Pain accuracy : is there a link between accuracy in pain report and accuracy in interoception and taste tasks?

Purpose: Pain intensity, as intensities of other subjective experiences is challenging to measure. The subjective nature of pain assessment and the variability in how patients are understanding and using pain scales are negatively affecting patient-health care provider communication and reducing the essay sensitivity of pain related studies. Little is known about the ability of patients to accurately report pain, and its possible relations with the ability to accurately report other bodily sensations. The aim of this study was to explore the relationships between the ability to accurately report pain and the ability to accurately report other sensations. Participants and methods: Healthy volunteers enrolled from local universities underwent the FAST procedure, to assess pain reporting accuracy, a taste task, to assess tastes (sweet and salty solutions) intensity reporting accuracy, and the heartbeat perception task, an interoceptive task aimed to assess how accurate subjects are in monitoring and reporting their own heartbeat. In addition, all subjects completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Perceived Stress Scale (PSS) and Hospital Anxiety and Depression Scale (HADS). Spearman’s correlations were used to assess relations between the accuracy tasks (FAST and taste) and interoception measures (heartbeat task and MAIA), as well associations with pain-related psychological questionnaires (PSS and HADS). Results: Ability to accurately report the sensations of different modalities were independent of each other (P>0.05 for all outcome measures). Positive correlations were found within modality, between reporting accuracy of salt and sweet solutions (Spearman’s r=0.477, P<0.001). No correlations were found between the psychological and accuracy measures. Conclusion: Pain reporting accuracy is not related to interoceptive awareness of other modalities. Further research is ongoing to investigate the clinical relevance of pain reporting accuracy.Objetivo: A avaliação da intensidade da dor, assim como a avaliação de outras experiências subjetivas tem representado um grande desafio para a investigação. A natureza subjetiva da avaliação da dor e a variabilidade que os doentes revelam na compreensão e utilização de escalas de dor tem tido um impacto negativo na comunicação entre os doentes e os profissionais de saúde, e tem tido consequências na diminuição da sensibilidade dos estudos relacionados com a dor. Pouco se sabe sobre a capacidade que os doentes têm de reportar com precisão a dor e que possíveis relações existem com a capacidade de reportarem com precisão outras sensações. Participantes e métodos: Foram recrutados participantes saudáveis de universidade locais, a quem foi aplicado um novo procedimento, o FAST, para avaliar a precisão nos relatos de dor, uma tarefa de paladar, para avaliar a precisão nos relatos de intensidades de diferentes gostos (soluções doces e salgadas), e a tarefa de perceção do batimento cardíaco, uma tarefa de interoceção utilizada com o objetivo de avaliar o quão precisos os indivíduos são na monitorização e no relato do seu batimento cardíaco. Para além disto, os participantes preencheram o MAIA (Avaliação Multidimensional da Consciência Interoceptiva), a Escala de Stress Percebido (ESP) e a Escala Hospitalar de Depressão e Ansiedade (HADS). As relações entre as tarefas de precisão (FAST e paladar) e as medidas de interoceção (batimento cardíaco e MAIA), assim como as associações com os questionários de dimensões psicológicas relacionados com a dor (ESP e EHDA), foram analisadas com o coeficiente de correlação de Spearman. Resultados: As capacidades para reportar de forma precisa as sensações de diferentes modalidades revelaram-se independentes (P>0.05 para todas as medidas de resultados). Foram encontradas correlações positivas na mesma modalidade sensorial (intramodalidade) entre a capacidade de reportar com precisão soluções doces e salgadas (correlações de Spearman r=0.477, P<0.001). Não se encontram correlações entre dimensões psicológicas e medidas de precisão. Conclusão: A capacidade para reportar a dor com precisão não se relaciona com a consciência interoceptiva de outras modalidades sensoriais. Novos estudos estão em curso, e são necessários, para melhor compreender arelevância clínica da precisão na avaliação da dor

Equity research - Starbucks

Mestrado em Contabilidade, Fiscalidade e Finanças EmpresariaisA presente Equity Research consiste na avaliação da Starbucks, líder de mercado na indústria do café, sendo formulada segundo as referências do CFA Institute. O principal propósito consiste em fornecer um preço alvo para o final de 2020, compreender se as ações estão sub ou sobrevalorizadas e de acordo com isso, dar uma recomendação final aos investidores. Para tal, foram desenvolvidos três modelos de avaliação, o método "Discounted Cash Flow" (DCF), "Relative Valuation" considerando os rácios comparáveis e por fim o "Dividend Discount Model" (DDM). Adicionalmente, foram definidos ainda os principais riscos de investimento e feita uma análise de sensibilidade.The present Equity research consists in the Starbucks Valuation, market leader in the coffee industry and was elaborated following the CFA Institute references. The main purpose consists in providing a price target for the year end of 2020 understanding if the stocks are over or undervalued and according to this give a final recommendation for the investors. For that, was developed three valuation models, the Discounted Cash Flow method (DCF), a Relative Valuation considering comparable multiple ratios and the Dividend Discount Model (DDM). In addition to that was also applied a Risk Assessment, reporting to the main risks with influence in the share price and made a Sensitivity Analysis.info:eu-repo/semantics/publishedVersio

Metals transfer from tobacco to cigarette smoke: Evidences in smokers’ lung tissue

Tobacco use kills millions of people every year around the world. The current level of 11 metals in tobacco was determined and their transfer rate to cigarette smoke was calculated as the difference between the total metal content in cigarettes and the amount present in its ashes. The metals content was also determined in the lung tissue of smokers and non-smokers in order to evaluate the marks that smoking leaves in this tissue. Metals content in tobacco ranged from less than 1μg/g (Co, Cd, Pb, As and Tl) to several hundreds of μg/g (Al, Mn and Ba). The highest transfer rate from tobacco to cigarette smoke was found for Tl (85-92%) and Cd (81-90%), followed by Pb (46-60%) and As (33-44%). Significantly higher levels of As, Cd and Pb were found in the lung tissue of smokers compared to non-smokers, showing that smoking results in an increase of these metals in the lungs and that they contribute to the carcinogenic potential of cigarette smoke. This study presents important data on current metals content in tobacco and its transference to cigarette smoke and provides evidence of their accumulation in smokers' lung tissue.info:eu-repo/semantics/publishedVersio

Is anxiety related to higher vulnerability to a body illusion? Results from the classical rubber hand illusion paradigm

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Time since onset might be of essence: a recommendation to assess the effects of combination of non-pharmacological neuromodulatory approaches at early stage since symptoms onset

In the past decade researchers began to assess the potential beneficial effects of non-invasive brain stimulation (NIBS) combined with a behavioral task as a treatment approach for various medical conditions. Transcranial direct current stimulation (tDCS) applied to the motor cortex combined with another treatment approach has been assessed as analgesic treatment in neuropathic and non-neuropathic pain conditions, and was found to exert only modest pain relief. Our group results show that combined tDCS and mirror therapy dramatically reduced acute phantom limb pain intensity with long-lasting effects, potentially preventing pain chronification. A review of the scientific literature indicates that our approach differs from that of others: We applied the intervention at the acute stage of the disease, whereas other studies applied the intervention in patients whose disease had already been established. We suggest that the timing of administration of the combined intervention is critical. Unlike in patients with chronic painful condition, in which the maladaptive plasticity associated with pain chronification and chronicity is well-consolidated, early treatment at the acute pain stage may be more successful in counterbalancing the not-yet consolidated maladaptive plasticity. We encourage the research community to test our hypothesis, both in the treatment of pain, and beyond.info:eu-repo/semantics/publishedVersio

Inflammatory bowel disease: quality of life and influence of supplementation

Intestinal Inflammatory Disease includes Crohn's Disease and Ulcerative Colitis, which are chronic evolution diseases. The main symptoms of these diseases are diarrhea, abdominal pain, fever, and nausea which affect patients' quality of life. However, there is evidence that supplementation can help patients with the symptoms and improve quality of life.info:eu-repo/semantics/publishedVersio

Test-retest and interrater reliability of experimental within-subject variability of pain reports as assessed by the focused analgesia selection test

Introduction: Within-subject variability (WSV) of pain intensity reports has been shown to predict the placebo response. The focused analgesia selection test (FAST), which allows to experimentally assess WSV of pain reports, has been used as a screening tool to identify participants who are likely to have a strong placebo response in drug-development clinical trials. Yet, the reliability of FAST has not been reported. Objectives: To assess test–retest and interrater reliability of the FAST outcomes. To mimic pharma-sponsored clinical trials, we enlisted inexperienced assessors who underwent limited training. Methods: Healthy volunteers performed the FAST twice within a week and were randomly assigned to either the test–retest group or the interrater group. T-tests, partial Pearson correlations, intraclass correlations (ICC), and Bland–Altman plots were generated to assess FAST outcomes’ reliability. Results: Sixty-three participants completed the study and were assigned to the test–retest (N 5 33) or interrater (N 5 30) arms. No statistically significant differences in the FAST outcomes were detected between the 2 sessions, except for the FAST covariance (FAST CoV) in the interrater assessment (P 5 0.009). Test–retest reliabilities of the FAST-main outcomes were r 5 0.461, ICC 5 0.385 for the FAST R2 and r 5 0.605, ICC 5 0.539 for the FAST ICC and in the interrater cohort, they were FAST R2 : r 5 0.321, ICC 5 0.337 and FAST ICC: r 5 0.355, ICC 5 0.330. Conclusion: Using inexperienced assessors, the FAST outcomes test–retest ranged from moderate to strong, whereas the interrater reliability ranged from weak to poor. These results highlight the importance of adequately training study staff members before using this tool in multicentre clinical trials.info:eu-repo/semantics/publishedVersio

No relationships between the within-subjects' variability of pain intensity reports and variability of other bodily sensations reports

Purpose: The subjective nature of pain assessment and its large variance negatively affect patient-health care provider communication and reduce the assay sensitivity of pain clinical trials. Given the lack of an objective gold standard measure, identifying the source (true or error) of the within-subject variability of pain reports is a challenge. By assessing the within-subjects variability of pain and taste reports, alongside with interoceptive measures, the current study is aimed to investigate if the ability to reliably report bodily sensations is a cross-modal characteristic. Patients and Methods: This prospective study enrolled healthy volunteers from local universities. After consenting, subjects underwent the Focus Analgesia Selection Task (FAST), to assess within-subjects variability of pain reports in response to experimental noxious stimuli; a taste task, which similarly assesses within-subjects variability of tastes (salty and sweet) intensity reports; and the heartbeat perception task, an interoceptive task aimed to assess how accurate subjects are in monitoring and reporting their own heartbeat. In addition, all subjects completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Perceived Stress Scale (PSS), and Hospital Anxiety and Depression Scale (HADS). Spearman's correlations were used to assess relations between all measures. Results: Sixty healthy volunteers were recruited. Variability of intensity reports of different modalities were independent of each other (P > 0.05 for all correlations). The only correlation found was within modality, between variability of intensity reports of salt and sweet tastes (Spearman's r = 0.477, P < 0.001). No correlations were found between any of the task results and questionnaire results. Conclusion: Within-subjects variability of pain reports do not relate to variability of reports of other modalities or to interoceptive awareness. Further research is ongoing to investigate the clinical relevance of within-subjects' variability of pain reports.info:eu-repo/semantics/publishedVersio

Relatório de estágio de marketing e promoção turística no grupo hoteleiro Lux Hotels

O presente relatório retrata a experiência vivida num estágio de marketing e promoção turística no grupo nacional hoteleiro Lux Hotels. Este relatório está estruturado em quatro capítulos de acordo com o estágio realizado. O estágio teve duração de nove meses, sendo que os primeiros sete meses decorreram no Lisboa Carmo Hotel, um dos hotéis do grupo, e os outros dois meses no departamento de marketing do grupo. O primeiro capítulo aborda a fundamentação teórica, onde são expostos e desenvolvidos os conceitos de marketing turístico, a importância do marketing no setor hoteleiro, o marketing e as relações públicas e, por fim, a importância da internet e das redes sociais no turismo. Todos estes temas estão diretamente ligados com as tarefas realizadas ao longo do estágio. O segundo capítulo descreve a empresa onde decorreu o estágio. Neste capítulo é apresentado, de forma pormenorizada, o grupo hoteleiro, a sua história, conceito e desenvolvimento, bem como uma análise pessoal ao marketing do grupo. Também neste capítulo é possível encontrar alguns aspetos personalizados acerca do Lisboa Carmo Hotel. O terceiro capítulo descreve todas as tarefas realizadas ao longo do estágio, relacionadas com marketing e promoção no turismo. Por último, o capítulo quatro são as conclusões, onde se pode ler uma análise critica acerca do estágio e tarefas desenvolvidas. Com este trabalho pretendo mostrar as funções de um agente de marketing num grupo hoteleiro a nível nacional

Reliability of the within-subjects variability of pain reports as assessed by the focused analgesia selection test (fast)

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