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

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

Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA) polymerase chain reaction (PCR), serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7%) and chronic gastritis (92.2% versus 85%) was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus) and polymorphonuclear (PMN) (in the antrum) cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

The born global phenomenon- The Portuguese case

The growing significance of companies that conduct international business at or near their funding has been critically challenging previous incremental models of international expansion. This thesis aims to cross-compare, by means of a multiple-case study, eight Portuguese start-ups among themselves and with the theoretical concept of born global firms versus traditional ones. This work project finds that: (1) active entrepreneurs with global vision from inception are essential for the implementation of international strategies; (2) only formal network plays a key role for successful internationalization and (3) inimitable sources of value creation, niche-focused strategies and unique intangible assets are also crucial.

Global trends in modern and contemporary islamic art

Disponível para consulta índice e introdução.

Expression of annexin A1 in Leishmania-infected skin and its correlation with histopathological features

ABSTRACTINTRODUCTION:The aim of this study was quantify annexin A1 expression in macrophages and cluster of differentiation 4 (CD4) + and cluster of differentiation 8 (CD8)+ T cells from the skin of patients with cutaneous leishmaniasis (n=55) and correlate with histopathological aspects.METHODS:Infecting species were identified by polymerase chain reaction-restriction fragment length polymorphism, and expression of annexin A1 was analyzed by immunofluorescence.RESULTS:All patients (n = 55) were infected with Leishmania braziliensis . Annexin A1 was expressed more abundantly in CD163 + macrophages in infected skin (p < 0.0001) than in uninfected skin. In addition, macrophages in necrotic exudative reaction lesions expressed annexin A1 at higher levels than those observed in granulomatous (p < 0.01) and cellular lesions p < 0.05). This difference might be due to the need to clear both parasites and necrotic tissue from necrotic lesions. CD4 + cells in cellular lesions expressed annexin A1 more abundantly than did those in necrotic (p < 0.05) and granulomatous lesions (p < 0.01). Expression in CD8 + T cells followed the same trend. These differences might be due to the pervasiveness of lymphohistiocytic and plasmacytic infiltrate in cellular lesions.CONCLUSIONS:Annexin A1 is differentially expressed in CD163 + macrophages and T cells depending on the histopathological features of Leishmania -infected skin, which might affect cell activation.

Universal banks and corporate control: Evidence from the global syndicated loan market

We investigate the effects of bank control over borrower firms whether by representation on boards of directors or by the holding of shares through bank asset management divisions. Using a large sample of syndicated loans, we find that banks are more likely to act as lead arrangers in loans when they exert some control over the borrower firm. Bank-firm governance links are associated with higher loan spreads during the 2003-2006 credit boom, but lower spreads during the 2007-2008 financial crisis. Additionally, these links mitigate credit rationing effects during the crisis. The results are robust to several methods to correct for the endogeneity of the bank- firm governance link. Our evidence, consistent with intertemporal smoothing of loan rates, suggests there are costs and benefits from banks’ involvement in firm governance.

Projecto de criação de metodologia de análise da Usabilidade para selecção de plataforma SaaS de Gestão de Projectos online CATCH, Global Marketing

O aparecimento de soluções de software baseadas na Cloud vieram democratizar o acesso a aplicações de suporte à actividade empresarial, permitindo a micro e pequenas empresas aceder a ferramentas que outrora apenas as grandes empresas poderiam financiar, dada a introdução de novas formas de pagamento mensais com base em contratos flexíveis, acesso via internet e ausência de instalação de hardware específico ou compra de licenças por utilizador – a verdadeira utilização de software como um serviço, vulgo SaaS (Software as a Service). As aplicações de tipo SaaS aportam inúmeros benefícios para as empresas e mesmo vantagens competitivas importantes, estando disponíveis soluções em diversas áreas, nomeadamente para a Gestão de Projectos, como ferramentas de CRM (Customer Relationship Management) e CMS (Content Management System), entre outros. Assim, as empresas de Marketing e Comunicação, caso da empresa em que se centra este Projecto, têm hoje em dia acesso a um conjunto de aplicações SaaS, que pelo seu custo acessível e fácil acesso online, permitem às empresas mais pequenas serem rapidamente tão competitivas quanto as maiores, por norma com processos mais pesados e tradicionais. Adicionalmente, assistimos também ao fenómeno da consumerização das TI, em que os consumidores passam a querer ter o mesmo tipo de User Experience (UX) de que usufruem na utilização de aplicações fora do seu trabalho, aplicadas à vida empresarial. Este Projecto argumenta que a Usabilidade deve ser um dos elementos chave para a selecção correcta de uma aplicação online de Gestão de Projectos (do tipo SaaS), algo que deveria ser facilitado pela aplicação de uma metodologia de teste da Usabilidade, disponível numa plataforma online de acesso livre. A metodologia deverá ser eficaz e passível de ser utilizada por colaboradores de uma micro ou pequena empresa, apoiando o seu processo decisório de investimento, sendo eles especialistas ou não na matéria. A metodologia proposta neste projecto exploratório pressupõe uma complementaridade entre a avaliação Heurística de Usabilidade pelo método de Nielsen e o Método de Purdue - Purdue Usability Testing Questionnaire (PUTQ).

Vascular lesions of the lumbar epidural space: magnetic resonance imaging features of epidural cavernous hemangioma and epidural hematoma

The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

Megabladder in experimental Chagas disease: pathological features of the bladder wall

Mega-organs, primarily in the digestive tract, are well known to occur in chronic Chagas disease. Acute experimental infection with Trypanosoma cruzi results in parasitism of a wide range of cells, tissues, and organs, including the urinary bladder. Infection of BALB/c mice with 100,000 bloodstream forms of the Y strain of T. cruzi induced acute infection with intense parasitism of all layers of the urinary bladder. Parasites were found in the mucosa, lamina propria, muscular, adventitial connective, and fat tissue. Desquamate epithelial cells with amastigotes in the bladder lumen were also found. After 60 days of infection, mice inoculated with 50 bloodstream forms developed dilated, thin-walled bladders that had inflammatory infiltrates and foci of fibrosis replacing areas of damaged muscular layer. These lesions result from direct damage to the muscle fibers by the T. cruzi, leading to myosites, muscle damage, and scarring. Direct damage of paraganglia cells secondary to parasitism, leading to dilatation, damage of muscle fibers, and scarring with replacement of muscular tissue with connective tissue, should also be considered as a cause of functional disturbance of the urinary bladder.

As apostas desportivas online associadas à combinação de resultados

The present dissertation is aimed at finding out whether the existing criminal protection of the sports ethics value is sufficient, regarding the dangers arising from the global online sports betting market and its characteristics. In the first chapter, the main issue will be introduced: the association between online sports bets and competition manipulations from a criminal point of view. In the second chapter, online sports bets will be defined, the characteristics of the referred global market explained and the danger said features bear to the manipulation of sports competitions exposed – also analysing the participants in this phenomenon. In chapter 3, it will be shown that the protection of sports ethics is a matter of public interest and that this interest is carried out by the sports federations as well. In the fourth chapter, the focus will be the criminal protection of sports ethics: its necessity based on the penal dignity of this system of sport associated values; the need to re-evaluate the existing protection due to the recognition of the existence of the online sports betting market; the existing criminal norms regarding the manipulation of sports competitions. Finally, in chapter 5, the intent will be to propose solutions to the identified problems concerning the sufficiency of the existing criminal legislation.

Clinical and epidemiological features of AIDS/tuberculosis comorbidity

Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo. METHODS: Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases. RESULTS: During the period, 559 patients were identified as presenting with AIDS/tuberculosis comorbidity. Risk behavior for AIDS was primarily heterosexual contact (38.9%), followed by intravenous drug use (29.3%) and homosexual/bisexual contact (23.2%). Regarding clinical features, there were higher rates of extrapulmonary tuberculosis when compared to tuberculosis without comorbidity. There was an increase in reporting of AIDS by ambulatory units during the period. Epidemiologically, there was a decrease in the male/female ratio, a predominance in the 20 to 39 year-old age group, and a majority of individuals who had less than 8 years of schooling and had low professional qualifications. CONCLUSIONS: High rates of AIDS/tuberculosis cases at our hospital indicate the need for better attention towards early detection of tuberculosis, especially in its extrapulmonary form. Since the population that attends this hospital tends to be of a lower socioeconomic status, better management of AIDS and tuberculosis is required to increase the rates of treatment adherence and thus lower the social costs.

Análise configuracional dos grandes conjuntos urbanos na Região de Lisboa (1945-1974) : contributos da sintaxe espacial para a história de arte como história da cidade

A presente investigação debruça-se sobre o estudo dos grandes conjuntos urbanos, tendo como referência a área de Lisboa no período entre 1945 e 1974. O seu objetivo principal é compreender o padrão espacial e respetivas variantes destas formas urbanas relativamente recentes bem como avaliar o seu impato na estrutura global da cidade e da sociedade. Tomando como ponto de partida a história de arte como história da cidade, a tese toma como objeto o grande conjunto urbano e aponta a hipótese do estudo da relação forma-fundo como meio de obter informações relevantes que relacionem o uso e função com respeito ao desenho do espaço aberto. Como diferentes arranjos entre espaços abertos e fechados implicam tipos espaciais distintos (Medeiros 2013), o estudo da relação entre a forma (cheio) e o fundo (vazio) dos grandes conjuntos urbanos e respetivas variações, pode fornecer-nos informação espacial relevante, que nos permitem compreender melhor estas formas urbanas recentes. Usando a abordagem própria da teoria da sintaxe espacial (Hillier e Hanson 1984), do tipo configuracional, determinam-se as relações entre os vários elementos constituintes dos sistemas espaciais formados nestas urbanizações. Essas relações são depois analisadas através de medidas e variáveis topológicas que nos permitem identificar qualidades e valores espaciais para a sociedade. Os resultados obtidos a partir dessas variáveis e medidas permitem-nos, depois, avaliar os graus de ‘formalidade’ e ‘urbanidade’ em cada sistema (Holanda 2002). Consequentemente, a avaliação qualitativa das características espaciais que se pretendem obter nesta investigação, tem como base a avaliação quantitativa, permitindo assim comparar mais facilmente os diversos casos de estudo. De entre o conjunto de casos analisados, o estudo revela uma série de características comuns, que nos permitem identificar um padrão específico de urbanismo modernista que reflete claramente um conjunto de ideologias associadas a uma visão reformista da sociedade através do espaço. Mas por outro lado, existem também um conjunto de características particulares de cada caso, que reportam para a estrutura morfológica da cidade tradicional. No que reporta à hipótese de estudo levantada nesta investigação sobre a relação forma-fundo, verifica-se através da amostra que esta relação aparece invertida. Esta diferenciação deve-se ao abandono dos tradicionais sistemas de rua e de quarteirão, ainda presentes nas urbanizações de Alvalade e do Areeiro e a sua substituição pelo bloco livre em espaço aberto como nos casos de Alfragide, Portela e Olivais. Tal facto, como prova a teoria da Sintaxe Espacial ou Lógica Social do Espaço, traduziu-se necessariamente em diferentes modos de vida pública e privada e consequentemente de vida espacial e social. Assim concluímos, através da análise dos casos de estudo apresentados, que embora fazendo parte duma mesma ideologia urbana com características comuns (genótipo modernista), os mesmos apresentam resultados espaciais totalmente diferenciados o que justifica a dificuldade da sua análise comparativa.