Protocol and rationale-the efficacy of minocycline as an adjunctive treatment for major depressive disorder: a double blind, randomised, placebo controlled trial

While current pharmacotherapies are efficacious, there remain a clear shortfall between symptom remission and functional recovery. With the explosion in our understanding of the biology of these disorders, the time is ripe for the investigation of novel therapies. Recently depression is conceptualized as an immune-inflammatory and nitro-oxidative stress related disorder. Minocycline is a tetracycline antibiotic that has anti-inflammatory, pro-oxidant, glutamatergic, neurotrophic and neuroprotective properties that make it a viable target to explore as a new therapy. This double blind, randomised, placebo controlled adjunctive trial will investigate the benefits of 200 mg/day of minocycline treatment, in addition to any usual treatment, as an adjunctive treatment for moderate-severe major depressive disorder. Sixty adults are being randomised to 12 weeks of treatment (with a 4 week follow-up post-discontinuation). The primary outcome measure for the study is mean change on the Montgomery-Asberg Depression Rating Scale (MADRS), with secondary outcomes including the Social and Occupational Functioning Assessment Scale (SOFAS), Clinical Global Impressions (CGI), Hamilton Rating Scale for Anxiety (HAM-A), Patient Global Impression (PGI), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and Range of Impaired Functioning Tool (LIFE-RIFT). Biomarker analyses will also be conducted at baseline and week 12. The study has the potential to provide new treatment targets, both by showing efficacy with a new class of 'antidepressant' but also through the analysis of biomarkers that may further inform our understanding of the pathophysiology of unipolar depression.

Micronutrient supplement use and diet quality in university students

Many national and international public health organisations recommend achieving nutrient adequacy through consumption of a wide variety of nutritious foods. Despite this, dietary supplement sales continue to increase. Understanding the characteristics of micronutrient supplement users and the relationship with diet quality can help develop effective public health interventions to reduce unnecessary consumption of vitamin and mineral supplements. Participants (n = 1306) were a convenience sample of students studying first year food and nutrition. Data was collected via a Food and Diet Questionnaire (FDQ) and a Food Frequency Questionnaire (FFQ). Supplement users were defined as participants who indicated consuming any listed supplement as frequently as once a month or more. Diet quality was assessed using a Dietary Guideline Index (DGI) score. Prevalence of supplement use was high in this study population with 56% of participants reporting supplement use; the most popular supplements consumed were multivitamins (28%) and vitamin C (28%). A higher DGI score was significantly associated with an increased likelihood of supplement use (mean: 105 ± 18 vs. 109 ± 17, p = 0.001). Micronutrient supplement use was associated with a higher DGI score, suggesting that supplements are more likely to be used by those who are less likely to require them.

Non-tradable share reform, liquidity, and stock returns in China

This article studies the influence of the non-tradable share reform in the cross-section of stock returns in China. Prior research has generally neglected this important development in the Chinese stock market. We find that the firm-specific illiquidity measures that reflect direct transaction costs, price impact and difficulties in trading immediacy, exhibit a positive and significant relationship with stock returns. These effects are particularly pronounced after the non-tradable share reform. Furthermore, in the post-reform era, portfolios with high illiquidity (i.e. high relative bid-ask spread, high Amihud illiquidity, low Amivest liquidity ratio) significantly outperform portfolios with low illiquidity, controlling for size, and book-to-market effects.

Qualitative synthesis and systematic review in health professions education

Context  Formal qualitative synthesis is the process of pooling qualitative and mixed-method research data, and then drawing conclusions regarding the collective meaning of the research. Qualitative synthesis is regularly used within systematic reviews in the health professions literature, although such use has been heavily debated in the general literature. This controversy arises in part from the inherent tensions found when generalisations are derived from in-depth studies that are heavily context-dependent.Methods  We explore three representative qualitative synthesis methodologies: thematic analysis; meta-ethnography, and realist synthesis. These can be understood across two dimensions: integrative to interpretative, and idealist to realist. Three examples are used to illustrate the relative strengths and limitations of these approaches.Discussion  Against a backdrop of controversy and diverse methodologies, readers must take a critical stand when reading literature reviews that use qualitative synthesis to derive their findings. We argue that notions of qualitative rigour such as transparency and acknowledgment of the researchers’ stance should be applied to qualitative synthesis.

Well-being and Resilience in Education

Compared to previous generations, today’s youth appear to be poorly equipped to meet the life challenges they face. This chapter focuses on two approaches to developing positive and resilient behavior in young people, namely the student well-being approach and the social and emotional learning (SEL) approach. These two approaches have slowly emerged to fill the void created by the failed self-esteem movement that began in the 1970s. Both approaches have strong links with positive psychology, a model that emphasizes the conditions, strengths, and behaviors that enable people to develop well-being, act resiliently, and thrive. Evidence-informed guidelines for developing and implementing universal school-based programs designed to enhance well-being and SEL are identified and examples of national and specific initiatives are outlined.

Depressive symptomatology, weight status and obesogenic risk among Australian adolescents: a prospective cohort study

OBJECTIVES: Adolescence is a period of increased risk for mental health problems and development of associated lifestyle risk behaviours. This study examined cross-sectional and longitudinal associations between obesogenic risk factors, weight status, and depressive symptomatology in a cohort of Australian adolescents.

DESIGN: Prospective cohort study.

SETTING: The study used repeated measures data from the Australian Capital Territory (ACT) It's Your Move project, an Australian community-based obesity prevention intervention. Intervention effect was non-significant therefore intervention and comparison groups were combined in this study.

PARTICIPANTS: Total sample was 634 secondary school students (female n=338, male n=296) with mean age 13 years (SD=0.6) at baseline (2012) and 15 years (SD=0.6) at follow-up (2014) recruited from 6 government secondary schools in the ACT.

PRIMARY AND SECONDARY OUTCOMES MEASURES: Primary outcome was depressive symptomatology measured by Short Mood and Feelings Questionnaire. Secondary outcomes were weight status, physical activity, screen time and diet related measures.

RESULTS: Increased physical activity was associated to lower depressive symptomatology among males (OR=0.35, p<0.05). Sweet drink (OR=1.15, p<0.05) and takeaway consumption (OR=1.84, p<0.05) were associated with higher levels of depressive symptomatology among females at follow-up. Males who were classified as overweight or obese at baseline, and remained so over the study period, were at increased risk of depressive symptomatology at follow-up (b=1.63, 95% CI 0.33 to 2.92). Inactivity among males over the 2-year study period was predictive of higher depressive symptomatology scores at follow-up (b=2.55, 95% CI 0.78 to 4.32). For females, those who increased their consumption of takeaway foods during the study period were at increased risk for developing depressive symptomatology (b=1.82, 95% CI -0.05 to 3.71).

CONCLUSIONS: There are multiple, probably complex, relationships between diet, physical activity and outcomes of obesity and mental health as well as between the outcomes themselves. Healthier diets and increased physical activity should be foundations for healthier body weight and mental health.

Predicting and breaking sedentary behaviour at work

This thesis aimed at designing and developing a system that can a) infer individuals’ need for a break from sedentary behaviour in the workplace, and b) persuade them to take a break through the use of different techniques from persuasive psychology. We postulated three variables, namely, individuals’ posture, stress levels and involvement in their computer mediated activity. We developed and field-studied a system that could infer these using a web camera and a key presses and mouse clicks log. We found that the system could predict posture from viewing depth and stress from the movement detected. We then created a general formula that predicts individuals’ need for a break using only the posture and stress predictors. Once the first objective was set, we built and field-studied a system that used three ways to communicate a recommendation for a break to a user: implicit, just-in time and ambient feedback. The implicit feedback was operationalized through changes in the users’ computer wallpaper that provided subtle visual cues. The just-in time feedback employed prompting at the bottom right side of the user’s screen. In addition, we implemented an intuitive behind-screen interaction technique where people can snooze a notification using simple gestures. The ambient feedback mechanism employed an origami sculpture sitting on the user’s desk. This prototype was continuously reflecting the user’s posture and performed rhythmic movements when to recommend breaks. A field study demonstrated the overall success of the system, with 69% of the break recommendations received by users were accepted. The study further revealed the strengths and weaknesses of the three persuasive mechanisms.

Meta-theories in research: positivism, postmodernism, and critical realism

No scholar or researcher is able to provide robust evidence that counters the scant reflection on metatheory – mostly ontology and epistemology – underlying management studies in general, and industrial marketing and purchasing research in particular. This paper is a contribution to the indispensable discussion of metatheoretical alternatives in research, and most importantly, the strengths and shortcomings thereof, and respective implications on research questions, objectives, and findings.

Seven stories: location based story-delivery system

Location aware content-based experiences have a substantial tradition in HCI, several projects over the last two decades have explored the association of digital media to specific locations or objects. However, a large portion of the literature has little focus on the creative side of designing of the experience and on the iterative process of user evaluations. In this thesis we present two iterations in the design and evaluation of a location based story delivery system (LBSDS), inspired by local folklore and oral storytelling in Madeira. We started by testing an already existing location based story platform, PlaceWear, with short multimedia clips that recounted local traditions and folktales, to this experience we called iLand. An initial evaluation of iLand, was conducted; we shadowed users during the experience and then they responded to a questionnaire. By analyzing the evaluation results we uncovered several issues that informed the redesign of the system itself as well as part of the story content. The outcome of this re design was the 7Stories experience. In the new experience we performed the integration of visual markers in the interface and the framing of the fragmented story content through the literary technique of the narrator. This was done aiming to improving the connection of the audience to the physical context where the experience is delivered. The 7Stories experience was evaluated following a similar methodology to the iLand evaluation but the user’s experience resulted considerably different; because of the same setting for the experience in both versions and the constancy of the most of the content across the two versions we were able to assess the specific effect of the new design and discuss its strengths and shortcomings. Although we did not run a formal and strict comparative test between the two evaluations, it is evident from the collected data how the specific design changes to our LBSDS influenced the user experience.

Farmacêuticos e suas atividades em farmácias comunitárias: uma análise de perfil

The aim of this study was to establish the profile of the pharmacist technician responsible for community pharmacies in the city of Natal/RN, featuring personal elements, perceived their role and place of pharmaceutical care, levels of job satisfaction, type and quality of services provided in human and structural framework. To that end, we made an exploratory cross-sectional study applying a questionnaire containing open and closed questions, which was applied to pharmaceutical technicians responsible for community pharmacies in Natal/RN, from September 2010 to September 2011. The sample was established by calculating the simple random sample, with a confidence level of 95% and a significance level of 0.05. To evaluate the satisfaction level of the activities performed by pharmacists in community pharmacies was used Simple Satisfaction Scale (Likert, 1935). To assess the attitudes and perceptions of pharmacists in relation to aspects of pharmaceutical care, we used the Model Attitude toward the object (Fishbein, Ajzen, 1975). The answers were converted into data were analyzed statistically using Epi Info 3.5.2 The results showed that the strengths and weaknesses in relation to the profile of the pharmacist and their activities in community pharmacies in Natal/RN are not different in other cities in the country . The most important aspects were: 51% (n = 90) of the establishments visited, the pharmacist was absent; 46% (n = 80) did not have postgraduate and of those who are or have completed 33% (n = 51) are in the area of Clinical Analysis; 56% (n = 98) 08h for day work and 64% (n = 111) claim that this load influence its performance; 83% (n = 146) receive as salary, the floor pharmacist regarding the state of Rio Grande do Norte; 44% (n = 76) are unhappy about the salary, which is the main difficulty cited; 78% (n = 136) say they are always sought by users and the receptivity of these considered good (52%, n = 91). The activities of higher satisfaction are those related to pharmaceutical care and lower the administrative. As regards attitudes and perceptions, the score was more negative to the question 'if the pharmacist feels working as a team with the doctor', in which 59% (n = 103) responded 'never'. 49% (n = 86) reported being "able" to take questions from users and 39% (n = 68) are 'dissatisfied' with respect to the structure of the practice of pharmacy to pharmaceutical care. Action is needed on the obstacles to the exercise of the pharmacist in the solution and minimize the negative and positive stimulus to

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Benefícios e dificuldades na adoção de um sistema de gestão da qualidade no Rio Grande do Norte

Taking competitive advantage or satisfy the client are the reasons why companies have been implementing a Quality Management System (QMS). It brings benefits such as the improvement in the processes, products and services; an enhancement in the image of the company (marketing) and satisfaction of the clients. As a whole, this paper aims to evaluate the results obtained from the implementation of the QMS in the certified companies in the ISO 9001 standard, contained in the database of INMETRO, of the Rio Grande do Norte State (RN). In order to achieve the goals, a bibliographical research about the theme quality management system was made and, subsequently a survey was made with the managers of the certified companies in RN, using the online questionnaire. Out of 27 companies that have the certificate in Rio Grande do Norte, 21 responded the data collection instrument. The data analysis was made through techniques of descriptive and multivariate statistics: cluster analysis. The research instrument used contained 20 questions that address the main theme of this dissertation. Using the cluster analysis, four groupings that possessed similarities concerning the survey answers were found. This analysis allowed us to conclude that the QMS boosts significant improvements in the organizations, such as: quality in the reputation of the company and sales increase. On the other hand, it allowed us to identify as main difficulties: the dissemination of the quality culture, lack of commitment of the whole organization and the resistance of the workers

Citologia: uma proposta formativa na EaD - UFRN a partir de concepções alternativas

Learning difficulties can have a direct influence on the teaching-learning process of students by reducing their school performance. One factor that may contribute to this negative influence on learning refers to the presence of alternative conceptions, which may have different origins in the educational process. It is of paramount importance, for teachers, for example, to identify the concepts and the difficulties of their students in order for that knowledge can be able to contribute significantly to improve the teaching and learning process. From the following considerations, the present study (still in progress) aims to investigate aspects related to the concepts and difficulties of graduating students in relation to the contents of Biology. The participants of the research were undergraduate students in Biological Sciences from UFRN, studying by Distance Learning (Educação a Distância). To develop the survey, questionnaires were developed to identify the contents in Biology that these students have more difficulties as well as an interview to raise misconceptions regarding the content of cytology. Another tool developed was a textbook evaluation form, which was applied in conjunction with a questionnaire in workshops (short courses) in order to identify possible errors and mistakes that could jeopardize the process of teaching and learning, such as the importance that these learners assign to textbooks in the educational process. From the data collected, a booklet on the content of cytology was developed as a product. It is expected that it can be applied in classrooms in order to improve the teaching and learning in references to Biology, to minimize, for example, alternative conceptions than can occur related to the theme

Does ISO 14001 work in Brazil?

As a result of increasing global awareness about the importance of the environment, depletion of natural resources and legal pressures for companies to manage their processes in a sustainable manner, ISO 14001 systems have been gaining increasingly more importance in the organizational scenario. These elements are even more critical in emerging nations due to less awareness and fewer demands by governments and the population in relation to environmental issues. Therefore, the main objective of this study is to verify the benefits and difficulties of Environmental Management Systems based on ISO 14001 at industries in the state of São Paulo - Brazil (an emerging country) by conducting a survey to subsidize the proposal for actions in the public, academic and private sectors to promote the use of this standard of reference and strengthen its results in Brazil. A questionnaire was sent to 194 companies from the National Institute of Metrology, Standardization and Industrial Quality database. 69 answered, representing a return rate of 35.36%. The main benefits identified are related to the development of preventive environmental actions, reduction in the consumption of power, water, gas and fuel oil, and a positive influence on other internal management processes. The main difficulties are related to cost increases from ISO 14001 management systems and the constant changes in environmental legislation in Brazil. Some actions are proposed at the end of the analyses to intensify the use and improve the results of this standard, such as changes in government legislation and its collective development and implementation in industries. (C) 2010 Elsevier Ltd. All rights reserved.

Fenótipo neuropsicológico de adolescentes com síndrome de Down

This research aimed to contribute to the characterization of a neuropsychological phenotype of adolescents with Down Syndrome (DS). A multicases study of six adolescents (three males and three females, aged 13 to 14 years) diagnosed with DS and treated at two institutions in the city of Natal (Brazil), was conducted. Participants were assessed using the methodological approach developed by Luria, which is composed by four complementary stages. The first one aimed to investigate the qualitative impact of DS in school life and social development of the adolescents; dimensions of behavior and social-affective aspects of the members of the study were investigated. In the second stage participants performed a battery of neuropsychological tests in order to identify strengths and weaknesses in their cognitive functioning. The third stage was incorporated into the second in order to analyze the quality of the activity of the participants along the quantitative evaluation, highlighting strategies used, errors produced among other indicators. Lastly, the fourth stage refers to the intervention with the participants. Although this is not a specific objective of the study, it is argued that the outcome of this research will subsidize the practice of different professionals working with this clinical group. The results of the first stage emphasized the presence of difficulties in social relationships and in school life of observed adolescents. In turn, the second and third stages pointed out to the presence of difficulties in tasks involving logical and abstract thinking, as well as difficulties in expressive language. In relation to visual memory, we observed a better performance in activities of lower complexity, ie, with less interference of executive functioning, particularly in terms of the functions of planning and initiative. Finally, it was found motor and mental retardation, affecting significantly the performance related to different cognitive areas. The results highlighted here can be considered as subsidies for future interventions, suggesting the need for developping projects that take into account different aspects constituents of the human subject, involving not only the individual with developmental changes, as well as their families, teachers, schools and society in general