A Automedicação nos alunos da Escola Superior de Saúde do Instituto Politécnico de Bragança

A automedicaçao é um fenómeno mais ou menos frequente e usado há muitos anos e a sua incidência e distribuição é relatada por organizações de saúde. Na opinião de Medeiros (2011) esta prática consiste no consumo de medicamentos com o objetivo de tratar e aliviar sintomas de doença bem como promover a saúde sem recurso à prescrição médica. Métodos: trata-se de um estudo quantitativo, observacional descritivo e transversal. Foi usado um questionário construído para o efeito, Objetivo: Avaliar se a automedicaçao é uma prática usada pêlos estudantes da Escola Superior de Saúde (ESSa) do Instituto Politécnico de Bragança e identificar ainda os motivos que levam a esta prática. A amostra foi constituída por 219 estudantes da ESSa. Para a análise dos dados utilizou-se o programa excel. Res.ultad.°s: al"'evalência da autome(l":a<;ao foi de 98%. Os medicamentos mais usados. analgésicos e antipiréticos com respostas de 86%. A razão mais apontada para o recurso a prática da automedicaçaofoi um "problema de saúde ligeiro" (79, 5). Foi considerada uma prática de risco por 77% dos estudantes. Conclusões: a automedicaçao é uma prática evidente nos alunos da ESSa. Estes resultados revelam alguma contradição e preocupação na medida em que apesar dos estudantes reconhecerem ser uma prática arriscada ela é praticada por muitos dos inquiridos.

Revisión sistemática de la literatura de las intervenciones diseñadas para el comportamiento de automedicación no responsable

La automedicación no responsable se ha convertido en un problema de salud pública global en las últimas décadas, por sus consecuencias individuales (por ejemplo, la intoxicación) y colectivas (por ejemplo, la resistencia microbiana a los antibióticos). Las intervenciones orientadas a este comportamiento han sido aisladas y muy diferentes. Aunque se tiene evidencia de que su aplicación puede traer beneficios en diferentes poblaciones, no se halló en la literatura una compilación sistemática de dichas intervenciones. El objetivo de la presente revisión es sistematizar la literatura científica sobre las diferentes alternativas de intervención del comportamiento individual de automedicación no responsable. En cuanto al método, la revisión de literatura involucró la búsqueda sistemática de “automedicación” e “intervención” en las bases de datos académicas internacionales con contenidos de psicología, suscritas por la Biblioteca de la Universidad del Rosario. Como resultado se encontró que las intervenciones orientadas al comportamiento de automedicación no responsable se pueden clasificar en dos grandes grupos: (a) intervenciones regulatorias, con dirección “arriba hacia abajo”, que suponen una acción de los Estados nacionales por medio de sus legislaciones o de entidades internacionales (por ejemplo, Organización Mundial de la Salud); y (b) intervenciones educativas, con dirección “abajo hacia arriba”, que suponen acciones con individuos y comunidades con el fin de enseñar acerca del uso adecuado de los medicamentos. Se concluye acerca de la necesidad de complementar ambos tipos de intervención, los cuales, si bien demuestran resultados positivos, aisladamente son insuficientes para contrarrestar integralmente este fenómeno creciente y complejo.

Revisión de la literatura científica sobre publicidad de medicamentos de venta libre y comportamiento del consumidor

El consumo de medicamentos es un asunto que actualmente se ha convertido en una preocupación a nivel global, ya que no todos los medicamentos están sujetos a prescripción médica, y esto implica que su consumo dependa de otras fuentes de información, como la publicidad masiva o el consejo de personas legas, entre otros. Esta revisión se basó en la publicidad y el impacto que tiene esta frente al consumidor. La presente revisión se dividió en dos categorías dado la relevancia del tema, en la primera se encuentra las características de los medicamentos de venta libre donde se evidenció cómo funciona el sector de la industria farmacéutica, las características de los medicamentos en general y los riesgos del abuso de este comportamiento. Así mismo, en la segunda categoria se habló sobre la publicidad y mercadeo de ventas libres donde se evidenció el alto impacto que tiene la publicidad en el consumidor, las restricciones que hay en el contexto nacional e internacional.

Exploring the factor structure of a new self- and other-oriented alcohol expectancy scale relating to sexual coercion and vulnerability

Introduction and Aim: Sexual assaults commonly involve alcohol use by the perpetrator, victim, or both. Beliefs about alcohol’s effects may impact on people’s perceptions of and responses to men and women who have had such experiences while intoxicated from alcohol. This study aimed to develop an alcohol expectancy scale that captures young adults’ beliefs about alcohol’s role in sexual aggression and victimisation. Design and Methods: Based on pilot focus groups, an initial pool of 135 alcohol expectancy items was developed, checked for readability and face validity, and administered via a cross-sectional survey to 201 male and female university students (18-25 years). Items were specified in terms of three target drinkers: self, men, and women. In addition, a social desirability measure was included. Results: Principal Axis Factoring revealed a 4-factor solution for the targets men and women and a 5-factor solution for the target self with 72 items retained. Factors related to sexual coercion, sexual vulnerability, confidence, self-centredness, and negative cognitive and behavioural effects. Social desirability issues were evident for the target self, but not for the targets men and women. Discussion and Conclusions: Young adults link alcohol’s effects with sexual vulnerabilities via perceived risky cognitions and behaviours. Due to social desirability, these expectancies may be difficult to explicate for the self but may be accessible instead via other-oriented assessment. The Sexual Coercion and Vulnerability Alcohol Expectancy Scale has potential as a tool to elucidate the established tendency for observers to excuse intoxicated sexual perpetrators while blaming intoxicated victims.

Commuting mode choice in transit oriented development: Disentangling the effects of competitive neighbourhoods, travel attitudes, and self-selection

This research identifies the commuting mode choice behaviour of 3537 adults living in different types of transit oriented development (TOD) in Brisbane by disentangling the effects of their “evil twin” transit adjacent developments (TADs), and by also controlling for residential self-selection, travel attitudes and preferences, and socio-demographic effects. A TwoStep cluster analysis was conducted to identify the natural groupings of respondents’ living environment based on six built environment indicators. The analysis resulted in five types of neighbourhoods: urban TODs, activity centre TODs, potential TODs, TADs, and traditional suburbs. HABITAT survey data were used to derive the commute mode choice behaviour of people living in these neighbourhoods. In addition, statements reflecting both respondents’ travel attitudes and living preferences were also collected as part of the survey. Factor analyses were conducted based on these statements and these derived factors were then used to control for residential self-selection. Four binary logistic regression models were estimated, one for each of the travel modes used (e.g. public transport, active transport, less sustainable transport such as the car/taxi, and other), to differentiate between the commuting behaviour of people living in the five types of neighbourhoods. The findings verify that urban TODs enhance the use of public transport and reduce car usage. No significant difference was found in the commuting behaviour between respondents living in traditional suburbs and TADs. The results confirm the hypothesis that TADs are the “evil twin” of TODs. The data indicates that TADs and the mode choices of residents in these neighbourhoods is a missed transport policy opportunity. Further policy efforts are required for a successive transition of TADs into TODs in order to realise the full benefits of these. TOD policy should also be integrated with context specific TOD design principles.

SOVEREIGN: A Self-Organizing, Vision, Expectation, Recognition, Emotion, Intelligent, Goal-Oriented Navigation System

Both animals and mobile robots, or animats, need adaptive control systems to guide their movements through a novel environment. Such control systems need reactive mechanisms for exploration, and learned plans to efficiently reach goal objects once the environment is familiar. How reactive and planned behaviors interact together in real time, and arc released at the appropriate times, during autonomous navigation remains a major unsolved problern. This work presents an end-to-end model to address this problem, named SOVEREIGN: A Self-Organizing, Vision, Expectation, Recognition, Emotion, Intelligent, Goal-oriented Navigation system. The model comprises several interacting subsystems, governed by systems of nonlinear differential equations. As the animat explores the environment, a vision module processes visual inputs using networks that arc sensitive to visual form and motion. Targets processed within the visual form system arc categorized by real-time incremental learning. Simultaneously, visual target position is computed with respect to the animat's body. Estimates of target position activate a motor system to initiate approach movements toward the target. Motion cues from animat locomotion can elicit orienting head or camera movements to bring a never target into view. Approach and orienting movements arc alternately performed during animat navigation. Cumulative estimates of each movement, based on both visual and proprioceptive cues, arc stored within a motor working memory. Sensory cues are stored in a parallel sensory working memory. These working memories trigger learning of sensory and motor sequence chunks, which together control planned movements. Effective chunk combinations arc selectively enhanced via reinforcement learning when the animat is rewarded. The planning chunks effect a gradual transition from reactive to planned behavior. The model can read-out different motor sequences under different motivational states and learns more efficient paths to rewarded goals as exploration proceeds. Several volitional signals automatically gate the interactions between model subsystems at appropriate times. A 3-D visual simulation environment reproduces the animat's sensory experiences as it moves through a simplified spatial environment. The SOVEREIGN model exhibits robust goal-oriented learning of sequential motor behaviors. Its biomimctic structure explicates a number of brain processes which are involved in spatial navigation.

Patient-provider communication, self-reported medication adherence, and race in a postmyocardial infarction population.

OBJECTIVES: Our objectives were to: 1) describe patient-reported communication with their provider and explore differences in perceptions of racially diverse adherent versus nonadherent patients; and 2) examine whether the association between unanswered questions and patient-reported medication nonadherence varied as a function of patients' race. METHODS: We conducted a cross-sectional analysis of baseline in-person survey data from a trial designed to improve postmyocardial infarction management of cardiovascular disease risk factors. RESULTS: Overall, 298 patients (74%) reported never leaving their doctor's office with unanswered questions. Among those who were adherent and nonadherent with their medications, 183 (79%) and 115 (67%) patients, respectively, never left their doctor's office with unanswered questions. In multivariable logistic regression, although the simple effects of the interaction term were different for patients of nonminority race (odds ratio [OR]: 2.16; 95% confidence interval [CI]: 1.19-3.92) and those of minority race (OR: 1.19; 95% CI: 0.54-2.66), the overall interaction effect was not statistically significant (P=0.24). CONCLUSION: The quality of patient-provider communication is critical for cardiovascular disease medication adherence. In this study, however, having unanswered questions did not impact medication adherence differently as a function of patients' race. Nevertheless, there were racial differences in medication adherence that may need to be addressed to ensure optimal adherence and health outcomes. Effort should be made to provide training opportunities for both patients and their providers to ensure strong communication skills and to address potential differences in medication adherence in patients of diverse backgrounds.

Self-reported medication non-compliance in the elderly

Objective: To assess self-reported compliance with prescribed medications in a population of elderly patients prior to their hospital admission in an attempt to understand further the factors which influence drug taking patterns.

Help needed in medication self-management for people with visual impairment: case-control study

Background: Visual impairment (VI) is rising in prevalence and contributing to increasing morbidity, particularly among older people. Understanding patients' problems is fundamental to achieving optimal health outcomes but little is known about how VI impacts on self-management of medication.

Aim: To compare issues relating to medication self-management between older people with and without VI.

Design and setting: Case-control study with participants aged =65 years, prescribed at least two long-term oral medications daily, living within the community.

Method: The study recruited 156 patients with VI (best corrected visual acuity [BCVA] 6/18 to 3/60) at low-vision clinics; community optometrists identified 158 controls (BCVA 6/9 or better). Researchers visited participants in their homes, administered two validated questionnaires to assess medication adherence (Morisky; Medication Adherence Report Scale [MARS]), and asked questions about medication self-management, beliefs, and support.

Results: Approximately half of the participants in both groups reported perfect adherence on both questionnaires (52.5% Morisky; 43.3%, MARS). Despite using optical aids, few (3%) with VI could read medication information clearly; 24% had difficulty distinguishing different tablets. More people with VI (29%) than controls (13%) (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.6 to 5.0) needed help managing their medication, from friends (19% versus 10%) or pharmacists (10% versus 2.5%; OR = 4.4, 95% CI = 1.4 to 13.5); more received social service support (OR = 7.1; 95% CI = 3.9 to 12.9).

Conclusion: Compared to their peers without VI, older people with VI are more than twice as likely to need help in managing medication. In clinical practice in primary care, patients' needs for practical support in taking prescribed treatment must be recognised. Strategies for effective medication self-management should be explored.

Validity of the DSM-Oriented Scales of the Child Behavior Checklist and Youth Self-Report

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Perpendicularly self-oriented and shape-controlled L1(0)-FePt nanorods directly synthesized by a temperature-modulated process

The synthesis and self-assembly of tetragonal phase-containing L1(0)-Fe(55)Pt(45) nanorods with high coercive field is described. The experimental procedure resulted in a tetragonal/cubic phase ratio close to 1:1 for the as-synthesized nanoparticles. Using different surfactant/solvent proportions in the process allowed control of particle morphology from nanospheres to nanowires. Monodisperse nanorods with lengths of 60 +/- 5 nm and diameters of 2-3 nm were self-assembled in a perpendicular oriented array onto a substrate surface using hexadecylamine as organic spacer. Magnetic alignment and properties assigned, respectively, to the shape anisotropy and the tetragonal phase suggest that the self-assembled materials are a strong candidate to solve the problem of random magnetic alignment observed in FePt nanospheres leading to applications in ultrahigh magnetic recording (UHMR) systems capable of achieving a performance of the order of terabits/in(2).

Oriented texture classification based on self-organizing neural network and Hough transform

This paper presents a technique for oriented texture classification which is based on the Hough transform and Kohonen's neural network model. In this technique, oriented texture features are extracted from the Hough space by means of two distinct strategies. While the first operates on a non-uniformly sampled Hough space, the second concentrates on the peaks produced in the Hough space. The described technique gives good results for the classification of oriented textures, a common phenomenon in nature underlying an important class of images. Experimental results are presented to demonstrate the performance of the new technique in comparison, with an implemented technique based on Gabor filters.

Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe

BACKGROund: Patient-oriented medicine is an emerging concept, encouraged by the World Health Organization, to greater involvement of the patient in the management of chronic diseases. The Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index is a self-assessment score allowing the patient to comprehensively evaluate the actual course of atopic dermatitis (AD), using subjective and objective criteria derived mainly from the SCORAD, a validated AD severity clinical assessment tool.