinical event committee and independent corelabs analyse all angiograms.Results: Compared to male patients, female patients were significantly older (68±10 vs ± 63±11 years; p<0.001), had higher incidence of diabetes (37% vs 27%; p<0.001) and hypertension (75% vs 66%; p<0.001), but lower frequency of previous MI, PCI/CABG and smoking history. Lesion characteristics were similar in two genders, except for lesions located at bifurcation which were more frequent inmale patients (22% vs 15% inmale and female patients respectively; p<0.001). Majority of QCA assessed parameters were similar with the exception for RVD, post-procedure MLD in-segment and %DS in-stent which were significantly lower in female patients (p<0.05 for all). In table 1 results at 6 months follow-up are presented and at the time of presentation 1 year results will be available. Table 1. Clinical results at 6 months follow-up Male (n=2394) Female (n=675) P value Cardiac Death 12 (0.5%) 5 (0.7%) 0.5550 MI 5 (2.1%) 4 (1.3%) 0.5089 TLR rate 17 (0.7%) 13 (1.9%) 0.0124 TLF rate 44 (1.8%) 17 (2.5%) 0.2745 Stent Thrombosis 12 (0.5%) 6 (0.9%) 0.2548Conclusions: Results indicate that there are differences in the demographics and risk factors in female and male patient's population. The frequency of adverse events at 6 months is low in both populations, showing trend toward slightly higher rate in female patients, particularly for target lesion revascularization.

Modeling and manufacturability assessment of bistable quantum-dot cells

We have investigated the behavior of bistable cells made up of four quantum dots and occupied by two electrons, in the presence of realistic confinement potentials produced by depletion gates on top of a GaAs/AlGaAs heterostructure. Such a cell represents the basic building block for logic architectures based on the concept of quantum cellular automata (QCA) and of ground state computation, which have been proposed as an alternative to traditional transistor-based logic circuits. We have focused on the robustness of the operation of such cells with respect to asymmetries derived from fabrication tolerances. We have developed a two-dimensional model for the calculation of the electron density in a driven cell in response to the polarization state of a driver cell. Our method is based on the one-shot configuration-interaction technique, adapted from molecular chemistry. From the results of our simulations, we conclude that an implementation of QCA logic based on simple ¿hole arrays¿ is not feasible, because of the extreme sensitivity to fabrication tolerances. As an alternative, we propose cells defined by multiple gates, where geometrical asymmetries can be compensated for by adjusting the bias voltages. Even though not immediately applicable to the implementation of logic gates and not suitable for large scale integration, the proposed cell layout should allow an experimental demonstration of a chain of QCA cells.

Vertaileva tutkimus Yhdistyneen Kuningaskunnan afrikkalaisten alusmaiden sosiaaliturvan tasosta

Tässä pro gradu -tutkielmassa tutkitaan kvalitatiivista vertailevaa analyysia käyttäen seitsemäntoista Yhdistyneen Kuningaskunnan alusmaan sosiaaliturvajärjestelmän tasoa. Tavoitteena oli selvittää, vaikuttaako isäntämaan antama taloudellinen tuki sosiaaliturvajärjestelmän kehittymisessä Tutkimus vastaa tutkimuskentän tarpeeseen kehitysmaiden järjestelmäkehityksen ja rahoituskanavien yhteyden tarkastelulle. Tutkimuksessa esitellään lyhyesti sosiaalipolitiikan ja sosiaaliturvajärjestelmätutkimuksen historiallista kehitystä, alan teorioita sekä viimeaikaista Afrikan sosiaaliturvajärjestelmiä koskevaa tutkimusta ja kansainvälisiä kehitysaputoimijoita. Tilastoaineistojen vertailussa hyödynnetään Charles Raginin kvalitatiivisen vertailevan analyysin keinoja (Qualitative Comparative Analysis, QCA). Maiden vertailussa selitettävinä tekijöinä ovat alusmaiden sosiaaliturvan taso ja köyhyysindeksi. Selittävinä tekijöinä ovat maan pääuskonto, naisten lukutaito, bruttokansantuote, vastaanotetun kehitysavun määrä ja yhteiskunnan vakausindeksi. Tutkimuksen perusteella voidaan todeta, että käytettyjen indikaattorien ja QCA-menetelmän osalta kehitysavun ja alusmaan sosiaaliturvajärjestelmän tason yhteyttä ei pystytä osoittamaan. Näyttäisi kuitenkin siltä että selittävistä tekijöistä naisten lukutaidolla, yhteiskunnan vakaudella sekä bruttokansantuotteella on suotuisa vaikutus maan sosiaaliturvan tasoon. Tutkimuksen kohdentaminen tarkemmin yksittäisten maiden historiaan ja nykytilanteeseen olisi seuraava luonnollinen tutkimuskohde.

Vertaileva tutkimus yhdistyneen kuningaskunnan afrikkalaisten alusmaiden sosiaaliturvan tasosta

Tässä pro gradu -tutkielmassa tutkitaan kvalitatiivista vertailevaa analyysia käyttäen seitsemäntoista Yhdistyneen Kuningaskunnan alusmaan sosiaaliturvajärjestelmän tasoa. Tavoitteena oli selvittää, vaikuttaako isäntämaan antama taloudellinen tuki sosiaaliturvajärjestelmän kehittymisessä Tutkimus vastaa tutkimuskentän tarpeeseen kehitysmaiden järjestelmäkehityksen ja rahoituskanavien yhteyden tarkastelulle. Tutkimuksessa esitellään lyhyesti sosiaalipolitiikan ja sosiaaliturvajärjestelmätutkimuksen historiallista kehitystä, alan teorioita sekä viimeaikaista Afrikan sosiaaliturvajärjestelmiä koskevaa tutkimusta ja kansainvälisiä kehitysaputoimijoita. Tilastoaineistojen vertailussa hyödynnetään Charles Raginin kvalitatiivisen vertailevan analyysin keinoja (Qualitative Comparative Analysis, QCA). Maiden vertailussa selitettävinä tekijöinä ovat alusmaiden sosiaaliturvan taso ja köyhyysindeksi. Selittävinä tekijöinä ovat maan pääuskonto, naisten lukutaito, bruttokansantuote, vastaanotetun kehitysavun määrä ja yhteiskunnan vakausindeksi. Tutkimuksen perusteella voidaan todeta, että käytettyjen indikaattorien ja QCA-menetelmän osalta kehitysavun ja alusmaan sosiaaliturvajärjestelmän tason yhteyttä ei pystytä osoittamaan. Näyttäisi kuitenkin siltä että selittävistä tekijöistä naisten lukutaidolla, yhteiskunnan vakaudella sekä bruttokansantuotteella on suotuisa vaikutus maan sosiaaliturvan tasoon. Tutkimuksen kohdentaminen tarkemmin yksittäisten maiden historiaan ja nykytilanteeseen olisi seuraava luonnollinen tutkimuskohde.

Étude rétrospective évaluant le VEGF comme biomarqueur d’athérosclérose mesurée par coronarographie quantitative et ultrason intra-vasculaire

Introduction : Puisque le VEGF promeut l’inflammation et la néovascularisation des plaques athérosclérotiques, il pourrait contribuer à l’athérogénèse. Cependant, les données cliniques tentant de lier le VEGF à la maladie cardiaque athérosclérotique (MCAS) sont controversées. Nous avons investigué l’association entre les niveaux de VEGF et la sévérité de la MCAS. Méthode : Nous avons effectué une étude rétrospective transversale : 56 patients présentant une MCAS stable et 112 patients avec un syndrome coronarien aigue (SCA) ont été étudiés. Nous avons investigué la relation entre la charge athérosclérotique et les niveaux sériques de VEGF en utilisant la coronarographie par analyse quantitative (QCA) et avons évalué la morphologie des plaques athérosclérotiques en utilisant l’imagerie intravasculaire ultrasonore (IVUS). Résultats : Les niveaux de VEGF étaient plus bas chez les patients avec SCA que chez ceux avec MCAS stable. On observe une corrélation positive entre les niveaux de VEGF et le fardeau de la MCAS stable mesurée par le QCA Cumulative Coronary Stenosis Score - CCSS (Pearson r= 0,423 et p = 0,001). En analyse multivariée, les niveaux sériques de VEGF demeuraient prédicteurs du CCSS (p=0,003) des patients avec une MCAS stable. Nous avons observé une corrélation positive entre les niveaux de VEGF et le volume de plaque (Spearman r = 0.381, p = 0.035) ainsi que le pourcentage de volume d’athérome (Spearman r = 0.466, p = 0.008) mesurés par IVUS. Conclusions : Notre étude suggère un usage potentiel des niveaux sérique de VEGF comme biomarqueur de MCAS.

Geog 1.Teacher's book.

Este recurso para el profesor ha sido escrito para que coincida con el programa nacional de estudios de la etapa clave tres (KS3) , y el plan de trabajo de QCA. Proporciona material de apoyo para el libro de texto. Está organizado de la forma siguiente: respuestas para su turno y otros ejercicios. Actividades fotocopiables en hojas de diferentes niveles. Ideas para el aprendizaje activo. Referencias TIC incluyendo páginas webs útiles.