Study of the Discriminative Validity of the PHQ-9 and PHQ-2 in a Sample of Brazilian Women in the Context of Primary Health Care

PURPOSE. This study aimed to assess the discriminative validity of the Brazilian version of the Patient Health Questionnaire (PHQ-9) and of its reduced version (PHQ-2). DESIGN AND METHODS. The sample consisted of 177 women (60 cases of depression and 117 noncases). The SCID-IV was used as the gold standard. FINDINGS. For the PHQ-9, a cutoff score equal to or higher than 10 proved to be the most adequate for the screening of depression, whereas the best cutoff score for the PHQ-2 was found to lie between 3 and 4. PRACTICE IMPLICATIONS. The systematic use of these instruments in nursing and in the context of primary health care could favor the early detection of depression.

Evaluation of distances between the mandibular teeth and the alveolar process in Brazilians with normal occlusion

Introduction: The aims of this study were to evaluate the distances between the mandibular permanent teeth and the alveolar process in Brazilians with normal occlusion and to compare them with normal American values. Methods: We used 59 mandibular casts from untreated subjects who had permanent dentition and the 6 keys to normal occlusion. A computer program was used to calculate the distances between the dental reference points and the alveolar process for each tooth. The mean values were then compared to the normal values by applying the Student t test at a significance level of 0.05. Results: The results showed a progressive increase of these distances from the anterior region (incisors) to the posterior region (molars), from 0.00 to 2.49 mm. All measurements had statistically significant differences from the American sample, except for the values for canines and first premolars. Conclusions: Brazilians with normal occlusion have more lingual crown positions for the incisors, second premolars, and molars compared with Americans with normal occlusion. Although these findings were statistically significant, they are unlikely to be clinically significant. (Am J Orthod Dentofacial Orthop 2010; 137: 308.e1-308.e4)

Interests and Values in Obama's foreign Policy: Leading from Behind?

Abstract This study will exam the relative importance of values and interests in Obama's foreign policy, focusing on crucial cases: the military actions related to Afghanistan, Iraq, Libya, Non-Syria, Al-Qaeda and ISIL. We will argue that his "leading from behind" strategy is not very distant from the foreign and defense strategies of his post-Cold War predecessors, by which democracy is seen as an assurance to security. According to Obama's strategy, Americans will only provide support for the building of democracy in the target countries, while this task should be performed by the locals themselves. Americans will provide military training to the new governments as well so they can be responsible for their own security, including preventing regrouping of terrorists in their soil. If Obama opposes the imposing of democracy by the use of force, empirical data shows that his administration is "not prepared to accept" any option that threats US security or American liberal-democratic values, bringing in this way values and interests very close to each other.

COMPARATIVE ANALYSIS OF AMERICAN AND SPANISH CRUISE PASSENGERS' BEHAVIORAL INTENTIONS

ABSTRACT Earlier studies of cross-national differences in consumer behavior in different consumption sectors have verified that cultural differences have a strong influence on consumers. Despite the importance of cross-national analysis, no studies in the literature examine the moderating effects of nationality on the construction of behavioral intentions and their antecedents among cruise line passengers. This study investigates the moderating effects of nationality on the relationships between perceived value, satisfaction, trust and behavioral intentions among Spanish and (U.S.) American passengers of cruise lines that use Barcelona as home port and port-of-call. A theoretical model was tested with a total of 968 surveys. Structural equation models (SEMs) were used, by means of a multigroup analysis. Results of this study indicated that Spaniards showed stronger relationships between trust and behavioral intentions, and between emotional value and satisfaction. Americans presented stronger relationships between service quality and satisfaction, and between service quality and behavioral intentions.

Current trends in the global tourism industry: evidence from the United States

Tourism is one of the largest U.S. industries, serving millions of international and domestic tourists yearly. Tourists visit the U.S. to see natural wonders, cities, historic landmarks, and entertainment venues. Americans seek similar attractions as well as recreation and vacation areas. Tourism competes in the global market, so it is important to understand current trends in the U.S. travel industry. Therefore, this article offers insight into important trends and suggests strategies for policy makers involved in the travel and tourism industry.

Representations of Portugal in Herman Hesse

The aim of my research is to answer the question: How is Portugal seen by non-Portuguese fictionists? The main reason why I chose this research line is the following: Portuguese essayists like Eduardo Lourenço and José Gil (2005) focus their attention on the image or representation of Portugal as conceived by the Portuguese; indeed there is a tendency in Portuguese cultural studies (and, to a certain extent, also in Portuguese philosophical studies) to focus on studying the so-called ‗portugalidade‘ (portugueseness), i.e., the essence of being Portuguese. In my view, the problem with the studies I have been referring to is that everything is self-referential, and if ‗portugueseness‘ is an issue, then it might be useful, when dealing with it, to separate subject from object of observation. That is the reason why we, in the CEI (Centro de Estudos Interculturais), decided to start this research line, which is an inversion in the current tendency of the studies about ‗portugueseness‘: instead of studying the image or representation of Portugal by the Portuguese, my task is to study the image or representation of Portugal by the non-Portuguese, in this case, in non-Portuguese fiction. For the present paper I selected three writers of the 20th century: the German Hermann Hesse and the North-Americans Philip Roth and Paul Auster

Obama's law : analysis of a breakthrough law on healthcare access and lessons for the Portuguese health system management

ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for “the core principle that everybody should have some basic security when it comes to their health care”. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures. The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed. The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.

Chagas disease in the State of Amazonas: history, epidemiological evolution, risks of endemicity and future perspectives

Chagas disease (CD) is a parasitic infection that originated in the Americas and is caused by Trypanosoma cruzi. In the last few years, the disease has spread to countries in North America, Asia and Europe due to the migration of Latin Americans. In the Brazilian Amazon, CD has an endemic transmission, especially in the Rio Negro region, where an occupational hazard was described for piaçaveiros (piassaba gatherers). In the State of Amazonas, the first chagasic infection was reported in 1977, and the first acute CD case was recorded in 1980. After initiatives to integrate acute CD diagnostics with the malaria laboratories network, reports of acute CD cases have increased. Most of these cases are associated with oral transmission by the consumption of contaminated food. Chronic cases have also been diagnosed, mostly in the indeterminate form. These cases were detected by serological surveys in cardiologic outpatient clinics and during blood donor screening. Considering that the control mechanisms adopted in Brazil's classic transmission areas are not fully applicable in the Amazon, it is important to understand the disease behavior in this region, both in the acute and chronic cases. Therefore, the pursuit of control measures for the Amazon region should be a priority given that CD represents a challenge to preserving the way of life of the Amazon's inhabitants.

Brazilian norms for the International Affective Picture System (IAPS): comparison of the affective ratings for new stimuli between Brazilian and North-American subjects

OBJECTIVE: The study presents the Brazilian norms for 240 new stimuli from International Affective Picture System (IAPS), a database of affective images widely used in research, compared to the North-American normative ratings. METHODS: The participants were 448 Brazilian university students from several courses (269 women and 179 men) with mean age of 24.2 (SD = 7.8), that evaluated the IAPS pictures in the valence, arousal and dominance dimensions by the Self-Assessment Manikin (SAM) scales. Data were compared across the populations by Pearson linear correlation and Student's t-tests. RESULTS: Correlations were highly significant for all dimensions; however, Brazilians' averages for arousal were higher than North-Americans'. CONCLUSIONS: The results show stability in relation to the first part of the Brazilian standardization and they are also consistent with the North-American standards, despite minor differences relating to interpretation of the arousal dimension, demonstrating that IAPS is a reliable instrument for experimental studies in the Brazilian population.

Nobel Prizes: Contributions to Cardiology

The Nobel Prize was created by Alfred Nobel. The first prize was awarded in 1901 and Emil Adolf von Behring was the first laureate in medicine due to his research in diphtheria serum. Regarding cardiology, Nobel Prize’s history permits a global comprehension of progress in pathophysiology, diagnosis and therapeutics of various cardiac diseases in last 120 years. The objective of this study was to review the major scientific discoveries contemplated by Nobel Prizes that contributed to cardiology. In addition, we also hypothesized why Carlos Chagas, one of our most important scientists, did not win the prize in two occasions. We carried out a non-systematic review of Nobel Prize winners, selecting the main studies relevant to heart diseaseamong the laureates. In the period between 1901 and 2013, 204 researches and 104 prizes were awarded in Nobel Prize, of which 16 (15%) studies were important for cardiovascular area. There were 33 (16%) laureates, and two (6%) were women. Fourteen (42%) were American, 15 (45%) Europeans and four (13%) were from other countries. There was only one winner born in Brazil, Peter Medawar, whose career was all in England. Reviewing the history of the Nobel Prize in physiology or medicine area made possible to identify which researchers and studies had contributed to advances in the diagnosis, prevention and treatment of cardiovascular diseases. Most winners were North Americans and Europeans, and male.

Població i família als Andes en el temps de la colònia: parroquia de Toacazo, Cotopaxi, Equador (s. XVIII-XIX )

Estudi elaborat a partir d’una estada a la Facultad Latinoamericana de Ciencias Sociales, durant l’ octubre del 2006. L’estudi de les haciendas creades a partir de la colonització espanyola als territoris americans no pot ser mai complet si no es pot entrar en la vida quotidiana de les persones que les constitueixen. La millor manera de fer-ho és a través d’assolir d’un exhaustiu estudi dels comportaments demogràfics –natalitat, nupcialitat, mortalitat, migracions—i familiars. L’objectiu d’aquest estudi ha estat localitzar una tipologia documental que permeti aquest treball a la parròquia de Toacazo a Cotopaxi (Equador) i, un cop assolida aquesta fita, fotografiar exhaustivament els registres parroquials, altrament dits registre civil antic. El període treballat va des de l’ 1720, any de fundació de la parròquia fins a 1857, any on s’acaba el tributo de indios o règim que regulava les normes de segregació racial de les poblacions.

Contribution to the geology of Thailand and implications for the geodynamic evolution of Southeast Asia

Abstract The purpose of this study is to unravel the geodynamic evolution of Thailand and, from that, to extend the interpretation to the rest of Southeast Asia. The methodology was based in a first time on fieldwork in Northern Thailand and Southernmost Myanmar, using a multidisciplinary approach, and then on the compilation and re-interpretation, in a plate tectonics point of view, of existing data about the whole Southeast Asia. The main results concern the Nan-Uttaradit suture, the Chiang Mai Volcanic Belt and the proposition of a new location for the Palaeotethys suture. This led to the establishment of a new plate tectonic model for the geodynamic evolution of Southeast Asia, implying the existence new terranes (Orang Laut and the redefinition of Shan-Thai) and the role of the Palaeopacific Ocean in the tectonic development of the area. The model proposed here considers the Palaeotethys suture as located along the Tertiary Mae Yuam Fault, which represents the divide between the Cimmerian Sibumasu terrane and the Indochina-derived Shan-Thai block. The term Shan-Thai, previously used to define the Cimmerian area (when the Palaeotethys suture was thought to represented by the Nan-Uttaradit suture), was redefined here by keeping its geographical location within the Shan States of Myanmar and Central-Northern Thailand, but attributing it an East Asian Origin. Its detachment from Indochina was the result of the Early Permian opening of the Nan basin. The Nan basin closed during the Middle Triassic, before the deposition of Carnian-Norian molasse. The modalities of the closure of the basin imply a first phase of Middle Permian obduction, followed by final eastwards subduction. The Chiang Mai Volcanic Belt consists of scattered basaltic rocks erupted at least during the Viséan in an extensional continental intraplate setting, on the Shan-Thai part of the Indochina block. The Viséan age was established by the dating of limestone stratigraphically overlying the basalts. In several localities of the East Asian Continent, coeval extensional features occur, possibly implying one or more Early Carboniferous extensional events at a regional scale. These events occurred either due to the presence of a mantle plume or to the roll-back of the Palaeopacific Ocean, subducting beneath Indochina and South China, or both. The Palaeopacific Ocean is responsible, during the Early Permian, for the opening of the Song Ma and Poko back-arcs (Vietnam) with the consequent detachment of the Orang Laut Terranes (Eastern Vietnam, West Sumatra, Kalimantan, Palawan, Taiwan). The Late Triassic/Early Jurassic closure of the Eastern Palaeotethys is considered as having taken place by subduction beneath its southern margin (Gondwana), due to the absence of Late Palaeozoic arc magmatism on its northern (Indochinese) margin and the presence of volcanism on the Cimmerian blocks (Mergui, Lhasa). Résumé Le but de cette étude est d'éclaircir l'évolution géodynamique de la Thaïlande et, à partir de cela, d'étendre l'interprétation au reste de l'Asie du Sud-Est. La méthodologie utilisée est basée dans un premier temps sur du travail de terrain en Thaïlande du nord et dans l'extrême sud du Myanmar, en se basant sur une approche pluridisciplinaire. Dans un deuxième temps, la compilation et la réinterprétation de données préexistantes sur l'Asie du Sud-est la été faite, dans une optique basée sur la tectonique des plaques. Les principaux résultats de ce travail concernent la suture de Nan-Uttaradit, la « Chiang Mai Volcanic Belt» et la proposition d'une nouvelle localité pour la suture de la Paléotethys. Ceci a conduit à l'établissement d'un nouveau modèle pour l'évolution géodynamique de l'Asie du Sud-est, impliquant l'existence de nouveaux terranes (Orang Laut et Shan-Thai redéfini) et le rôle joué par le Paléopacifique dans le développement tectonique de la région. Le modèle présenté ici considère que la suture de la Paléotethys est située le long de la faille Tertiaire de Mae Yuam, qui représente la séparation entre le terrain Cimmérien de Sibumasu et le bloc de Shan-Thai, d'origine Indochinoise. Le terme Shan-Thai, anciennement utilise pour définir le bloc Cimmérien (quand la suture de la Paléotethys était considérée être représentée par la suture de Nan-Uttaradit), a été redéfini ici en maintenant sa localisation géographique dans les états Shan du Myanmar et la Thaïlande nord-centrale, mais en lui attribuant une origine Est Asiatique. Son détachement de l'Indochine est le résultat de l'ouverture du basin de Nan au Permien Inférieur. Le basin de Nan s'est fermé pendant le Trias Moyen, avant le dépôt de molasse Carnienne-Norienne. Les modalités de fermeture du basin invoquent une première phase d'obduction au Permien Moyen, suivie par une subduction finale vers l'est. La "Chiang Mai Volcanic Belt" consiste en des basaltes éparpillés qui ont mis en place au moins pendant le Viséen dans un contexte extensif intraplaque continental sur la partie de l'Indochine correspondant au bloc de Shan-Thai. L'âge Viséen a été établi sur la base de la datation de calcaires qui surmontent stratigraphiquement les basaltes. Dans plusieurs localités du continent Est Asiatique, des preuves d'extension plus ou moins contemporaines ont été retrouvées, ce qui implique l'existence d'une ou plusieurs phases d'extension au Carbonifère Inférieur a une échelle régionale. Ces événements sont attribués soit à la présence d'un plume mantellique, ou au rollback du Paléopacifique, qui subductait sous l'Indochine et la Chine Sud, soit les deux. Pendant le Permien inférieur, le Paléopacifique est responsable pour l'ouverture des basins d'arrière arc de Song Ma et Poko (Vietnam), induisant le détachement des Orang Laut Terranes (Est Vietnam, Ouest Sumatra, Kalimantan, Palawan, Taiwan). La fermeture de la Paléotethys Orientale au Trias Supérieur/Jurassique Inférieur est considérée avoir eu lieu par subduction sous sa marge méridionale (Gondwana), à cause de l'absence de magmatisme d'arc sur sa marge nord (Indochinoise) et de la présence de volcanisme sur les blocs Cimmériens de Lhassa et Sibumasu (Mergui). Résumé large public L'histoire géologique de l'Asie du Sud-est depuis environ 430 millions d'années a été déterminée par les collisions successives de plusieurs continents les uns avec les autres. Il y a environ 430 millions d'années, au Silurien, un grand continent appelé Gondwana, a commencé à se «déchirer» sous l'effet des contraintes tectoniques qui le tiraient. Cette extension a provoqué la rupture du continent et l'ouverture d'un grand océan, appelé Paléotethys, éloignant les deux parties désormais séparées. C'est ainsi que le continent Est Asiatique, composé d'une partie de la Chine actuelle, de la Thaïlande, du Myanmar, de Sumatra, du Vietnam et de Bornéo a été entraîné avec le bord (marge) nord de la Paléotethys, qui s'ouvrait petit à petit. Durant le Carbonifère Supérieur, il y a environ 300 millions d'années, le sud du Gondwana subissait une glaciation, comme en témoigne le dépôt de sédiments glaciaires dans les couches de cet âge. Au même moment le continent Est Asiatique se trouvait à des latitudes tropicales ou équatoriales, ce qui permettait le dépôt de calcaires contenant différents fossiles de foraminifères d'eau chaude et de coraux. Durant le Permien Inférieur, il y a environ 295 millions d'années, la Paléotethys Orientale, qui était un relativement vieil océan avec une croûte froide et lourde, se refermait. La croûte océanique a commencé à s'enfoncer, au sud, sous le Gondwana. C'est ce que l'on appelle la subduction. Ainsi, le Gondwana s'est retrouvé en position de plaque supérieure, par rapport à la Paléotethys qui, elle, était en plaque inférieure. La plaque inférieure en subductant a commencé à reculer. Comme elle ne pouvait pas se désolidariser de la plaque supérieure, en reculant elle l'a tirée. C'est le phénomène du «roll-back ». Cette traction a eu pour effet de déchirer une nouvelle fois le Gondwana, ce qui a résulté en la création d'un nouvel Océan, la Neotethys. Cet Océan en s'ouvrant a déplacé une longue bande continentale que l'on appelle les blocs Cimmériens. La Paléotethys était donc en train de se fermer, la Neotethys de s'ouvrir, et entre deux les blocs Cimmériens se rapprochaient du Continent Est Asiatique. Pendant ce temps, le continent Est Asiatique était aussi soumis à des tensions tectoniques. L'Océan Paléopacifique, à l'est de celui-ci, était aussi en train de subducter. Cette subduction, par roll-back, a déchiré le continent en détachant une ligne de microcontinents appelés ici « Orang Laut Terranes », séparés du continent par deux océans d'arrière arc : Song Ma et Poko. Ceux-ci sont composés de Taiwan, Palawan, Bornéo ouest, Vietnam oriental, et la partie occidentale de Sumatra. Un autre Océan s'est ouvert pratiquement au même moment dans le continent Est Asiatique : l'Océan de Nan qui, en s'ouvrant, a détaché un microcontinent appelé Shan-Thai. La fermeture de l'Océan de Nan, il y a environ 230 millions d'années a resolidarisé Shan-Thai et le continent Est Asiatique et la trace de cet événement est aujourd'hui enregistrée dans la suture (la cicatrice de l'Océan) de Nan-Uttaradit. La cause de l'ouverture de l'Océan de Nan peut soit être due à la subduction du Paléopacifique, soit aux fait que la subduction de la Paléotethys tirait le continent Est Asiatique par le phénomène du « slab-pull », soit aux deux. La subduction du Paléopacifique avait déjà crée de l'extension dans le continent Est Asiatique durant le Carbonifère Inférieur (il y a environ 340-350 millions d'années) en créant des bassins et du volcanisme, aujourd'hui enregistré en différents endroits du continent, dont la ceinture volcanique de Chiang Mai, étudiée ici. A la fin du Trias, la Paléotethys se refermait complètement, et le bloc Cimmérien de Sibumasu entrait en collision avec le continent Est Asiatique. Comme c'est souvent le cas avec les grands océans, il n'y a pas de suture proprement dite, avec des fragments de croûte océanique, pour témoigner de cet évènement. Celui-ci est visible grâce à la différence entre les sédiments du Carbonifère Supérieur et du Permieñ Inférieur de chaque domaine : dans le domaine Cimmérien ils sont de type glaciaire alors que dans le continent Est Asiatique ils témoignent d'un climat tropical. Les océans de Song Ma et Poko se sont aussi refermés au Trias, mais eux ont laissé des sutures visibles

Hispanic population in the USA: the opportunity to create a shared brand

El tema d’aquest treball de recerca ha nascut gràcies a l’experiència viscuda a Carolina del Sud (EEUU) com estudiant i treballador. És un fet que la població hispana als Estats Units és cada cop mes important, el que ha provocat un canvi en la mentalitat de les empreses del lloc. S’han adonat que no és suficient amb seguir l’estratègia de comunicació que tenien anteriorment, i ara han de fer mes cas a un nou públic objectiu. Saber com han de fer-ho es la fita d’aquest treball.

The History of Rome in Painting

There are many paths to reach Rome, immense field open to the eye through the centuries and days, where the presence of the story is haunting. All the artists came to Rome: Italians of various Italian and also French, Dutch, Flemish, Spanish, English and Americans. These painters whose works tell its long history for having lived in the glare of light forever are the Roman pantheon of arts: what are all the anonymous authors of the frescoes of ancient Rome and medieval, but Fabriano, Cimabue , Giotto, Botticelli, Raphael, Giulio Romano, Michelangelo, Caravaggio, Guido Reni, Guercino, Titian, Vasari, Velasquez, Le Nain, Poussin, Zuccari, Van Wittel, Eckersberg, Giraudet, David, Panini, Hubert Robert, Reynolds, Fuseli, Ingres, Sargent, Caffi, Vernet, Turner, Corot, Caffi, De Chirico, etc..

Health and income: a robust comparison of Canada and the US

This paper uses sequential stochastic dominance procedures to compare the joint distribution of health and income across space and time. It is the First application of which we are aware of methods to compare multidimensional distributions of income and health using procedures that are robust to aggregation techniques. The paper's approach is more general than comparisons of health gradients and does not require the estimation of health equivalent incomes. We illustrate the approach by contrasting Canada and the US using comparable data. Canada dominates the US over the lower bidimensional welfare distribution of health and income, though not generally in terms of the uni-dimensional distribution of health or income. The paper also finds that welfare for both Canadians and Americans has not unambiguously improved during the last decade over the joint distribution of income and health, in spite of the fact that the uni-dimensional distributions of income have clearly improved during that period.