Apoptose, microinflamação e expressão de receptores de hidrocarboneto arílico nos folículos pilosos de pacientes com alopecia de padrão feminino

Pós-graduação em Patologia - FMB

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Duke Anticoagulation Satisfaction Scale

Aim. The aim of this study was to evaluate the internal reliability and validity of the BrazilianPortuguese version of Duke Anticoagulation Satisfaction Scale (DASS) among cardiovascular patients. Background. Oral anticoagulation is widely used to prevent and treat thromboembolic events in several conditions, especially in cardiovascular diseases; however, this therapy can induce dissatisfaction and reduce the quality of life. Design. Methodological and cross-sectional research design. Methods. The cultural adaptation of the DASS included the translation and back-translation, discussions with healthcare professionals and patients to ensure conceptual equivalence, semantic evaluation and instrument pretest. The BrazilianPortuguese version of the DASS was tested among subjects followed in a university hospital anticoagulation outpatient clinic. The psychometric properties were assessed by construct validity (convergent, known groups and dimensionality) and internal consistency/reliability (Cronbachs alpha). Results. A total of 180 subjects under oral anticoagulation formed the baseline validation population. DASS total score and SF-36 domain correlations were moderate for General health (r = -0.47, p < 0.01), Vitality (r = -0.44, p < 0.01) and Mental health (r = -0.42, p < 0.01) (convergent). Age and length on oral anticoagulation therapy (in years) were weakly correlated with total DASS score and most of the subscales, except Limitation (r = -0.375, p < 0.01) (Known groups). The Cronbachs alpha coefficient was 0.79 for the total scale, and it ranged from 0.76 (hassles and burdens)0.46 (psychological impact) among the domains, confirming the internal consistency reliability. Conclusions. The BrazilianPortuguese version of the DASS has shown levels of reliability and validity comparable with the original English version. Relevance to clinical practice. Healthcare practitioners and researchers need internationally validated measurement tools to compare outcomes of interventions in clinical management and research tools in oral anticoagulation therapy.

Statistical evaluation of time-dependent metabolite concentrations: estimation of post-mortem intervals based on in situ 1H-MRS of the brain

Knowledge of the time interval from death (post-mortem interval, PMI) has an enormous legal, criminological and psychological impact. Aiming to find an objective method for the determination of PMIs in forensic medicine, 1H-MR spectroscopy (1H-MRS) was used in a sheep head model to follow changes in brain metabolite concentrations after death. Following the characterization of newly observed metabolites (Ith et al., Magn. Reson. Med. 2002; 5: 915-920), the full set of acquired spectra was analyzed statistically to provide a quantitative estimation of PMIs with their respective confidence limits. In a first step, analytical mathematical functions are proposed to describe the time courses of 10 metabolites in the decomposing brain up to 3 weeks post-mortem. Subsequently, the inverted functions are used to predict PMIs based on the measured metabolite concentrations. Individual PMIs calculated from five different metabolites are then pooled, being weighted by their inverse variances. The predicted PMIs from all individual examinations in the sheep model are compared with known true times. In addition, four human cases with forensically estimated PMIs are compared with predictions based on single in situ MRS measurements. Interpretation of the individual sheep examinations gave a good correlation up to 250 h post-mortem, demonstrating that the predicted PMIs are consistent with the data used to generate the model. Comparison of the estimated PMIs with the forensically determined PMIs in the four human cases shows an adequate correlation. Current PMI estimations based on forensic methods typically suffer from uncertainties in the order of days to weeks without mathematically defined confidence information. In turn, a single 1H-MRS measurement of brain tissue in situ results in PMIs with defined and favorable confidence intervals in the range of hours, thus offering a quantitative and objective method for the determination of PMIs.

The VEINES-QOL/Sym questionnaire is a reliable and valid disease-specific quality of life measure for deep vein thrombosis in elderly patients.

PURPOSE To prospectively evaluate the psychometric properties of the Venous Insufficiency Epidemiological and Economic Study (VEINES-QOL/Sym) questionnaire, an instrument to measure disease-specific quality of life and symptoms in elderly patients with deep vein thrombosis (DVT), and to validate a German version of the questionnaire. METHODS In a prospective multicenter cohort study of patients aged ≥ 65 years with acute venous thromboembolism, we used standard psychometric tests and criteria to evaluate the reliability, validity, and responsiveness of the VEINES-QOL/Sym in patients with acute symptomatic DVT. We also performed an exploratory factor analysis. RESULTS Overall, 352 French- and German-speaking patients were enrolled (response rate of 87 %). Both language versions of the VEINES-QOL/Sym showed good acceptability (missing data, floor and ceiling effects), reliability (internal consistency, item-total and inter-item correlations), validity (convergent, discriminant, known-groups differences), and responsiveness to clinical change over time in elderly patients with DVT. The exploratory factor analysis of the VEINES-QOL/Sym suggested three underlying dimensions: limitations in daily activities, DVT-related symptoms, and psychological impact. CONCLUSIONS The VEINES-QOL/Sym questionnaire is a practical, reliable, valid, and responsive instrument to measure quality of life and symptoms in elderly patients with DVT and can be used with confidence in prospective studies to measure outcomes in such patients.

Inestabilidad laboral. Presentación de un modelo empírico acerca de su impacto psicológico

Las investigaciones sobre el impacto que la inestabilidad laboral tiene para los trabajadores presentan la limitación de evaluar las relaciones entre las distintas variables involucradas por separado, sin examinar posibles relaciones de mediación entre ellas. El objetivo de este trabajo es poner a prueba un modelo conceptual sobre las relaciones de mediación entre el malestar debido a inestabilidad laboral y el impacto psicológico, en el marco de la teoría interactiva del estrés por medio de un Análisis de Senderos (Path Análisis). Participaron del estudio 191 trabajadores, con una media de edad de 31 años (DE = 11). Los resultados mostraron que el modelo propuesto inicialmente no se ajustó a los datos. Se exploraron modelos alternativos consistentes con el modelo conceptual original y con la evidencia empírica. Se propone un nuevo modelo de relaciones causales entre las variables, con Malestar debido a la Inestabilidad Laboral como variable independiente, la Tensión y los Recursos Personales como variables intervinientes y el Enojo, la Desesperanza y la Satisfacción como variables dependientes. Se discute la importancia teórica y para la intervención del modelo resultante

Inestabilidad laboral. Presentación de un modelo empírico acerca de su impacto psicológico

Las investigaciones sobre el impacto que la inestabilidad laboral tiene para los trabajadores presentan la limitación de evaluar las relaciones entre las distintas variables involucradas por separado, sin examinar posibles relaciones de mediación entre ellas. El objetivo de este trabajo es poner a prueba un modelo conceptual sobre las relaciones de mediación entre el malestar debido a inestabilidad laboral y el impacto psicológico, en el marco de la teoría interactiva del estrés por medio de un Análisis de Senderos (Path Análisis). Participaron del estudio 191 trabajadores, con una media de edad de 31 años (DE = 11). Los resultados mostraron que el modelo propuesto inicialmente no se ajustó a los datos. Se exploraron modelos alternativos consistentes con el modelo conceptual original y con la evidencia empírica. Se propone un nuevo modelo de relaciones causales entre las variables, con Malestar debido a la Inestabilidad Laboral como variable independiente, la Tensión y los Recursos Personales como variables intervinientes y el Enojo, la Desesperanza y la Satisfacción como variables dependientes. Se discute la importancia teórica y para la intervención del modelo resultante

Inestabilidad laboral. Presentación de un modelo empírico acerca de su impacto psicológico

Las investigaciones sobre el impacto que la inestabilidad laboral tiene para los trabajadores presentan la limitación de evaluar las relaciones entre las distintas variables involucradas por separado, sin examinar posibles relaciones de mediación entre ellas. El objetivo de este trabajo es poner a prueba un modelo conceptual sobre las relaciones de mediación entre el malestar debido a inestabilidad laboral y el impacto psicológico, en el marco de la teoría interactiva del estrés por medio de un Análisis de Senderos (Path Análisis). Participaron del estudio 191 trabajadores, con una media de edad de 31 años (DE = 11). Los resultados mostraron que el modelo propuesto inicialmente no se ajustó a los datos. Se exploraron modelos alternativos consistentes con el modelo conceptual original y con la evidencia empírica. Se propone un nuevo modelo de relaciones causales entre las variables, con Malestar debido a la Inestabilidad Laboral como variable independiente, la Tensión y los Recursos Personales como variables intervinientes y el Enojo, la Desesperanza y la Satisfacción como variables dependientes. Se discute la importancia teórica y para la intervención del modelo resultante

The anatomy of Russian information warfare. The Crimean operation, a case study. OSW Point of View Number 42, May 2014

The Crimean operation has served as an occasion for Russia to demonstrate to the entire world the capabilities and the potential of information warfare. Its goal is to use difficult to detect methods to subordinate the elites and societies in other countries by making use of various kinds of secret and overt channels (secret services, diplomacy and the media), psychological impact, and ideological and political sabotage. Russian politicians and journalists have argued that information battles are necessary for “the Russian/Eurasian civilisation” to counteract “informational aggression from the Atlantic civilisation led by the USA”. This argument from the arsenal of applied geopolitics has been used for years. This text is an attempt to provide an interpretation of information warfare with the background of Russian geopolitical theory and practice.

Age-related striatal BOLD changes without changes in behavioral loss aversion

Loss aversion (LA), the idea that negative valuations have a higher psychological impact than positive ones, is considered an important variable in consumer research. The literature on aging and behavior suggests older individuals may show more LA, although it is not clear if this is an effect of aging in general (as in the continuum from age 20 and 50 years), or of the state of older age (e.g., past age 65 years). We also have not yet identified the potential biological effects of aging on the neural processing of LA. In the current study we used a cohort of subjects with a 30 year range of ages, and performed whole brain functional MRI (fMRI) to examine the ventral striatum/nucleus accumbens (VS/NAc) response during a passive viewing of affective faces with model-based fMRI analysis incorporating behavioral data from a validated approach/avoidance task with the same stimuli. Our a priori focus on the VS/NAc was based on (1) the VS/NAc being a central region for reward/aversion processing; (2) its activation to both positive and negative stimuli; (3) its reported involvement with tracking LA. LA from approach/avoidance to affective faces showed excellent fidelity to published measures of LA. Imaging results were then compared to the behavioral measure of LA using the same affective faces. Although there was no relationship between age and LA, we observed increasing neural differential sensitivity (NDS) of the VS/NAc to avoidance responses (negative valuations) relative to approach responses (positive valuations) with increasing age. These findings suggest that a central region for reward/aversion processing changes with age, and may require more activation to produce the same LA behavior as in younger individuals, consistent with the idea of neural efficiency observed with high IQ individuals showing less brain activation to complete the same task.

Cognitive behaviour therapy for mothers of children with food allergy:a case series

Background: Food allergy affects quality of life in patients and parents and mothers report high levels of anxiety and stress. Cognitive Behaviour Therapy (CBT) may be helpful in reducing the psychological impact of food allergy. The aim of this study was to examine the appropriateness and effectiveness of CBT to improve psychological outcomes in parents of children with food allergy. Methods: Five parents (all mothers) from a local allergy clinic requested to have CBT; six mothers acted as controls and completed questionnaires only. CBT was individual and face-to face and lasted 12 weeks. All participants completed measures of anxiety and depression, worry, stress, general mental health, generic and food allergy specific quality of life at baseline and at 12 weeks. Results: Anxiety, depression and worry in the CBT group significantly reduced and overall mental health and QoL significantly improved from baseline to 12 weeks (all p < 0.05) in mothers in the CBT group; control group scores remained stable. Conclusions: CBT appears to be appropriate and effective in mothers of children with food allergy and a larger randomised control trial now needs to be conducted. Ways in which aspects of CBT can be incorporated into allergy clinic visits need investigation.

Improved estimation of postmortem interval with Cardiac Troponin T and improved analytical methods

Accurate knowledge of the time since death, or postmortem interval (PMI), has enormous legal, criminological, and psychological impact. In this study, an investigation was made to determine whether the relationship between the degradation of the human cardiac structure protein Cardiac Troponin T and PMI could be used as an indicator of time since death, thus providing a rapid, high resolution, sensitive, and automated methodology for the determination of PMI. ^ The use of Cardiac Troponin T (cTnT), a protein found in heart tissue, as a selective marker for cardiac muscle damage has shown great promise in the determination of PMI. An optimized conventional immunoassay method was developed to quantify intact and fragmented cTnT. A small sample of cardiac tissue, which is less affected than other tissues by external factors, was taken, homogenized, extracted with magnetic microparticles, separated by SDS-PAGE, and visualized with Western blot by probing with monoclonal antibody against cTnT. This step was followed by labeling and available scanners. This conventional immunoassay provides a proper detection and quantitation of cTnT protein in cardiac tissue as a complex matrix; however, this method does not provide the analyst with immediate results. Therefore, a competitive separation method using capillary electrophoresis with laser-induced fluorescence (CE-LIF) was developed to study the interaction between human cTnT protein and monoclonal anti-TroponinT antibody. ^ Analysis of the results revealed a linear relationship between the percent of degraded cTnT and the log of the PMI, indicating that intact cTnT could be detected in human heart tissue up to 10 days postmortem at room temperature and beyond two weeks at 4C. The data presented demonstrates that this technique can provide an extended time range during which PMI can be more accurately estimated as compared to currently used methods. The data demonstrates that this technique represents a major advance in time of death determination through a fast and reliable, semi-quantitative measurement of a biochemical marker from an organ protected from outside factors. ^

Temporal changes in immigration stress, adaptation, and the factors contributing to the immigration -adaptation process in newly immigrant parents

The adaptation process to a new land can be an arduous transition for families who migrate from their countries in an attempt to evade negative life conditions. Family-based immigration has been the cornerstone of immigration policy for the U.S. However, there has been a relative lack of attention given in immigration studies to the impact of immigration particularly on parents. Furthermore, little is known about their adjustment to their post-migration circumstances, particularly the initial phase of migration, where the psychological impact of immigration tends to be concentrated. It is even rarer that investigators have addressed longitudinally the dynamic process of parents' adaptation to a new ecology, which can shed a great deal of light on its mechanisms. In this dissertation, changes over time in levels of stress, adjustment (affect balance and life satisfaction), and the factors (social support, economic hardship, and discrimination) contributing to stress and adjustment were examined in newly immigrant parents from Argentina, Colombia, Cuba, Haiti, and the West Indies. Moderating effects of gender and country-of-origin were examined as well. This study also aimed to investigate to what extent the contributing factors impacted stress and adjustment, not only concurrently, but also over the first three years of post-migration. Analysis of variance results showed that both affect balance and social support increased whereas life satisfaction decreased over time. There was no significant change in stress, however. Both gender and group effects were also observed. Mothers experienced higher stress whereas fathers experienced higher discrimination. Among groups, Haitians appeared at the greatest risk in terms of stress, discrimination, and economic hardship. A structural equation modeling analysis showed that the relative importance of contributing factors changed over time in the process of immigrants' adaptation. Yet, social support emerged as a powerful protective factor in that its effects carried over time, and discrimination was a primary mediator through which other predictors were related to stress and adjustment. These findings shed light on the "hows and whys" of the immigration-adaptation process, by demonstrating the significance of specific conditions of life change to psychological outcomes as newly immigrant parents adapt to their post-migration ecology.

Closing the Gap: Young People's Views on Learning at School

The UK has been criticised for its inequitable education system, as student outcomes are strongly linked to parental socio-economic status. Children and young people experiencing poverty are less likely than their better off peers to leave school with good grades, which can perpetuate disadvantage in later life. The attainment gap between children and young people experiencing poverty and their better off peers in the UK is widening, despite an increasing media and policy focus in this area. Poverty-related educational inequality is a complex area and there is no conclusive evidence in what works to reduce its effects. While there is a plethora of research on the impact of poverty on education, very little of it includes the voice of children and young people and/or the psychological impact of poverty on learning. The importance of hearing the views of children and young people is central to educational psychology, as is social justice and facilitating access to the curriculum for all students. The barriers presented by the experience of poverty to learning are thus vital for educational psychologists to address. This study used qualitative methods to explore the learning journey of Key Stage 3 (age 12-13) young people experiencing poverty in an English coastal borough. Questions from the Little Box of Big Questions 2 were used as a tool in semi-structured interviews, in addition to questions devised by the researcher. Young people discussed aspects of their lives that enabled them to learn at school, and aspects that presented barriers to learning. The research used Positive Psychology, taking a strengths based approach to explore the skills young people thought they brought to education, skills they would like to develop, and how they could be supported in this. The study has highlighted themes that, if addressed, could potentially raise the attainment of children and young people experiencing poverty.

Mastectomia e corporalidade: impacto da cirurgia estético-reconstrutiva

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica,

A Parentalidade tardia : Os pais, os filhos e o amanhã

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica