Use of psychoactive drugs and related falls among older people living in a community in Brazil

INTRODUCTION: Population aging in Brazil has increased the prevalence of neurodegenerative diseases (Parkinson's and Alzheimer's disease) and affective disorders (anxiety, depression), all common in old age. A retrospective study was carried out with the purpose of ascertaining if there is an association between falls and psychoactive medication use among older residents of a community in Brazil. METHODS: All residents aged 65+ (n=161) of one neighborhood of Campo Belo, Brazil (population of 48,000) were evaluated regarding the use of psychoactive drugs and the occurrence of falls in the 12 months preceding the study. Vision and hearing screenings were also performed. RESULTS: From the study population, 9.3% were taking prolonged half-life benzodiazepines, 4.4% anticonvulsants (mostly barbiturates), 2.5% antidepressants (all cyclics) and 8.1% alpha-methyldopa. No subject reported use of hypnotics, neuroleptics or drugs to treat Alzheimer's or Parkinson's diseases (except biperiden). As a whole, drugs that increase the risk of falls were used by 1/5 of this population. In the 12-month period preceding the study, 27 residents (16.8%) experienced falls and, of those, 4 (14.8%) had fracture(s). There was an independent association between psychoactive drug use and falls when variables such as age, gender, vision and hearing were controlled (p=0.02). CONCLUSIONS: Although the population of this neighborhood must be considered young (only 4% are 65 years old or more), there are already problems related to the use of psychoactive drugs among people. Prescribed anxiolytics, anticonvulsants, antidepressants and antihypertensives are not appropriate for this age group and their use is associated with falls.

Sistema de neurónios espelho no síndrome de down: estudo das variações dos ritmos Mu No Eeg

A capacidade de compreensão das acções dos outros e de imitação tem sido descrita como fundamental para a cognição social do ser humano. Recentemente tem sido atribuída a responsabilidade desta capacidade a um sistema neuronal denominado de Sistema de Neurónios Espelho, que se tem demonstrado estar afectado em perturbações mentais que se caracterizam por alterações severas da teoria da mente e da empatia, como é o caso do autismo. No caso do Síndrome de Down, verifica-se a coexistência de boas competências sociais e de capacidades práxicas e de imitação intactas, com dificuldades de interpretação de situações sociais e de reconhecimento de emoções, que nos levam a questionar acerca da actividade do seu Sistema de Neurónios Espelho. As oscilações do ritmo de frequências um (8-13 Hz) no córtex sensório-motor perante a observação de acções são consideradas um reflexo da actividade dos neurónios espelho, estando estabelecido que em pessoas saudáveis ocorre uma supressão mu na realização de movimentos com o membro superior e na sua observação quando realizados por outras pessoas. Neste estudo registou-se electroencefalograficamente a supressão dos ritmos mu em 11 pessoas com SD e em 20 pessoas sem SD nas seguintes condições: observação de um vídeo com duas bolas em movimento, observação de um vídeo com um movimento repetido de uma mão e realização movimentos com a mão. A baseline foi registada através da observação de um ponto estático. Constatamos que existe supressão dos ritmos mu na observação das acções dos outros em pessoas com Síndrome Down da mesma forma que ocorre na realização do próprio movimento, sugerindo uma relativa preservação do funcionamento dos neurónios espelho e dos mecanismos básicos de cognição social. Estes resultados vão de encontro aos estudos que apontam para a integridade das capacidades de imitação no Síndrome Down. Verificamos também que não se encontram diferenças significativas na supressão dos ritmos mu entre os grupos de pessoas com Síndrome Down e de Controlo em relação às condições usadas na investigação.

Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand to sit in post-stroke vs healthy subjects

O documento em anexo encontra-se na versão post-print (versão corrigida pelo editor).

Orientation system for people with cognitive disabilities

In health care there has been a growing interest and investment in new tools to have a constant monitoring of patients. The increasing of average life ex-pectation and, consequently, the costs in health care due to elderly population are the motivation for this investment. However, healthmonitoring is not only important to elderly people, it can be also applied to people with cognitive disabilities. In this article we present some systems, which try to support these persons on doing their day-to-day activities and how it can improve their life quality. Also, we present an idea to a project that tries to help the persons with cognitive disabilities by providing assistance in geo-guidance and keep their caregivers aware of their location.

Futebol: o caminho de África até à Europa

Similarly to its past, Africa plays a similar role in the football world as it did during History, if we look at the creation of some of the most powerful empires in the world (the Portuguese, French or English, for example) – as an almost unlimited workforce ‘supplier’. Africa is still searching for its own place in the football world map. With a recent history filled with social conflicts, civil wars and racial discrimination, it was possibly in this continent that the sport was first seen as a means towards social evolution and as ‘peacemaker’. Although these problems also exist in African stadiums, supporters all over the continent go to matches to celebrate and socialize; in a reality constantly shrouded in conflicts and oppression, football is like a ‘light at the end of the tunnel’ to those who believe in a continent sustained by healthy political relations between countries, democratic values and a socially fair ‘use’ of a country’s potential – and always for the profit of its own people. But while see the attempt to use football with that objective, others see it as their ticket out of their country, to avoid getting involved in military conflicts and seek better life conditions for themselves and their families (both those who accompany them and those who remain in Africa). Others, still, try to make the most of others’ will to leave a less favourable social reality; Portugal, for its past as a colonizing country, also saw in the African players a way to develop the football phenomenon in its European territory. This article attempts to analyze the influence of Portuguese colonialism in the emigration of African players to Europe, since Portugal presents itself as one of the biggest ‘importers’ of these players.

Quality of life of the caregivers of people with aphasia. A systematic review.

Purpose: Systematic review to identify the factors associated to the quality of life (QOL) of the caregivers of people with aphasia (PWA). Methods: Studies were searched using Medline, Pubmed, Cochrane Library, CINAHL, PsycINFO and Web of Science databases. Peer-reviewed papers that studied the QOL of PWA’s caregivers or the consequences of aphasia in caregivers’ life were included. Findings were extracted from the studies that met the inclusion criteria. Results: No data is available reporting particularly the QOL of PWA caregivers’ or their QOL predictors. Nevertheless, it was possible to extract aspects related to QOL from the studies that report the consequences of aphasia, and life changes in PWA’s caregivers. Nine (9) studies including PWA’s caregivers were found, but only 5 reported data separately on them. Methodological heterogeneity impedes cross-study comparisons, although some considerations can be made. PWA’s caregivers reported life changes such as: loss of freedom; social isolation; new responsibilities; anxiety; emotional loneliness; need for support and respite. Conclusions: Changes in social relationships, in emotional status, increased burden and need for support and respite were experienced by PWA’s caregivers. Stroke QOL studies need to include PWA caregivers’ and report separately on them. Further research is needed in this area in order to determine their QOL predictors and identify what interventions and referrals better suit their needs.

Avaliação da infecção de megacariócitos e plaquetas pelo VHC e sua influência na fisiopatologia da hepatite C

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Idosos ativos, idosos saudáveis

Mestrado em Fisioterapia

Implications of the Intervention Program for Physical Activity (IPPA) in the perception of illness and wellbeing in people with Multiple Sclerosis (MS)

The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90 minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time A) and end (time B) of the IPPA. We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest that there are differences between time A and B, the perception of illness decreased (p<0.08), while wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the perception of disease severity and personal wellbeing.

Magnesium, insulin resistance and body composition in healthy postmenopausal women

Objective: This study was conducted to determine the association between magnesium (Mg), body composition and insulin resistance in 136 sedentary postmenopausal women, 50 to 77 years of age. Methods: Diabetics, hypertensives and women on hormonal replacement therapy were excluded and the remaining 74 were divided according to BMI≥25 (obese: OG) and BMI<25 kg/m2 (non-obese: NOG). Nutritional data disclosed that intakes were high for protein and saturated fat, low for carbohydrates, polyunsaturated fat and Mg and normal for the other nutrients, according to recommended dietary allowances (RDA). Mg values in red blood cells (RBC-Mg) and plasma (P-Mg), were determined, as were fasting glucose, and insulin levels, Homeostasis Model Assessment (HOMA), body mass index (BMI), body fat percent (BF %), abdominal fat (AF) and free fat mass (FFM). Results: RBC-Mg values were low in both groups when compared with normal values. There were significant differences in body composition parameters, HOMA and insulin levels, with higher basal insulin levels in OG. RBC-Mg was directly correlated with insulin, HOMA and FFM in both groups, according to Pearson correlations. HOMA in OG was also directly correlated with BMI, FFM and AF. In NOG, HOMA was only correlated with FFM. The low RBC-Mg levels observed were probably due to low Mg intake and to deregulation of factors that control Mg homeostasis during menopause. Conclusions: Both Mg deficit and obesity may independently lead to a higher risk for insulin resistance and cardiovascular disease.

Diversity and characterisation of coagulasenegative staphylococci isolated from healthy individuals in Portugal

In the past few years the interest in coagulase-negative staphylococci (CoNS) has significantly increased in human medicine. CoNS are common commensal colonisers of the human skin, although now also recognised as major nosocomial pathogens. Over the last decades, several studies have been carried out in order to understand the pathogenicity mechanisms of CoNS. The well known determinants in the pathogenesis of CoNS infections are their ability to form biofilms and an exceptional resistance to several antibiotics. Nevertheless, there is a lack of studies regarding the commensal lifestyle of these microorganisms. Additionally, it is now hypothesised that commensal bacteria might be a reservoir of pathogenic determinants. Therefore, the work described throughout this thesis was aimed to perform a phenotypic and genotypic characterisation of different CoNS species isolated from healthy Portuguese individuals. A total of 61 CoNS isolates, comprising 7 different species, were obtained and characterised at the level of biofilm formation and antibiotic susceptibility profiles. According to the results, biofilm formation ability and presence of biofilm-associated genes were commonly found features, highlighting their pivotal role in the colonising lifestyle of CoNS. This study also addressed the correlation between phenotypic and genotypic characteristics of biofilm formation, corroborating and raising questions about the importance of some genes in this process. Moreover, it was observed a great proportion of isolates with decreased susceptibility and multiple resistances to some important antibiotics. A significant association between antibiotic resistance and biofilm formation was also demonstrated, and some hypotheses about the nature of such association were provided. Lastly, the expression patterns of two biofilm-associated genes at two distinct biofilm developmental stages were determined, confirming their importance in the accumulative stage of biofilm formation. Overall, the results presented in this thesis indicate that staphylococcal skin flora might be an important reservoir of potentially pathogenic bacteria and, simultaneously, bring to light new perceptions about the molecular basis of staphylococcal biofilm formation, and the nature of the association between antibiotic resistance and biofilm formation.

A influência da marcha com tripé nos parâmetros metabólicos em jovens e idosos

Introdução: Os parâmetros metabólicos durante a marcha normal e a sua regulação são importantes devido ao metabolismo oxidativo ser o principal meio através do qual o organismo humano gera energia para realizar as atividades do quotidiano. Nem sempre a marcha é realizada de forma independente e necessita do apoio de auxiliares de marcha, como o tripé, que tem por função ampliar a base de sustentação e melhorar o equilíbrio. Objetivo: Analisar a influência de utilização de um tripé na marcha, na despesa energética em jovens e idosos saudáveis Métodos: Realizou-se um estudo observacional transversal numa amostra de 21 voluntários, com idade entre 18 a 25 anos e mais ou igual a 60 anos. Realizaram-se as avaliações com o Cosmed K4b2 (Cosmed, Rome, Italy), sendo através do mesmo que os dados foram recolhidos. Foi utilizado o teste de Friedman, com P <0,05. Resultados: Os resultados obtidos para o gasto energético nos jovens foram inferiores aos valores obtidos pelos idosos. Relativamente ao metabolismo energético o substrato energético utilizado pelos jovens foi o proteico e o lipídico pelos idosos. Entre sexos foram os homens quem tiveram um maior gasto energético. Conclusão: O uso do tripé durante a marcha não influencia o gasto energético em adultos jovens e/ou idosos saudáveis.

Young people's blood alcohol concentration and the alcohol consumption city law, Brazil

The paper assesses blood alcohol concentration and risk behaviors for traffic accidents before and after the implementation of a law which prohibits the use of alcoholic beverages on city gas stations. In Porto Alegre, Southern Brazil, young people go out at night and drive to gas station convenience stores to buy alcoholic beverages which are consumed on the premises of parking lots in gas stations. Data were obtained from self-administered questionnaires and breath analyzers in two cross-sectional collections with purposive samples of youngsters in May and July 2006 (n=62, and n=50, respectively). There were no significant differences between the groups before and after the city law was passed. Blood alcohol concentration greater than 0.06% was found in 35.5% of pre-law group and 40% of post-law group (p=0.62). Results point out heavy alcohol use in both groups, which did not change after the law was passed.

Projecto de conceito e estrutura de website: para sensibilizar jovens para uma dieta alimentar saudável

O marketing social veio teorizar a forma como as entidades, públicas ou privadas, tentam alterar comportamentos e hábitos de saúde. A eficácia das campanhas de saúde pública aumentou em grande parte devido ao uso das técnicas de marketing social. A finalidade deste projecto de investigação é elaborar uma proposta de estrutura de website, cujo objectivo consiste em sensibilizar jovens para a necessidade de seguir hábitos alimentares saudáveis, considerando que este pode vir a ser parte de uma estratégia de comunicação de marketing social integrada, criada por um organismo, com ou sem fins lucrativos, ou simplesmente existir enquanto portal de informação online independente. O público-alvo definido para este projecto são os jovens com idades compreendidas entre os 18 e os 34 anos, a frequentar o ensino superior ou que já possuam habilitação superior. Com o intuito de atingir os objectivos propostos elaborou-se um inquérito por questionário, o qual foi analisado quantitativamente. A amostra para esta investigação é constituída por 272 inquiridos. Concluiu-se com este projecto que o processo de planeamento de um website deve ser meticulosamente delineado, quer seja parte integrante de uma campanha, quer actue de forma isolada; e que, quanto melhor se investigarem as disposições do público-alvo, a alteração de comportamentos dos utilizadores, induzida pelo website, será tanto mais possível.

Promoção do uso de alimentos promotores de saúde na dieta de grupos socioeconómicos desfavorecidos

Dissertação de Mestrado, Tecnologia e Segurança Alimentar, 13 de Julho de 2015, Universidade dos Açores.