A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia

Abstract Background: Depression is highly prevalent within individuals diagnosed with schizophrenia, and is associated with an increased risk of suicide. There are no current evidence based treatments for low mood within this group. The specific targeting of co-morbid conditions within complex mental health problems lends itself to the development of short-term structured interventions which are relatively easy to disseminate within health services. A brief cognitive intervention based on a competitive memory theory of depression, is being evaluated in terms of its effectiveness in reducing depression within this group. Methods/Design: This is a single blind, intention-to-treat, multi-site, randomized controlled trial comparing Positive Memory Training plus Treatment as Usual with Treatment as Usual alone. Participants will be recruited from two NHS Trusts in Southern England. In order to be eligible, participants must have a DSM-V diagnosis of schizophrenia or schizo-affective disorder and exhibit at least a mild level of depression. Following baseline assessment eligible participants will be randomly allocated to either the Positive Memory Training plus Treatment as Usual group or the Treatment as Usual group. Outcome will be assessed at the end of treatment (3-months) and at 6-month and 9-month post randomization by assessors blind to group allocation. The primary outcome will be levels of depression and secondary outcomes will be severity of psychotic symptoms and cost-effectiveness. Semi-structured interviews will be conducted with all participants who are allocated to the treatment group so as to explore the acceptability of the intervention. Discussion: Cognitive behaviour therapy is recommended for individuals diagnosed with schizophrenia. However, the number of sessions and length of training required to deliver this intervention has caused a limit in availability. The current trial will evaluate a short-term structured protocol which targets a co-morbid condition often considered of primary importance by service users. If successful the intervention will be an important addition to current initiatives aimed at increasing access to psychological therapies for people diagnosed with severe mental health problems. Trial registration: Current Controlled Trials. ISRCTN99485756. Registered 13 March 2014.

Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial

Background Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg) with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Methods/Design Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. Discussion The objective of this clinical trial is to determine whether there are specific effects of specialist psychotherapy that reduce relapse in unipolar major depression in adolescents and thereby costs of treatment to society. We also anticipate being able to utilise psychotherapy experience, neuroimaging, genetic and hormone measures to reveal what techniques and their protocols may work best for which patients.

Descriptive Sensory Analysis and Acceptance of Stingless Bee Honey

Stingless bee honey samples were evaluated by sensory descriptive analysis using free choice profile methodology. Appearance, flavor, and aroma were described and the data were treated with Generalized Procrustes Analysis. Individual descriptive terms ranged from 8 to 20. Plotting the samples in a bidimensional plan indicated that appearance attributes (color and viscosity) and sweet, sour and acid flavor were strongly correlated with x axis (Dimension 1) while coconut, wood, acid, sour, and sweet flavor aroma attributes were correlated with y axis (Dimension 2). The affective test was also performed and with the exception of the Melipona scutellaris honey, all the other samples showed good acceptance. Honeys that were described as sweeter and less acid were preferred by nontrained assessors, indicating that the regular consumer recognizes honey produced by Apis mellifera bee as a standard.

Políticas de recursos humanos, do discurso oficial à prática : estudo realizado na administração direta do estado do Espírito Santo

O distanciamento entre discurso oficial prática das políticas de Recursos Humanos definidas para os servidores da Administração Direta do Poder Executivo do Estado do Espirito Santo no período de 1971/1991, neste estudo de caso, foi analisado tomando-se como base conceituai teoria de Análise de Políticas Públicas Recursos Humanos. Verificou-se as Diretrizes programadas as ações que foram implementadas, utilizando-se documentos oficiais, Planos de Governos, Mensagens Legislativas, Leis, Decretos outros documentos abrangendo cinco períodos diferentes de governo, compreendendo um espaço histórico de vinte anos da Administração Pública Estadual Capixaba, englobando parte do período de "Regime Militar Autoritário", "Abertura Política" "Nova República". Buscando-se ressaltar aspectos importantes conseguir descrição mais precisa da situação em estudo, realizou-se pesquisa de campo, utilizando-se instrumento da entrevista semi-estruturada. Foram selecionados entrevistados Dirigentes Assessores Públicos, bem como Secretários de Estado que atuaram no cenário em investigação. No período 1971/91, as diretrizes propostas seguiram procedimentos racionais as ações foram implementadas de forma isolada, distanciando-se das diretrizes propostas nos planos dos Governos. distanciamento entre discurso e a prática, chega ser considerado como um procedimento natural, haja vista, que pesquisa permeou cinco períodos de governos, cujo cenário político foi bastante diferente, entretanto, prática adotada pelos diversos governantes administradores públicos, em relação Administração Pública especialmente ao tratamento dispensado aos Recursos Humanos, foi desenvolvida com mesma desconsideração. De onde se conclui que no período 1971/91, as diretrizes da política de Recursos Humanos para os servidores da Administração Direta do poder Executivo do Estado do Espirito Santo permaneceram apenas na retórica do discurso governamental, e, em nenhum momento na prática elas foram implementadas nível de Governo.

Adequação do currículo do curso de pedagogia: habilitação em administração escolar e orientação educacional: ao mercado de trabalho

O objetivo deste trabalho foi o de estudar o currículo do Curso de Pedagogia (habilitação em Administração Escolar e Orientação Educacional) da Faculdade de Educação da Universidade do Amazonas. Procurou-se examinar também a relação existente entre a formação e as condições de desempenho de Administradores Escolares e Orientadores Educacionais atuando nas Escolas Estaduais de 1º e 2º graus, na cidade de Manaus, Estado do Amazonas. O trabalho consta de duas etapas: a primeira contém a importância do estudo, as hipóteses que fundamentaram o mesmo e a fundamentação teórica, onde nos detivemos principalmente nas figuras dos dois especialistas: o Adm.Esc. e o O.E., em seus aspectos teóricos e atribuições legais; a segunda constitue-se de uma Pesquisa de campo, onde foram utilizados três instrumentos, abrangendo as seguites áreas: avaliação dos cursos; metodologia; estágio supervisionado; avaliação do rendimento; realidade social e condições de atuação. A população estudada consta de 80 elementos exercendo as funções de Diretores, Administradores Escolares e Orientadores Educacionais. Os resultados obtidos evidenciaram um hiato entre a formação oferecida pela Faculdade de Educação da Universidade do Amazonas, e as condições de atuaçao dos profissionais em estudo. Os Adm. Esc. (em função de Assessor) estão exercendo funções para as quais não necessitam formação em nível superior; os O.E. não dispõem de condições para uma atuação efetiva, dentro do que é preconizado pelos teóricos da Orientação Educacional; os profissionais estudados apontam como principal ponto de estrangulamento em seu desempenho o distanciamento entre a teoria e a prática oferecidas nos cursos de graduação; notou-se que os O.E. mostraram-se mais críticos quanto à formação recebida, do que os Adm. Esc. Sugere-se no final do trabalho, pesquisas que visem aprofundar o conhecimento da realidade educacional pesquisada.

A quantitative and qualitative evaluation of reports of clinical trials published in six Brazilian dental journals indexed in the Scientific Electronic Library Online (SciELO)

Introduction: Open access publishing is becoming increasingly popular within the biomedical sciences. SciELO, the Scientific Electronic Library Online, is a digital library covering a selected collection of Brazilian scientific journals many of which provide open access to full-text articles. This library includes a number of dental journals some of which may include reports of clinical trials in English, Portuguese and/or Spanish. Thus, SciELO could play an important role as a source of evidence for dental healthcare interventions especially if it yields a sizeable number of high quality reports. Objective: The aim of this study was to identify reports of clinical trials by handsearching of dental journals that are accessible through SciELO, and to assess the overall quality of these reports. Material and methods: Electronic versions of six Brazilian dental Journals indexed in SciELO were handsearched at www.scielo.br in September 2008. Reports of clinical trials were identified and classified as controlled clinical trials (CCTs - prospective, experimental studies comparing 2 or more healthcare interventions in human beings) or randomized controlled trials (RCTs - a random allocation method is clearly reported), according to Cochrane eligibility criteria. Criteria to assess methodological quality included: method of randomization, concealment of treatment allocation, blinded outcome assessment, handling of withdrawals and losses and whether an intention-to-treat analysis had been carried out. Results: The search retrieved 33 CCTs and 43 RCTs. A majority of the reports provided no description of either the method of randomization (75.3%) or concealment of the allocation sequence (84.2%). Participants and outcome assessors were reported as blinded in only 31.2% of the reports. Withdrawals and losses were only clearly described in 6.5% of the reports and none mentioned an intention-to-treat analysis or any similar procedure. Conclusions: The results of this study indicate that a substantial number of reports of trials and systematic reviews are available in the dental journals listed in SciELO, and that these could provide valuable evidence for clinical decision making. However, it is clear that the quality of a number of these reports is of some concern and that improvement in the conduct and reporting of these trials could be achieved if authors adhered to internationally accepted guidelines, e. g. the CONSORT statement.

A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P < 0.05) and 2 (F= 3.1, P < 0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F= 1.1, P > 0.05) and groups 2 and 3 (F= 1.6, P > 0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P < 0.05; F= 4.4, P < 0.05).Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

EMBALAGEM INDIVIDUAL DE MANGAS CV. TOMMY ATKINS em FILME PLÁSTICO: EFEITO SOBRE A VIDA DE PRATELEIRA

Estudou-se o efeito da embalagem de policloreto de vinila (PVC) sobre a vida de prateleira de mangas cv. Tommy Atkins armazenadas sob refrigeração. Mangas no estádio de maturidade fisiológica, com casca verde ou levemente avermelhada, foram embaladas individualmente, com filme de 10mm de espessura, e armazenadas por 28 dias a 12ºC (80-90% UR). Frutos sem embalagem serviram de controle. Durante o período de armazenagem, foram feitas avaliações sensoriais utilizando o método de escala hedônica não estruturada para aceitação da aparência e do sabor, utilizando-se de 30 provadores não treinados por sessão. Determinou-se também a perda de massa, a acidez titulável e os teores de sólidos solúveis e vitamina C ao longo da armazenagem. As mangas embaladas apresentaram uma vida de prateleira de 21 dias contra 6 dias das não embaladas, e uma taxa de perda de massa 3,5 vezes menor que as não embaladas. em relação à taxa de degradação de vitamina C, não houve diferença entre os tratamentos. A combinação da embalagem com a armazenagem a 12ºC aumentou a vida de prateleira do produto pela redução da atividade metabólica e do desenvolvimento de podridão.

Escala diagramática para quantificação da severidade de manchas em folhas de Eucalyptus globulus Labill. causadas por Teratosphaeria nubilosa (Cooke) Crous & U. Braun

The leaf spot (Mycosphaerella leaf disease = MLD) caused by Teratosphaeria nubilosa has caused damage in eucalypt plantations in southern and southeastern Brazil. The need to assess the disease in the field to evaluate of this damage, efficiency control, evaluation of germplasm induces to the necessity of having a visual scale for evaluation of disease. The objective was to develop a diagrammatic scale for young leaves and one for adult leaves of Eucalyptus globules for MLD. To do so, the leaves collected in the field were scanned for image analysis. The damaged area, the healthy leaf area and the external area of the same scale RGB (Red, Green, Blue) were determined. Subsequently, it was determinate the levels of severity depending on the sample distribution with seven levels for young leaves and six for adult leaves. For the visual acuity test and validate the scale, the leaves were evaluated for severity, with and without scale. With this proposed scales, the assessors showed good accuracy both for young and adult leaves with R2=0,98 and R2=0,80, respectively. The importance of the development of diagrammatic scales for assessing MLD in eucalyptus must to the fact that allows quantification of the symptoms accurately and precisely.

Aqui, ali e acolá: caminhos e experiências do ensino do lugar em práticas docentes

Pós-graduação em Geografia - IGCE

Determinação do perfil sensorial de amostras comerciais de cachaça

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Formação acadêmica do fisioterapeuta: a utilização de jogos e brincadeiras nos atendimentos de crianças

Pós-graduação em Educação - FFC

Avaliação de clones de seringueira quanto à resistência ao oídio

Five commercial rubber tree clones in a clonal nursery were assessed for resistance to powdery mildew, as well as for the disease fluctuation and its correlation with the climate conditions in the study period. For this assessment, a diagrammatic scale was developed from 150 central leaflets randomly collected at different ages and attack levels. Validation of scale was done by five assessors. Results indicated that all clones showed susceptibility to the pathogen, and the attack was higher for younger leaflets. According to the climate data, mild temperatures and relative humidity below 60% favored the epidemic.

Sensory profile and acceptability of traditional and double-distilled cachaca aged in oak casks

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Perfil de uso de recursos ergogênicos em academias da cidade de Bauru/SP

The increasing number of gyms and their patrons increasingly concerned about the health, appearance and aesthetics propagated by the media and the supply of ergogenic both food as hormonal some without proof of its effects generated interest for the study of consumption of such ergogenic goers by academies of Bauru/SP; objective was also to assess whether the Physical Education professionals are prepared to guide properly, such as the use of these goers ergogenic. To this end, a questionnaire specific to each category was used, to be answered voluntarily and anonymously, with closed and open questions divided into two parts: one for socio demographic characterization and another in which were discussed issues regarding the use/orientation ergogenic. The research involved a sample of 12 academies and 205 attendees, including 152 men (74.15%) and 53 (25.85) women. Among men, 61.18% (n=93) did use ergogenic(s) food(s), while among women, this percentage was 33.96% (n=18). Regarding the use of hormonal resources, only 4.61% (n=7) of men said they used; there were no cases of women using hormonal resources. Were also interviewed 19 assessors/trainers/teachers, two which fifteen (15) men and four (4) women. Most consumers of ergogenic: (1) is understood in the age group 21-30 years and the socioeconomic classification bands called B1 and B2; (2) practice bodybuilding and consumption ergogenic resources with purpose of muscular hypertrophy; (3) practicing bodybuilding for a period between 1 and 5 years, consumes ergogenic(s) for a period less than one year, and perhaps the most significant event, starts the consumption of ergogenic(s) in a period of less than one year after starting the practice of bodybuilding, and that there are consumers who start consuming ergogenic as soon begin the practice of bodybuilding; (4) has as its main source of indication for the use of ergogenic, the gym instructor, among which, some respondents reported...