Promotor da Saúde : o Farmacêutico Promotor de Saúde nas Empresas

Para as sociedades contemporâneas, onde o predomínio de transtornos mentais parece comprometer a qualidade de vida e a prosperidade económica, não só através de custos diretos de saúde e serviços sociais, mas também devido à perda de emprego e produtividade, a implementação de programas de promoção de saúde ocupacional é imperativa. Os principais objetivos desta monografia são o estudo dos níveis de stresse ocupacional de uma amostra de trabalhadores portugueses, análise do seu conhecimento sobre gestão de stresse e o desenvolvimento de um projeto de promoção de saúde, a realizar por farmacêuticos, que visa um incremento de saúde e bem-estar dos colaboradores no seu local de trabalho. Trata-se de um estudo descritivo observacional e transversal. Aplicou-se um questionário por inquérito online, confidencial e voluntário, onde participaram 240 indivíduos dos quais 104 preencheram os critérios de inclusão. Sessenta e seis são mulheres. Os conhecimentos sobre sintomas associados ao stresse são apenas alguns (51%) ou até mesmo inexistentes (46%), e a maioria da população em estudo não sabe como prevenir (77%) e/ou gerir (82%) o stresse no local de trabalho. O estudo corrobora a existência de fatores de stresse profissional. Programas de promoção de saúde ocupacional, como aquele planificado ao longo do trabalho, podem melhorar o bem-estar, a saúde mental e consequentemente aumentar a produtividade, diminuindo o absentismo dos trabalhadores em Portugal.

Vulnerabilidade ao Stresse Profissional e Qualidade de Vida no Trabalho : Estudo empírico numa amostra de cuidadores/as formais de pessoas portadoras de deficiência Cláudia Marques Caçote Leiria

Portugal é dos países com maior índice de stresse da UE, sendo a profissão dos/as cuidadores/as de pessoas deficientes uma das que apresenta maior vulnerabilidade ao stresse profissional em deterioramento da Qualidade de Vida no Trabalho (QVT). Este trabalho visou analisar a relação entre vulnerabilidade ao stresse profissional e QVT nos/as cuidadores/as formais das IPSS de Ourém, com resposta na área da deficiência. A amostra foi composta por 225 colaboradores/as formais. Neste estudo aplicaram-se os instrumentos o inventários QVT de Rafael & Lima (2007) e 23 QVS de Vaz Serra (2000). Os resultados demonstraram que é inexistente a correlação entre QVT (frequência) e vulnerabilidade ao stresse e salientaram a importância do apoio social e familiar no trabalho para a promoção de QVT, sendo o stresse profissional dependente das variáveis habilitações literárias, categoria profissional e tempo de serviço.

A Relação entre a Resiliência e a Vulnerabilidade ao Stresse : estudo numa organização de práticas positivas

Este estudo analisou as inter-relações que se estabelecem entre resiliência e stresse numa organização de práticas positivas assumidas e outra sem assunção dessas práticas. Abordaram-se as temáticas stresse, resiliência, organizações positivas, coping, percorrendo a sua evolução histórica até à atualidade. Adotou-se uma metodologia de investigação de natureza quantitativa. A amostra final foi constituída por 141 inquéritos validados, com idades entre os 18 e os 65 anos. Avaliaram-se os níveis indicadores fatuais de resiliência, aplicando a Escala de Resiliência de Wagnild e Young (1993), traduzida e adaptada para o português por Pesce, et al. (2005), e avaliaram-se os níveis de stresse aplicando-se o Questionário de Vulnerabilidade ao Stresse (23 QVS) criado por Adriano Vaz-Serra (2000). Os instrumentos apresentaram as qualidades psicométricas exigidas (sensibilidade e fidedignidade), a ER apresentou o coeficiente alfa de Cronbach de 0,777 e a QVS23 de 0,759. Estudou-se a variabilidade do grau de resiliência e da vulnerabilidade ao stresse em função das variáveis (idade, sexo, escolaridade, estado civil, antiguidade na empresa e no posto de trabalho). Os resultados revelam diferenças significativas face à idade, e habilitações literárias na vulnerabilidade ao stresse. A variável estado civil exerce efeito diferencial na resiliência. Concluiu-se que o tipo de práticas não influi na resiliência. Os colaboradores das organizações positivas são menos vulneráveis ao stresse, nomeadamente nas dimensões “Condições de vida adversas” e “Dramatização de Existência”. Não se verificou correlação entre a resiliência e o stresse.

PokerMapper: : mapping executive functions, poker playing ability and responsible gambling in online environments

Research objectives Poker and responsible gambling both entail the use of the executive functions (EF), which are higher-level cognitive abilities. The main objective of this work was to assess if online poker players of different ability show different performances in their EF and if so, which functions are the most discriminating ones. The secondary objective was to assess if the EF performance can predict the quality of gambling, according to the Gambling Related Cognition Scale (GRCS), the South Oaks Gambling Screen (SOGS) and the Problem Gambling Severity Index (PGSI). Sample and methods The study design consisted of two stages: 46 Italian active players (41m, 5f; age 32±7,1ys; education 14,8±3ys) fulfilled the PGSI in a secure IT web system and uploaded their own hand history files, which were anonymized and then evaluated by two poker experts. 36 of these players (31m, 5f; age 33±7,3ys; education 15±3ys) accepted to take part in the second stage: the administration of an extensive neuropsychological test battery by a blinded trained professional. To answer the main research question we collected all final and intermediate scores of the EF tests on each player together with the scoring on the playing ability. To answer the secondary research question, we referred to GRCS, PGSI and SOGS scores.  We determined which variables that are good predictors of the playing ability score using statistical techniques able to deal with many regressors and few observations (LASSO, best subset algorithms and CART). In this context information criteria and cross-validation errors play a key role for the selection of the relevant regressors, while significance testing and goodness-of-fit measures can lead to wrong conclusions.   Preliminary findings We found significant predictors of the poker ability score in various tests. In particular, there are good predictors 1) in some Wisconsin Card Sorting Test items that measure flexibility in choosing strategy of problem-solving, strategic planning, modulating impulsive responding, goal setting and self-monitoring, 2) in those Cognitive Estimates Test variables related to deductive reasoning, problem solving, development of an appropriate strategy and self-monitoring, 3) in the Emotional Quotient Inventory Short (EQ-i:S) Stress Management score, composed by the Stress Tolerance and Impulse Control scores, and in the Interpersonal score (Empathy, Social Responsibility, Interpersonal Relationship). As for the quality of gambling, some EQ-i:S scales scores provide the best predictors: General Mood for the PGSI; Intrapersonal (Self-Regard; Emotional Self-Awareness, Assertiveness, Independence, Self-Actualization) and Adaptability  (Reality Testing, Flexibility, Problem Solving) for the SOGS, Adaptability for the GRCS. Implications for the field Through PokerMapper we gathered knowledge and evaluated the feasibility of the construction of short tasks/card games in online poker environments for profiling users’ executive functions. These card games will be part of an IT system able to dynamically profile EF and provide players with a feedback on their expected performance and ability to gamble responsibly in that particular moment. The implementation of such system in existing gambling platforms could lead to an effective proactive tool for supporting responsible gambling. 

Enhancing the health of medical students : outcomes of an integrated mindfulness and lifestyle program

Medical students experience various stresses and many poor health behaviours. Previous studies consistently show that student wellbeing is at its lowest pre-exam. Little core-curriculum is traditionally dedicated to providing self-care skills for medical students. This paper describes the development, implementation and outcomes of the Health Enhancement Program (HEP) at Monash University. It comprises mindfulness and ESSENCE lifestyle programs, is experientially-based, and integrates with biomedical sciences, clinical skills and assessment. This study measured the program’s impact on medical student psychological distress and quality of life. A cohort study performed on the 2006 first-year intake measured effects of the HEP on various markers of wellbeing. Instruments used were the depression, anxiety and hostility subscales of the Symptom Checklist-90-R incorporating the Global Severity Index (GSI) and the WHO Quality of Life (WHOQOL) questionnaire. Pre-course data (T1) was gathered mid-semester and post-course data (T2) corresponded with pre-exam week. To examine differences between T1 and T2 repeated measures ANOVA was used for the GSI and two separate repeated measures MANOVAs were used to examine changes in the subscales of the SCL-90-R and the WHOQOL-BREF. Follow-up t-tests were conducted to examine differences between individual subscales. A total of 148 of an eligible 270 students returned data at T1 and T2 giving a response rate of 55%. 90.5% of students reported personally applying the mindfulness practices. Improved student wellbeing was noted on all measures and reached statistical significance for the depression (mean T1 = 0.91, T2 = 0.78; p = 0.01) and hostility (0.62, 0.49; 0.03) subscales and the GSI (0.73, 0.64; 0.02) of the SCL-90, but not the anxiety subscale (0.62, 0.54; 0.11). Statistically significant results were also found for the psychological domain (62.42, 65.62; p < 0.001) but not the physical domain (69.11, 70.90; p = 0.07) of the WHOQOL. This study is the first to demonstrate an overall improvement in medical student wellbeing during the pre-exam period suggesting that the common decline in wellbeing is avoidable. Although the findings of this study indicate the potential for improving student wellbeing at the same time as meeting important learning objectives, the limitations in study design due to the current duration of follow-up and lack of a control group means that the data should be interpreted with caution. Future research should be directed at determining the contribution of individual program components, long-term outcomes, and impacts on future attitudes and clinical practice.

The work conditions of allied health professionals : the impact on satisfaction, commitment and psychological distress

The present study investigated the extent to which the Demand-Control-Support (DCS) model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals'. Allied health professionals from an Australian healthcare organization were surveyed, with 113 participating (52,6%). Multiple regression analyses revealed that the DCS model predicted all the outcome variables of job satisfaction, organizational commitment and psychological distress. Conversely, significant contributions of the organizational justice variables were limited to organizational commitment and psychological distress. The results of the study provide practical implications for the job conditions of allied health professionals, in particular, the delivery of support and maintaining high levels of justice.

Managing panic disorder in general medical practice

Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns. This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies. Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.

Assessing the validity of tympanic temperature to predict core temperature of firefighters in different environmental conditions

The present study examined the validity of tympanic temperature measurements as a predictor of core temperature on the fireground in different environmental conditions. Fiftyone volunteer firefighters participated in the study across four different conditions, the conditions consisted of; 1) passive (i.e., no intervention) cooling in cold ambient temperatures (0-6°C); 2) cooling (through water immersion) in cool ambient temperatures (10-12ºC); 3) cooling (through water immersion) in warm ambient temperatures (21.5°C); and, 4) passive cooling in warm ambient temperatures (22°C). Firefighters wore full structural personal protective clothing while performing common firefighting duties including search and rescue tasks for 20-40 minutes. There was no difference between core and tympanic temperature immediately post-exercise across any condition. However, for all conditions, tympanic temperature dropped significantly faster than core temperature from 0 minutes, and remained significantly lower (p < 0.05) than core temperature from nine to 20 minutes post-training. The results show that there is no consistent difference between core and tympanic temperature during recovery from a simulated firefighting task across a range of different ambient conditions. Agencies should, accordingly, prioritize investigating other practical markers of core temperature as part of a broader heat stress management plan for firefighters.

Avaliação endócrina e anatomo-morfológica do trato genital de fêmeas suínas

Pós-graduação em Medicina Veterinária - FMVZ

Impacto do estresse no bem-estar dos animais e na qualidade da carcaça e da carne

Pós-graduação em Zootecnia - FCAV

Estresse psicológico e desempenho de atletas juniores: uma análise documental

Soccer is one of the most practiced sports in the world, and for many years, some areas of physical education has been doing studies related to the improvement of their income from these areas if this sport psychology. The psychological aspects are very influential and involved in the daily life of an athlete, especially for basic categories of athletes who see in soccer a dream to come true or only a source of income for his family, where such aspects act beneficially or evil for the athlete. Stress, in particular, can appear in various situations and in various ways, and different influences and reactions athlete to athlete, also resulting in physiological changes and variations in performance. Stress, and especially stressful situations, like any psychological aspect should be identified in order to train your athlete to know how to deal with stressful situations. Know what are the stressors, which carries the stress load for the athlete, how to handle the stressful situations, using psychological training in the preseason, know how to use stress management techniques, and be able to manage it all so your athlete reaches an optimal level of income is described in the present work, in order to provide a theoretical and updated reference for professionals of Physical Education, so that they stay up to date on sports psychology and also understand a little more on this subject, which is still little discussed within soccer and often overlooked by many professionals who are already in the context of competitive soccer

The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease

Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.

Work-related behavior and experience patterns and predictors of mental health in German physicians in medical practice

Background and Objectives: Work-related stress and burnout among physicians are of increasing relevance. The aim of this study was to investigate work-related behavior and experience patterns and predictors of mental health of physicians working in medical practice in Germany. Methods: We surveyed a stratified, random sample of 900 physicians from different specialties. The questionnaire included the standardized instruments Work-related Behavior and Experience Pattern (AVEM) and the Short Form-12 Health Survey (SF-12). Results: Only one third of physicians reported high or very high general satisfaction with their job, but 64% would choose to study medicine again. Only 18% of physicians presented a healthy behavior and experience pattern. Almost 40% presented a pattern of reduced motivation to work, 21% were at risk of overexertion, and 22% at risk for burnout. Willingness to study medicine again, fulfilled job expectations, professional years, marital status, and behavior patterns were significant predictors of mental health and accounted for 35.6% of the variance in mental health scores. Job-related perceptions also had a significant effect on burnout. Conclusions: The strong influence of work-related perceptions suggests a need for realistic expectation management in medical education, as well as support in stress management and coping strategies during medical training.

Getting started with taiji: investigating students expectations and teachers appraisals of taiji beginners courses

In recent years, Taiji has been frequently investigated and considered as a stress management intervention. Although health care providers' appraisals and consumers' expectations are regarded as essential for treatment outcome, little attention has been drawn to this issue in Taiji research. In our study we have conducted two surveys to explore beginners' (n = 74) expectations and teachers' (n = 136) appraisals of their Taiji courses in general as well as more particularly related to stress management. Qualitative data analysis revealed that beginners mainly expected to learn a new method that is applicable in their daily life to foster peace of mind and to enhance their stress management. Congruently moderate-to-high improvements in stress management have also been found in quantitative analysis, whereby a lower educational level predicted higher expectations (P = 0.016). Taiji-teachers stated body- and mind-related benefits most frequently and appraised moderate-to-high improvements in stress management. Higher appraisals were predicted by a shorter teaching experience (P = 0.024). Our results inform about beginners' expectations and teachers' appraisals related to a Taiji-beginners course and highlight the role of educational background and teaching experience in shaping stress-management-related beginners' expectations and teachers' appraisals.

Study protocol: Transition from localized low back pain to chronic widespread pain in general practice: identification of risk factors, preventive factors and key elements for treatment--a cohort study

Background Chronic localized pain syndromes, especially chronic low back pain (CLBP), are common reasons for consultation in general practice. In some cases chronic localized pain syndromes can appear in combination with chronic widespread pain (CWP). Numerous studies have shown a strong association between CWP and several physical and psychological factors. These studies are population-based cross-sectional and do not allow for assessing chronology. There are very few prospective studies that explore the predictors for the onset of CWP, where the main focus is identifying risk factors for the CWP incidence. Until now there have been no studies focusing on preventive factors keeping patients from developing CWP. Our aim is to perform a cross sectional study on the epidemiology of CLBP and CWP in general practice and to look for distinctive features regarding resources like resilience, self-efficacy and coping strategies. A subsequent cohort study is designed to identify the risk and protective factors of pain generalization (development of CWP) in primary care for CLBP patients. Methods/Design Fifty-nine general practitioners recruit consecutively, during a 5 month period, all patients who are consulting their family doctor because of chronic low back pain (where the pain is lasted for 3 months). Patients are asked to fill out a questionnaire on pain anamnesis, pain-perception, co-morbidities, therapy course, medication, socio demographic data and psychosomatic symptoms. We assess resilience, coping resources, stress management and self-efficacy as potential protective factors for pain generalization. Furthermore, we raise risk factors for pain generalization like anxiety, depression, trauma and critical life events. During a twelve months follow up period a cohort of CLBP patients without CWP will be screened on a regular basis (3 monthly) for pain generalization (outcome: incident CWP). Discussion This cohort study will be the largest study which prospectively analyzes predictors for transition from CLBP to CWP in primary care setting. In contrast to the typically researched risk factors, which increase the probability of pain generalization, this study also focus intensively on protective factors, which decrease the probability of pain generalization.