917 resultados para Psychiatric Rating-scale
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RESUMO: Introdução: Vários estudos têm encontrado evidência para a relação entre as crenças e atitudes dos profissionais de saúde, a sua abordagem de tratamento, referida como orientada segundo o modelo biomédico ou modelo biopsicossocial (Bishop, 2008; Mutsaers, 2012), e os resultados obtidos. É sugerido que, no tratamento da dor lombar crónica, os profissionais que orientam o seu raciocínio e prática segundo o modelo biomédico, tendem a obter piores resultados quando comparados com os obtidos pelos profissionais que orientam o seu raciocínio e prática segundo uma abordagem biopsicossocial. Esta área de estudo tem salientado a importância de desenhar instrumentos capazes de identificar a orientação preferencial dos profissionais de saúde no tratamento da dor crónica de natureza músculo-esquelética, entre os quais se encontra a “Pain Attitudes and Beliefs Scale for Physiotherapists” (PABS-PT). Objetivo: Adaptar culturalmente a PABS-PT para a população de fisioterapeutas portugueses que intervêm em utentes com dor (lombar) crónica, e contribuir para a sua validação Metodologia: A versão original (língua inglesa) do PABS-PT foi adaptada para a língua e cultura portuguesas, através das etapas definidas nas normas orientadoras estabelecidas para este processo (Beaton et al., 2002; MAPI Institute, 2001). A avaliação das propriedades psicométricas da versão portuguesa foi realizada com recurso a uma amostra de 202 fisioterapeutas e estudantes finalistas do curso de licenciatura em Fisioterapia. Inicialmente foi realizada a análise fatorial exploratória da escala através do método das componentes principais. Posteriormente avaliou-se a consistência interna das componentes obtidas com recurso ao alpha de Cronbach (α). Para analisar a validade de constructo foram correlacionadas as componentes obtidas com a versão portuguesa da “Health Care Providers’ Pain and Impairment Relationship Scale” (HC-PAIRS), recorrendo ao cálculo do coeficiente de Spearman. Resultados: O processo de adaptação cultural não revelou dificuldades importantes sendo considerado que a versão portuguesa da PABS-PT é de fácil compreensão e preenchimento, e os seus itens adequados para avaliar as crenças e atitudes dos fisioterapeutas portugueses relativas à intervenção na dor crónica músculo-esquelética. Os resultados revelaram uma estrutura fatorial de duas componentes, identificadas com as componentes da escala original que explicam 30,96% da variância total. A consistência interna encontrada é boa, para a componente biomédica (α de Cronbach = 0,826), mas muito fraca para a componente biopsicossocial (α de Cronbach= 0,589). Relativamente à validade convergente e discriminativa, foi encontrada uma associação estatisticamente significativa e positiva, entre as componentes 1 (biomédica) da versão nportuguesa da PABS e a HC-PAIRS (Rs = 0,481, p≤ 0,005), e negativa, fraca e significativa entre a pontuação total da componente 2 (biopsicossocial) e a HC-PAIRS (Rs = -0,038, p=0,612). Conclusão: A versão portuguesa do PABS-PT é de fácil compreensão e aparenta ser um instrumento válido para a medição da orientação preferencial dos fisioterapeutas, relativamente às suas atitudes e crenças na avaliação e tratamento de utentes com dor crónica de natureza músculo-esquelética. No entanto, a componente biopsicossocial requer uma análise mais aprofundada para que possa, com rigor, ser utilizada na definição de uma orientação preferencialmente biopsicossocial.--------------ABSTRACT: Introduction: Previous studies have found a relation between the beliefs and attitudes of health professionals, their treatment approach, which can follows a biomedical or a biopsychosocial orientation (Bishop, 2008; Mutsaers, 2012), and the outcomes obtained. Therefore, is suggested that the professionals who tend to approach chronic low back pain patients according to the biomedical model have worse outcomes than professionals who use a biopsychosocial approach in there clinical reasoning. This research field has highlighted the importance of developing measures capable of identifying the preferred orientation of health professionals in the treatment of chronic pain of musculoskeletal nature, including the “Pain Attitudes and Beliefs Scale for Physiotherapists” (PABS-PT). Objective: To cross culturally adapt and validate the PABS-PT for the Portuguese population of physiotherapists. Methodology: The original version (English version) of the PABS-PT was adapted to the Portuguese language and culture, through the guidelines established for these processes (Beaton et al., 2002; MAPI Institute, 2001). The psychometric evaluation of the Portuguese version was carried out on a sample of 202 p physiotherapist and final year students of the physiotherapy course. Initially, an exploratory factorial analysis was performed through the method of the main components. Then, the internal consistence of the main components was evaluated using the Cronbach’s alpha (α). The convergent construct validity was analysed through the correlation between the obtained components of PABS-PT and the Health Care Provider’s Pain and Impairment Relationship Scale (HC-PAIRS), using the Spearmen correlation coefficient. Results: No major difficulties were found during the cultural adaptation process of PABS-PT to Portugal, which means that the Portuguese version is easy to understand and fulfill, and items are appropriated to evaluate the beliefs and attitudes of the Portuguese physiotherapists who treat chronic pain of musculoskeletal origins. The results revealed a factorial structure of two components, as the original scale, explaining 30,96% of the total variance. Internal consistence results were good, for the biomedical component (Cronbach’s α = 0,826), but very weak for the biopsychosocial componente (Cronbach’s α = 0,589). Relatively to convergent and discriminative validity, a statistically significant association was found, between the components 1 (biomedical) of the Portuguese version of PABS-PT and the HC-PAIRS (Rs= 0,481, p≤ 0,005) and negative, weak and significant between the total score of component 2 (biopsychosocial) and the HC-PAIRS (Rs = -0,038, p=0,612). Conclusion: The Portuguese Version of PABS-PT is easy to understand and seems to be a valid instrument to measure the attitudes and beliefs of physiotherapists in the management of patients with chronic low back pain. However, the biopsychosocial component requires a further deep analysis to examine a preferable biopsychosocial orientation.
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RESUMO: INTRODUÇÃO: A OMS (2001) revela que cerca de 450 milhões de pessoas sofrem de perturbações mentais ou comportamentais em todo o mundo, mas apenas uma pequena minoria tem tratamento, ainda que elementar. Transformam-se em vítimas por causa da sua doença e convertem-se em alvos de estigma e discriminação. O suicídio é considerado como um grande problema de saúde pública em todo o mundo, é uma das principais causas de morte de jovens adultos e situa-se entre as três maiores causas de morte na população entre 15-34 anos (OMS, 2001). As perturbações mentais aumentam o risco de suicídio. A depressão, esquizofrenia, e a utilização de substâncias incrementam o risco de suicídio. Estudos (Sartorius, 2002; Magliano et al., 2012) mostram que os profissionais de saúde, tal como o público em geral, podem ter atitudes negativas e estigma em relação às pessoas com perturbações mentais, podendo agir em conformidade, uma vez feito e conhecido o diagnóstico psiquiátrico. Os clínicos gerais são os receptores das perturbações mentais e tentativas de suicídio nas principais portas de entrada no acesso a cuidados de saúde. As crenças, conhecimentos e contacto com a doença mental e o suicídio, podem influenciar a atenção clínica. OBJECTIVOS: Avaliar o estigma e as percepções dos médicos de clínica geral em relação às tentativas de suicídio, o suicídio e perturbações mentais bem como os possíveis factores associados a estes fenómenos. MATERIAIS E MÉTODOS: Estudo do tipo transversal, combinando métodos quantitativos e qualitativos. A amostra é constituída por 125 sujeitos, médicos de clínica geral. Utilizaram-se as versões adaptadas dos seguintes instrumentos: Questionário sobre Percepções e Estigma em Relação à Saúde Mental e ao Suicídio (Liz Macmin e SOQ, Domino, 2005) e a Escala de Atitudes sobre a Doença Mental (Amanha Hahn, 2002). Para o tratamento estatístico dos dados usou-se a estatística 1) descritiva e 2) Análise estatística das hipóteses formuladas (Qui Quadrado - 2) a correlação entre variáveis (Spearman: ρ, rho). Os dados conectados foram limpos de inconsistências com base no pacote informático e estatístico SPSS versão 20. Para a aferição da consistência interna foi usado o teste de Alfa de Cronbach. RESULTADOS: Uma boa parte da amostra (46.4%) refere que não teve formação formal ou informal em saúde mental e (69.35%) rejeitam a ideia de que “grupos profissionais como médicos, dentistas e psicólogos são mais susceptíveis a cometer o suicídio”. Já (28.0%) têm uma perspectiva pessimista quanto a possibilidade de recuperação total dos sujeitos com perturbação mental. Sessenta e oito(54.4%) associa sujeitos com perturbação mental, a comportamentos estranhos e imprevisíveis, 115 (92.0%) a um baixo QI e 35 (26.7%) a poderem ser violentas e e perigosas. Os dados mostram uma associação estatisticamente significativa (p0.001) entre as variáveis: tempo de serviço no SNS, recear estar perto de sujeitos com doença mental e achar que os sujeitos com doença mental são mais perigosos que outros. Em termos estatísticos, existe uma associação estatitisticamente significativa entre as duas variáveis(X2=9,522; p0.05): percepção de que “é vergonhoso ter uma doença mental” e os conhecimentos em relação à doença mental. Existe uma correlação positiva, fraca e estatisticamente significativa entre os conhecimentos dos clínicos gerais(beneficiar-se de formação em saúde mental) e a percepção sobre os factores de risco (0,187; P0,039). DISCUSSÃO E CONCLUSÕES: A falta de conhecimento sobre as causas e factores de risco para os comportamentos suicidários, opções de intervenção e tratamento, particularmente no âmbito da doença mental, podem limitar a procura de ajuda individual ou dos próximos. Percepções negativas como o facto de não merecerem prioridade nos serviços, mitos (frágeis e cobarde, sempre impulsivo, chamadas de atenção, problemas espirituais) podem constituir-se como um indicador de que os clínicos gerais podem sofrer do mesmo sistema de estigma e crenças, de que sofre o público em geral, podendo agir em conformidade (atitudes de afastamento ereceio). As atitudes são influenciadas por factores como a formação, cultura e sistema de crenças. Sujeitos com boa formação na área da saúde mental têm uma percepção positiva e optimista sobre os factores de risco e uma atitude positiva em relação aos sujeitos com doença mental e comportamentos suicidários.-------------ABSTRACT: INTRODUCTION: The WHO (2001) reveals that about 450 million people suffer from mental or behavioral disorders worldwide, but only a small minority have access to treatment, though elementary. They become victims because of their disease and they become the targets of stigma and discrimination. Suicide is seen as a major public health problem worldwide, is a leading cause of death for young adults and is included among the three major causes of death in the population aged 15-34 years (WHO, 2001). Mental disorders increase the risk of suicide. Depression, schizophrenia, and the substances misuse increase the risk of suicide. Studies (Sartorius, 2002; Magliano et al, 2012) show that health professionals, such as the general public, may have negative attitudes and stigma towards people with mental disorders, and can act accordingly after psychiatric diagnosis is known. General practitioners are the main entry points of mental disorders and suicide attempts in the health sistem. Beliefs, knowledge and contact with mental illness and suicide, may influence clinical care. OBJECTIVES: To assess stigma and perceptions of general practitioners in relation to suicide attempts, suicide and mental disorders as well as possible factors associated with these phenomena. MATERIAL AND METHODS: This was a descriptive cross-sectional study, combining quantitative and qualitative methods. The sample consisted of 125 subjects, general practitioners. We used adapted versions of the following instruments: Questionnaire of Perceptions and Stigma in Relation to Mental Health and Suicide (Liz Macmin and SOQ, Domino, 2005) and the Scale of Attitudes on Mental Illness (Tomorrow Hahn, 2002). For the statistical treatment of the data we used: 1) descriptive (Data distribution by absolute and relative frequencies for each of the variables under study (including mean and standard deviation measures of central tendency and deviation), 2) statistical analysis of hypotheses using (Chi Square - 2, a hypothesis test that is intended to find a value of dispersion for two nominal variables, evaluating the association between qualitative variables) and the correlation between variables (Spearman ρ, rho), a measure of non-parametric correlation, which evaluates an arbitrary monotonic function can be the description of the relationship between two variables, without making any assumptions about the frequency distribution of the variables). For statistical analysis of the correlations were eliminated subjects who did not respond to questions. The collected data were cleaned for inconsistencies based on computer and statistical package SPSS version 20. To measure the internal consistency was used the Cronbach's alpha test. RESULTS: A significant part of the sample 64 (46.4%) reported no formal or informal training in mental health and 86 (69.35%) reject the idea that "professional groups such as doctors, dentists and psychologists are more likely to commit suicide." On the other hand, 42 (28.0%) have a pessimistic view of the possibility of full recovery of individuals with mental disorder. Sixty-eight ( 54.4 % ) of them associates subjects with mental disorder to strange and unpredictable behavior, 115 ( 92.0 % ), to low IQ, 35 ( 26.7 % ) and even to violent and dangerous behavior, 78 ( 62.4 % ) The data show a statistically significant (p = 0.001) relationship between the following variables: length of service in the NHS, fear of being close to individuals with mental illness and considering individuals with mental illness more dangerous than others. In statistical terms, there is a dependency between the two variables (X2 = 9.522, p> 0.05): the perception that "it is shameful to have a mental illness" and knowledge regarding mental illness. There is a positive and statistically significant weak correlation between knowledge of general practitioners (benefit from mental health training) and the perception of the risk factors (0,187; P0,039). DISCUSSION AND CONCLUSIONS: The lack of knowledge about the causes and risk factors for suicidal behavior, intervention and treatment, particularly in the context of mental illness options, may decreaseseeking for help by individual and their relatives. Negative perceptions such as considering that they dont deserve priority in services, myths (weak and cowards, always impulsive, seeking for attentions, spirituals problems) may indicate that general practitioners, may suffer the same stigma and beliefs systems as the general public, and can act accordingly (withdrawal and fear attitudes). Attitudes are influenced by factors such as education, culture and belief system. Subjects with good training in mental health have a positive and optimistic perception of the risk factors and a positiveattitude towards individuals with mental illness and suicidal behaviour.
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Online data collection is becoming increasingly common and has some advantages compared to traditional paper-and-pencil formats, such as reducing loss of data, increasing participants' privacy, and decreasing the effect of social desirability. However, the validity and reliability of this administration format must be established before results can be considered acceptable. The aim of this study was to evaluate the validity, reliability, and equivalence of paper-and-pencil and online versions of the Weight Concerns Scale (WCS) when applied to Brazilian university students. A crossover design was used, and the Portuguese version of the WCS (in both paper-and-pencil and online formats) was completed by 100 college students. The results indicated adequate fit in both formats. The simultaneous fit of data for both groups was excellent, with strong invariance between models. Adequate convergent validity, internal consistency, and mean score equivalence of the WCS in both formats were observed. Thus, the WCS presented adequate reliability and validity in both administration formats, with equivalence/stability between answers.
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Tese de Doutoramento apresentada ao ISPA - Instituto Universitário
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IntroductionThe prevalence of sexual dysfunction (SD) and dissatisfaction with sexual life (DSL) in patients with chronic hepatitis C virus infection (CHC) was jointly investigated via a thorough psychopathological analysis, which included dimensions such as fatigue, impulsiveness, psychiatric comorbidity, health-related quality of life (HRQL) and sociodemographic and clinical characteristics.MethodsMale and female CHC patients from an outpatient referral center were assessed using the Brief Fatigue Inventory, the Barrat Impulsiveness Scale, the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale (HAM-A), and the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF). Structured psychiatric interviews were performed according to the Mini-International Neuropsychiatric Interview. SD was assessed based on specific items in the BDI (item 21) and the HAM-A (item 12). DSL was assessed based on a specific question in the WHOQOL-BREF (item 21). Multivariate analysis was performed according to an ordinal linear regression model in which SD and DSL were considered as outcome variables.ResultsSD was reported by 60 (57.1%) of the patients according to the results of the BDI and by 54 (51.4%) of the patients according to the results of the HAM-A. SD was associated with older age, female gender, viral genotype 2 or 3, interferon-α use, impulsiveness, depressive symptoms, antidepressant and benzodiazepine use, and lower HRQL. DSL was reported by 34 (32.4%) of the patients and was associated with depressive symptoms, anxiety symptoms, antidepressant use, and lower HRQL.ConclusionsThe prevalence of SD and DSL in CHC patients was high and was associated with factors, such as depressive symptoms and antidepressant use. Screening and managing these conditions represent significant steps toward improving medical assistance and the HRQL of CHC patients.
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Release of chloroethene compounds into the environment often results in groundwater contamination, which puts people at risk of exposure by drinking contaminated water. cDCE (cis-1,2-dichloroethene) accumulation on subsurface environments is a common environmental problem due to stagnation and partial degradation of other precursor chloroethene species. Polaromonas sp. strain JS666 apparently requires no exotic growth factors to be used as a bioaugmentation agent for aerobic cDCE degradation. Although being the only suitable microorganism found capable of such, further studies are needed for improving the intrinsic bioremediation rates and fully comprehend the metabolic processes involved. In order to do so, a metabolic model, iJS666, was reconstructed from genome annotation and available bibliographic data. FVA (Flux Variability Analysis) and FBA (Flux Balance Analysis) techniques were used to satisfactory validate the predictive capabilities of the iJS666 model. The iJS666 model was able to predict biomass growth for different previously tested conditions, allowed to design key experiments which should be done for further model improvement and, also, produced viable predictions for the use of biostimulant metabolites in the cDCE biodegradation.
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INTRODUCTION: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV) infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples. METHODS: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA) was detected by polymerase chain reaction (PCR). RESULTS: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection. CONCLUSIONS: Saliva samples can be used in large-scale neonatal screening for CMV infection.
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Abstract: INTRODUCTION Risk of schistosomiasis expansion to semi-arid northeastern Brazil under the influence of the Integration Project of the São Francisco River (IPSFR) was assessed. METHODS: Stool examinations of schoolchildren, epidemiological investigation, and survey of the local host snail Biomphalaria straminea were performed in five IPSFR municipalities. RESULTS Six of 4,770 examined schoolchildren were egg-positive for Schistosoma mansoni. Biomphalaria straminea was widespread, but not naturally infected with S. mansoni. Snails experimentally exposed to two laboratory S. mansoni strains yielded infection indices of 1-4.5%. CONCLUSIONS: There is evidence of active schistosomiasis transmission in the area; thus, intensive surveillance actions are required.
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Diffusion of Innovation is a topic of interest for researchers and practitioners. Although substantial research is conducted on user categories, researchers often focus on the first half of the curve, ignoring the late adopters. We conduct two studies to measure the attributes of late adopters. In our first study of mobile phone users, we develop the Late-Adopter Scale. We then test it on a sample of laptop users. This scale is multi-dimensional, presents nomological and discriminant validity and has three dimensions: 1) rate of adoption, 2) resistance to innovation, and 3) skepticism. Findings reveal that all three Late Adopter Scale dimensions are significantly associated with low price preference. Moreover, in both samples skepticism is associated with high preference for simple products, lower leading edge status, and lower product involvement. Discussion focuses on implications of this new scale to theory and practice of new product development and diffusion of innovation.
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A large-scale inventory of trees > 10cm DBH was conducted in the upland "terra firme" rain forest of the Distrito Agropecuário da SUFRAMA (Manaus Free Zone Authority Agricultural District) approximately 65Km north of the city of Manaus (AM), Srasil. Thegeneral appearance and structure of the forest is described together with local topography and soil texture. Thepreliminary results of the Inventory provide a minimum estimate of 698 tree species in 53 families in the 40Km radius sampled, including 17 undescribed species. Themost numerically abundant families, Lecythidaceae, Leguminosae, 5apotaceae and Burseraceae as also among the most species rich families. One aspect of this diverse assemblage is the proliferation of species within certain genera, Including 26 genera In 17 families with 6 or more species or morphospecies. Most species have very low abundances of less than 1 tree per hectare. While more abundant species do exist at densities ranging up to a mean of 12 trees per ha, many have clumped distributions leading to great variation in local species abundance. The degree of similarity between hectare samples based int the Coefficient of Community similarity Index varies widely over different sample hectares for five ecologically different families. Soil texture apparently plays a significant role In determining species composition in the different one hectare plots examined while results for other variable were less consistent. Greater differences in similarity indices are found for comparisons with a one hectare sample within the same formation approximately 40Km to the south. It is concluded that homogeneity of tree community composition within this single large and diverse yet continuous upland forest formation can not be assumed.
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A multivariate approach was applied to data of small-scale fisheries developed in Central Amazon, using information about catch composition, environment, fishing gear and season of the hydrological cycle. The correspondence analysis demonstrated to be a good tool for the analysis related multispecies fisheries. The analysis identified patterns of use of fisheries resources by the riverine communities, showing the correlation between the environmental factors and the fishing strategy for the capture of target fish species, indicating the high level of empiric knowledge about the environment and fisheries.
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As increasingly more sophisticated materials and products are being developed and times-to-market need to be minimized, it is important to make available fast response characterization tools using small amounts of sample, capable of conveying data on the relationships between rheological response, process-induced material structure and product characteristics. For this purpose, a single / twin-screw mini-extrusion system of modular construction, with well-controlled outputs in the range 30-300 g/h, was coupled to a in- house developed rheo-optical slit die able to measure shear viscosity and normal-stress differences, as well as performing rheo-optical experiments, namely small angle light scattering (SALS) and polarized optical microscopy (POM). In addition, the mini-extruder is equipped with ports that allow sample collection, and the extrudate can be further processed into products to be tested later. Here, we present the concept and experimental set-up [1, 2]. As a typical application, we report on the characterization of the processing of a polymer blend and of the properties of extruded sheets. The morphological evolution of a PS/PMMA industrial blend along the extruder, the flow-induced structures developed and the corresponding rheological characteristics are presented, together with the mechanical and structural characteristics of produced sheets. The application of this experimental tool to other material systems will also be discussed.
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The MAP-i doctoral program of the Universities of Minho, Aveiro and Porto
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The RMR system is still very much applied in rock mechanics engineering context. It is based on the evaluation of six weights to obtain a final rating. To obtain the final rating a considerable amount of information is needed concerning the rock mass which can be difficult to obtain in some projects or project stages at least with accuracy. In 2007 an alternative classification scheme based on the RMR, the Hierarchical Rock Mass Rating (HRMR) was presented. The main feature of this system was the adaptation to the level of knowledge existent about the rock mass to obtain the classification of the rock mass since it followed a decision tree approach. However, the HRMR was only valid for hard rock granites with low fracturing degrees. In this work, the database was enlarged with approximately 40% more cases considering other types of granite rock masses including weathered granites and based on this increased database the system was updated. Granite formations existent in the north of Portugal including Porto city are predominantly granites. Some years ago a light rail infrastructure was built in the city of Porto and surrounding municipalities whi h involved considerable challenges due to the high heterogeneity levels of the granite formations and the difficulties involved in their geomechanical characterization. In this work it is intended to provide also a contribution to improve the characterization of these formations with special emphasis to the weathered horizons. A specific subsystem applicable to the weathered formations was developed. The results of the validation of these systems are presented and show acceptable performances in identifying the correct class using less information than with the RMR system.
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We investigate palm species distribution, richness and abundance along the Mokoti, a seasonally-dry river of southeastern Amazon and compare it to the patterns observed at a large scale, comprising the entire Brazilian territory. A total of 694 palms belonging to 10 species were sampled at the Mokoti River basin. Although the species showed diverse distribution patterns, we found that local palm abundance, richness and tree basal area were significantly higher from the hills to the bottomlands of the study region, revealing a positive association of these measures with moisture. The analyses at the larger spatial scale also showed a strong influence of vapor pressure (a measure of moisture content of the air, in turn modulated by temperature) and seasonality in temperature: the richest regions were those where temperature and humidity were simultaneously high, and which also presented a lower degree of seasonality in temperature. These results indicate that the distribution of palms seems to be strongly associated with climatic variables, supporting the idea that, by 'putting all the eggs in one basket' (a consequence of survival depending on the preservation of a single irreplaceable bud), palms have become vulnerable to extreme environmental conditions. Hence, their distribution is concentrated in those tropical and sub-tropical regions with constant conditions of (mild to high) temperature and moisture all year round.