Estudo comparativo de condutas de saúde entre universitários no início e no final do curso

OBJETIVO: Analisar as diferenças nas condutas de saúde de estudantes da área de saúde de universidades públicas no início e no final do curso. MÉTODOS: Estudo realizado com amostra estratificada por curso e por universidade, de 735 estudantes de ciências da saúde de universidades públicas do estado de Pernambuco, em 2006. Os dados foram coletados com a aplicação do questionário National College Health Risk Behavior Survey, validado previamente para utilização com estudantes universitários. Para análise de associação foi utilizado o teste qui-quadrado ou exato de Fisher. Os resultados foram considerados significantes para p<0,05. RESULTADOS: A maioria dos estudantes era do gênero feminino (69,5%). Um menor percentual de estudantes ao final da graduação informou morar com os pais ou responsáveis. As condutas de violência, relacionadas ao peso e à atividade física não apresentaram diferenças significativas, assim como a maioria das condutas de segurança no trânsito e de alimentação. O consumo de álcool (68,8% vs 83,3%), tabaco (40,7% vs 52,5%) e inalantes (10,2% vs 21,9%) e a prática de relação sexual (62,5% vs 85,0%) foram mais freqüentes entre estudantes do final do curso, com diferenças estatisticamente significativas. CONCLUSÕES: Em geral, as condutas de saúde não diferiram significativamente entre os estudantes do início e os do final do curso de graduação na área de saúde.

Mapping non-suicidal self-injury in adolescence: Development and confirmatory factor analysis of the impulse, self-harm and sucidal ideation questionnaire for adolescents (ISSIQ-A)

Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.

Programa de competências pessoais e sociais para adultos em exclusão social

Trabalho apresentado em XIII Congreso Internacional Galego-Portugués de Psicopedagoxía, Área 8 Interculturalidad, inclusión social y educación. Universidad da Coruña, 3 de Setembro de 2015.

Programa de competências pessoais e sociais para adultos em exclusão social

Trabalho apresentado em XIII Congreso Internacional Galego-Portugués de Psicopedagoxía, Área 8 Interculturalidad, inclusión social y educación. Universidad da Coruña, 3 de Setembro de 2015.

Education for health: alcohol and young aged school teenagers

Introduction: Alcohol consumption starts at an early age in Portuguese people. Health problems and risk behavior associated with excessive consumption can be prevented or highly reduced through effective school programs. Health professionals, such as biomedical scientists, (BSc), are important in promoting healthy lifestyles through the transmission of knowledge. Objective: Explore the role of the BSc in promoting health via intervention and clarification actions, (ICA), with 9th grade students from Agrupamento de Escolas da Portela e Moscavide (AEPM) and Visconde Juromenha (AEVJ); Verify the relationship between participating in the ICA and the level of knowledge acquired from it. Methods: Behaviors and beliefs concerning alcohol consumption and knowledge about the repercussions of it in the human body, mainly regarding the liver, were assessed by questionnaire. The questionnaire was completed before and after the ICA, by the control group (CG) and the study group (SG), respectively. The answers concerning knowledge were given points, later converted to a score from 0 to 100%. Data was analyzed applying descriptive statistics and the t-student test using SPSS 20.0. Results: After statistical analysis, it was found an average score of 48.8% for SG and 46.2% for CG. The difference between groups was statistically significant only in AEPM where ICA included a practical methodology (microscopic and macroscopic observation of pork livers), contrary to AEVJ. Conclusions: BSc intervention through ICA’s improves teenagers’ knowledge. Theoretical knowledge associated with practical approaches improves the retention of information and the development of a conscious behavior about the consumption of alcohol.

Relação entre qualidade da quditoria e manipulação de resultados

A presente dissertação tem como objetivo analisar se existe relação entre a manipulação de resultados e a qualidade da auditoria, baseado no estudo do comportamento de determinados “accruals” nas empresas portuguesas não cotadas. Nos diversos estudos existentes sobre o tema “Relação da Qualidade da Auditoria e Manipulação de Resultados”, surgem abordados muitos aspetos, nomeadamente no que respeita às motivações, às formas de manipulação e métodos de deteção que se verifica no campo da auditoria e, este trabalho, pretende abordar se o processo da auditoria é, ou não, eficaz na deteção destas práticas efetuadas pelos gestores, pois isso influencia a confiança naqueles que utilizam a informação financeira. Desta forma, o trabalho pretende basear-se nestas abordagens e complementar visões e conclusões. Neste âmbito, surgem perspetivas e informações que alertam para comportamentos de risco, assim como a sua origem, ou seja, as motivações que provocam esta prática, tanto por parte dos gestores como dos administradores. É nesta perspetiva que este trabalho se enquadra, numa sociedade contemporânea que continuadamente dá exemplos reais e concretos destas práticas. Um ponto é comum, que é o facto de a manipulação dos resultados surgir principalmente pelo motivo dos interesses e motivações por parte dos gestores em conseguirem benefícios. Na tese são abordados os incentivos que levam à manipulação no contexto português, que parecem estar relacionados com o contexto económico e fiscal, onde é desenvolvida a atividade dos agentes económicos. Outra abordagem importante no trabalho é a referência às principais metodologias de detenção da manipulação de resultados, nomeadamente os modelos baseados nos accruals e na distribuição de resultados. O modelo empírico deste estudo consiste numa regressão linear múltipla, com o objetivo de explicar a relação, entre a variável accruals discricionários e as variáveis Big4, a dimensão da empresa, o endividamento, o volume de negócios e a rendibilidade. Para complementar este estudo a análise empírica incidiu sobre 4723 empresas portuguesas não cotadas, a amostra usada foi baseada na base de dados SABI, para um período de análise entre 2011 a 2013. Os resultados encontrados sugerem que existe relação entre a qualidade da auditoria e a manipulação dos resultados concluindo que as empresas auditadas pelas Big4 apresentam accruals discricionários inferiores às restantes empresas.

Molecular epidemiology of HIV-1 in Rio Grande, RS, Brazil

We conducted a molecular epidemiological study to investigate HIV-1 strains in Rio Grande, southern Brazil, searching for an association with transmission mode and risk behavior. Patients (185) identified at an AIDS treatment reference Hospital, from 1994 to 1997, were included; from which 107 blood samples were obtained. Nested PCR was realized once for each sample; for amplified samples (69) HIV subtypes were classified using the heteroduplex mobility assay. Subtypes identified were B (75%), C (22%) and F (3%). All infections with C were diagnosed after 1994. Comparing patients with B and C, no differences were detected regarding demographic, clinical and laboratory characteristics; survival analysis did not reveal differences in HIV to AIDS evolution. A higher proportion of injecting drug users, IDU (not significant, p<.07) was found among those with C. This suggests that C may have been introduced in this area through IDU, and is being spread, probably by their sexual partners, to persons with other risk practices.

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.

Prevalência da C.trachomatis entre homens que fazem sexo com homens (HSH) que frequentam um centro clínico comunitário alternativo em Barcelona

RESUMO - Enquadramento: A infeção por Chlamydia trachomatis (CT) é considerada um grave problema de Saúde Pública. É causa de infeções sintomáticas tanto no homem como na mulher, bem como, de infeções assintomáticas que podem ter consequências muito graves a longo prazo. A presença de CT sem tratamento aumenta o risco de transmissão do vírus da imunodeficiência humana. Existem vários estudos publicados de prevalência da CT por todo o mundo, no entanto, estudos de prevalência da CT em populações assintomáticas, envolvendo homens que fazem sexo com homens (HSH) são raros na Europa. Assim, o presente estudo, ao estimar a prevalência e ao descrever as caraterísticas epidemiológicas e de conduta dos HSH, pretende contribuir para o plano de ação contra as IST´s e VIH na Catalunha, através de estratégias concretas para deteção e prevenção da CT. Métodos: Trata-se de um estudo observacional, transversal de prevalência da CT em HSH utentes de um serviço comunitário em Barcelona, com recurso a técnicas de diagnóstico de biologia molecular e a um questionário. Durante Março e Junho de 2015, foram recrutados 200 voluntários de um serviço comunitário em Barcelona que foram testados para CT e NG em três locais anatómicos através de uma PCR em tempo real utilizando o ensaio Anyplex™ CT/NG Real-time Detection. Resultados: O presente estudo permitiu uma caraterização da situação atual quanto á prevalência e aos fatores de risco associados á infeção por CT em HSH. A prevalência nesta população específica foi de 12,6% e os fatores risco associados foram o facto de serem VIH e praticarem sexo anal insertivo/recetivo com parceiro estável. Conclusões: Os resultados obtidos reforçam a necessidade do desenvolvimento de estratégias adequadas de controlo e prevenção da CT nesta população de risco, tais como: rastreios frequentes e tratamento dos casos positivos para quebrar a cadeia de transmissão, promoção da saúde, educação e notificação dos parceiros sexuais. Também demonstram a importância destes rastreios nos três locais anatómicos: uretra, reto e faringe.

O que é comportamento de risco para transtornos alimentares em adolescentes?

OBJETIVO: Caracterizar comportamento de risco para transtornos alimentares (TA) e sua frequência entre adolescentes em uma revisão da literatura nacional e internacional. MÉTODOS: Foi realizada uma busca bibliográfica por meio de uma revisão integrativa nas bases de dados PubMed (US National Library of Medicine)e Lilacs e no portal SciELO,utilizando-se os descritores relacionados à "eating disorder risk behavior". Foram selecionados artigos publicados nos últimos 10 anos, nos idiomas português, espanhol e inglês, e especificamente com adolescentes. Foram avaliados 76 artigos e analisados a nomenclatura e os instrumentos utilizados para avaliar comportamento de risco para TA e sua prevalência. RESULTADOS: Encontrou-se uma série de termos para avaliar risco para TA. A metodologia mais utilizada foi a de questionários e escalas, destacando-se o EAT-26 ou 40 e o BITE, dentre os mais frequentes; a prevalência de risco variou de 0,24% a 58,4%. CONCLUSÃO: Diferentes nomenclaturas e instrumentos são utilizados para avaliar comportamento de risco para TA entre adolescentes, com grande amplitude nos resultados de prevalência. Maior padronização de termos e metodologia de avaliação permitiriam melhor comparação entre estudos epidemiológicos em diferentes localidades.

Comportamentos de risco na juventude: Uma perspetiva de género e interseccional

Tese de Doutoramento em Psicologia - Especialidade em Psicologia Social

Application of receptive music therapy in internal medicine and cardiology

OBJECTIVE: To investigate the effects of receptive music therapy in clinical practice. METHODS: Receptive music therapy was individually applied via musical auditions, including five stages: musical stimulation, sensation, situation, reflection, and behavioral alteration. Following anamnesis and obtainment of consent, patients answered a first questionnaire on health risk evaluation (Q1), and after participating in 16 weekly music therapy sessions, answered a second one (Q2). RESULTS: Two men and 8 women, aged above 18 years, referred to us due to symptoms of stress, emotional suffering, and the need to change lifestyles (health risk behavior) were studied between August 1998 and December 1999. Comparison between answers to Q1 and Q2, showed a trend (P=0.059) for reduction of ingestion of cholesterol-rich foods and for increased prospects in life with a tendency towards improvement, and also of increased intake of fiber-rich food (55.6%), increased levels of personal satisfaction (44.5%), and decreased levels of stress (66.7%). CONCLUSION: The study demonstrated decreased stress levels and increased personal satisfaction, higher consumption of fiber-rich food, lower cholesterol intake, and a better perspective on life, suggesting that receptive music therapy may be applied in clinical practice as an auxiliary therapeutic intervention for the treatment of behavioral health risks.

Psychosocial adjustment and physical health in children of divorce

Objective: To review the literature on the effects of parental divorce over the psychological maladjustment and physical health problems in children of divorced parents, thus contributing to the integration of existing scientific knowledge based on the biopsychosocial model of the impact of divorce on children’s physical health as proposed by Troxel and Matthews (2004). Sources: Review of the literature using MEDLINE and PsycInfo (1980-2007) databases, selecting the most representative articles on the subject. Special attention was paid to contributions by internationally renowned investigators on the subject. Summary of the findings: Divorce may be responsible for a decline of physical and psychological health in children. The developmental maladjustment of children is not triggered by divorce itself, but rather by other risk factors associated with it, such as interparental conflict, parental psychopathology, decline in socio-economic level, inconsistency in parenting styles, a parallel and conflicting co-parenting relationship between parents and low levels of social support. Such risk factors trigger maladjusted developmental pathways, marked by psychopathological symptoms, poor academic performance, worst levels of physical health, risk behavior, exacerbated psychophysiological responses to stress and weakening of the immune system. Conclusions: Clear links were observed between experiencing parental divorce and facing problems of physical and psychological maladjustment in children. Divorce is a stressor that should be considered by health professionals as potentially responsible for maladjusted neuropsychobiological responses and for decline in children’s physical health.

Prendre des risques, ça rapporte ? Conduites à risques et perception des risques chez des adolescents tout-venant

Risk taking and its association with substance use by adolescents are often studied among clinical populations. The behavior of non-clinical adolescent samples is less well-known. According to some scholars, the adoption of risk behaviors can be predicted by a function of perceptions of both benefits and risks of such behaviors. However, the literature is still controversial about their respective significance. In this study, a non-clinical sample of 221 adolescents, aged 14 to 20, completed two questionnaires: the RIPS-R to estimate risk taking behaviors as well as perception of the risks and benefits of such behaviors, and the DEP-ADO to measure substance use. Our results show a high annual prevalence of socially accepted risk behaviors (drinking alcohol, not studying for exams, smoking tobacco). However, socially repressed behaviors (brawling, vandalism) are very occasional and are associated with problematic substance use. Globally, engagement in risk behaviors is more closely linked with the perceptions of its benefits than the perception of its risks. Finally, limitations and implications of these results for research and prevention are provided. Les prises de risques et leur association avec la consommation de substances chez les adolescents ont souvent été étudiées auprès de populations cliniques. Le comportement des jeunes tout-venant est en revanche moins bien connu. Selon certains théoriciens, la participation à des conduites à risques peut être déterminée en fonction des perceptions de leurs bénéfices et dangers potentiels. Toutefois, la littérature ne s'accorde pas sur l'importance respective que ces perceptions revêtent. Dans cette étude, 221 adolescents tout-venant, âgés de 14 à 20 ans, ont complété deux questionnaires : le RIPS-R pour évaluer la prise de risques et leur perception en termes de risques et de bénéfices, et la DEP-ADO pour mesurer la consommation de substances. Les résultats mettent en évidence une prévalence annuelle élevée des comportements à risques socialement acceptables (boire de l'alcool, fumer du tabac). En revanche, les comportements réprimés socialement (bagarres, actes de vandalisme) s'avèrent très occasionnels et sont associés à la consommation problématique de substances. Globalement, c'est la perception des bénéfices qui est le plus fortement liée au fait d'adopter un comportement à risque. Finalement, les limites et les implications pratiques de ces résultats sont discutées. © 2010 Elsevier Masson SAS. Tous droits réservés.

Construcción y validación de un cuestionario para medir conductas, conocimientos y actitudes sobre la higiene de las manos en personal sanitario en formacion.

Background: Hand hygiene in the health context is a complex behaviour. There have been rarely given the role of the knowledge and attitudes as predictors of hand hygiene behaviour. The main objective of this work is the description of the development of a questionnaire on hand hygiene and the analysis of their measurement properties. Method: An instrument which was designed and validated a questionnaire. It was held in January 2009. It finally has had 50 items that assess risk behaviour intention before and after contact with the patient, declarative knowledge and attitudes about hand hygiene. It has been applied to 431 students of health sciences at the University of Granada. Results: There were three factor analysis, ultimately obtaining a general convergence value that explains 46.01% of the total variance and high reliability (a=0,843). There is correlation between knowledge and behavior intentions before and after patient contact (p <0.01).In turn, the attitude correlates only with behavioral intention before (p <0.05). The hand hygiene behavior refers to a higher mean after the completion of various health activities before the same (4.26 and 3.96 respectively). Both declarative knowledge and attitudes significantly predict behavioral intention, in particular the conduct before the contact with the patient (R2 = 0.100, standardized Beta 0.256 for knowledge and 0.145 for attitudes). Conclusions: The questionnaire shows high internal consistency. We have obtained a valid tool for assessing risk behavior, knowledge and attitudes about students’ hand hygiene in health sciences. The tool detects deficiencies in basic skills in students.