Depressão, ansiedade e estresse em usuários de cuidados primários de saúde

Aim: Describe levels of depression, anxiety and stress among users of an urban/rural health centre, analyse sex differences and comorbidity between depression, anxiety and stress. Method: Descriptive co-relational study with a Portuguese version of DASS-21; consecutive sample (n=343). Results: 40.52%, 43.48% and 45.06% of individuals present some degree of depression, anxiety and of stress, respectively. Severe or very severe levels of disturbance were found in 20.87% (anxiety), 22.38% (stress) and 12.24% (depression) of individuals. Women present higher levels of depression, anxiety and stress. Depression, Anxiety and Stress are strongly and positively associated. Conclusion: These results show high point prevalence - higher than in other countries - and reveal differences in sex as well as comorbidity. They may allow for the development of a local and community intervention strategy for mental health promotion and disease prevention, particularly for women.Los objetivos de este estudio fueron: describir niveles de depresión, ansiedad y estrés de los usuarios de un centro de salud urbana/rural, analizar diferencias de género y la comorbilidad entre depresión, ansiedad y estrés. Se trata de un estudio descriptivo correlacional aplicando una versión portuguesa de la DAS-21 en una muestra consecutiva (n=343). Se constató algún grado de depresión, ansiedad y estrés en 40,52%, 43,48% y 45,06% de los individuos, respectivamente. Se identificaron niveles graves o muy graves de ansiedad en 20,87% de los individuos, de estrés en 22,38% y de depresión en 12,24%. Las mujeres presentaron niveles promedios de depresión, ansiedad y de estrés más elevados. La depresión, la ansiedad y el estrés están fuertemente y positivamente asociados. Se concluye que estos resultados apuntan para una elevada prevalencia - más alta que en otros países - y revelan diferencias de género y comorbilidad. Con base en los hallazgos, se podrá desarrollar una estrategia de intervención local y comunitaria para la promoción de la salud mental y prevención de la enfermedad, particularmente de las mujeres.Os objetivos deste estudo foram descrever níveis de depressão, ansiedade e estresse dos usuários de um centro de saúde urbano/rural, analisar diferenças de sexo e a comorbilidade entre depressão, ansiedade e estresse. Este é um estudo descritivo correlacional, aplicando-se uma versão portuguesa da DASS-21, em amostra consecutiva (n=343). Tem-se como resultados que 40,52, 43,48 e 45,06% dos indivíduos apresentam, respetivamente, algum grau de depressão, ansiedade e estresse. Identificaram-se níveis graves ou muito graves de ansiedade em 20,87% dos indivíduos, de estresse em 22,38% e de depressão em 12,24%. As mulheres apresentam níveis médios de depressão, ansiedade e estresse mais elevados. Depressão, ansiedade e estresse estão forte e positivamente associados. Esses resultados apontam para elevada prevalência - mais alta que em outros países - e revelam diferenças de sexo e comorbilidade. Com base neles, poder-se-á desenvolver estratégia de intervenção local e comunitária para a promoção da saúde mental e prevenção da doença, particularizando as mulheres

Adaptation to Portuguese of the Depression, Anxiety and Stress Scales (DASS)

Objective: to adapt to Portuguese, of Portugal, the Depression, Anxiety and Stress Scales, a 21-item short scale (DASS 21), designed to measure depression, anxiety and stress. Method: After translation and back-translation with the help of experts, the DASS 21 was administered to patients in external psychiatry consults (N=101), and its internal consistency, construct validity and concurrent validity were measured. Results: The DASS 21 properties certify its quality to measure emotional states. The instrument reveals good internal consistency. Factorial analysis shows that the two-factor structure is more adequate. The first factor groups most of the items that theoretically assess anxiety and stress, and the second groups most of the items that assess depression, explaining, on the whole, 58.54% of total variance. The strong positive correlation between the DASS 21 and the Hospital Anxiety and Depression scale (HAD) confirms the hypothesis regarding the criterion validity, however, revealing fragilities as to the divergence between theoretically different constructs.Objetivo: adaptar a la lengua portuguesa, de Portugal, la Depression, Anxiety and Stress Scale, versión corta de 21 ítems, (DASS-21), que permite evaluar depresión, ansiedad y estrés. Método: Después de haber sido traducida y retrovertida, con la ayuda de peritos, la DASS-21 fue administrada a enfermos en consulta externa de psiquiatría (N=101), y fue evaluada la consistencia interna, la validez de constructo y la validez concurrente. Resultados: Las propiedades de la DASS-21 atestiguan su calidad para evaluar estados emocionales. El instrumento reveló buena consistencia interna. El análisis factorial muestra que la estructura de dos factores es la más ajustada. El primer factor agrupa la mayoría de los ítems que teóricamente evalúan ansiedad y estrés, y el segundo agrupa la mayoría de los ítems que evalúan depresión, explicando en su conjunto el 58,54% de la variación total. La fuerte correlación positiva entre la DASS-21 y la escala Hospital Anxiety and Depression confirma la hipótesis relativa a la validez de criterio, siendo sin embargo reveladas fragilidades relativamente a la divergencia entre constructos teóricamente diferentes.Objetivo: adaptar para a língua Portuguesa, de Portugal, a Depression, Anxiety and Stress Scale, versão curta de 21 itens (DASS-21), que permite avaliar depressão, ansiedade e estresse. Método: Após ter sido traduzida e retrovertida, com a ajuda de peritos, a DASS-21 foi administrada a doentes em consulta externa de psiquiatria (N=101), e foi avaliada a consistência interna, a validade de construto e a validade concorrente. Resultados: As propriedades da DASS-21 atestam a sua qualidade para avaliar estados emocionais. O instrumento revelou boa consistência interna. A análise fatorial mostra que a estrutura de dois fatores é mais ajustada. O primeiro fator agrupa a maioria dos itens que teoricamente avaliam ansiedade e estresse e o segundo agrupa a maioria dos itens que avaliam depressão, explicando no seu conjunto 58,54% da variância total. A forte correlação positiva entre a DASS-21 e a HAD confirma a hipótese relativa à validade de critério, sendo no entanto reveladas fragilidades relativamente à divergência entre construtos teoricamente diferentes

Encouraging brand attachment on consumer behaviour: Pet-friendly tourism segment

Purpose: The aim of this paper is to study the factors that influence consumer behaviour through brand attachment, in the pet-friendly segment in Portugal. Pet-friendly tourism has stood out as a very recognized and valid tourism and marketing segment, growing worldwide, urging the complex needed advances on tourism practices performance. Methods: The application of the model to a group of 190 respondents carried out in order to analyse the relationships between brand attachment, trust, satisfaction, commitment, loyalty and quality of service. To test our measurement model, data was analysed using the SmartPLS 3.2. Results: Results reveal that quality of the service, satisfaction, trust and commitment had a strong relationship with the loyalty of the respondents. As for the brand attachment, the variables that showed the most influence were satisfaction, trust and commitment. Implications: The research still needs to be empirically applied in pet-friendly tourism settings to enrich their robustness in a cross-cultural tourism experiences, covering a wider spread of abroad tourism destinations and products. This study thus contributes to a better clarity at the theoretical level of brand attachment and consumer behaviour, as well as making it possible to understand from the consumers’ side, which characteristics are part of their decision-making process, granting relevant data that can cooperate in the definition of better marketing strategies

Modify Flipped Model of Co-regulation and Shared-regulation Impact in Higher Education, and Role of Facilitator on Student's Achievement

2021 International Conference on Computational Science and Computational Intelligence (CSCI'21)Flipped learning approach is a well-organized learning model leading to efficient active learning, effective peer-to-peer collaboration, and student-teacher interaction. However, to date, strategic implementation of co-regulation and shared regulation is rare in a flipped model in higher education. Hence, applying the self-regulation, co-regulation and shared-regulation strategies in flipped learning model is something necessary. Aims: This research is to propose and modify the current flipped learning model by adding some elements like providing some co-regulation and shared regulation strategies to enhance the level of student’s self-regulation skills giving rise to better student’s academic achievements by using technology next to instructor support. Methodology: The proposed model consists of the self-regulation, co-regulation and shared regulation strategies to enhance student’s academic performance in a peer-to-peer interactive way by creating a pool of scripted dialogical regulation questions to collaboratively assessment of the student’s self-regulation resulted from learning analytics and semantic analysis of the regulation dialogical questions and answers exchanged by students online. Results: The expected outcome of this research is a modified flipped model for students in higher education to strategically have an effective self-regulation and peer-to-peer co-regulation. Their enhancement leads to effective peer-to-peer collaboration and better academic success.N/

Ultradiluições de Natrum muriaticum no desempenho agronômico do tomateiro-cereja sob estresse salino

ABSTRACTConsidered an agricultural input by the Ministry of Agriculture and Supply, homeopathy has been increasingly used in agriculture, especially in plants. It is an important technology to be adopted to reverse a framework of saline stress, because since the current procedures are little known, have hight costs and resources are not renewable. The present study aims to evaluate the effect of the homeopathic preparation Natrum muriaticum (Nat-m) on agronomic performance and physiological parameters of cherry tomatoes submitted to saline stress. The statistical design was a completely randomized design with eight treatments and five replications. The treatments consisted in the application of Nat-m 3cH, 5cH, 7cH, 9cH, 11cH, 13cH and two controls: etanol 70% and distilled water. They were conducted in a greenhouse and the treatments were applied weekly. Satisfactory results were observed with the applications of Nat-m 11cH and 13cH, with a significant increase in the characteristics such as height, diameter of the lap, number of leaves, number of flowers per cluster, number of fruits, fresh fruit mass, as well as on the productivity of tomato plants. Lower averages of the proline content were obtained with the application of these homeopathic preparations, this response may be associated with the osmotic adjustment promoted by the use of ultradiluitions. Natrum muriaticum positively affected the vegetative and reproductive development of cherry tomato plants submitted to saline stress.Considerada insumo agrícola pelo Ministério da Agricultura e do Abastecimento, a homeopatia vem sendo utilizada de forma crescente na agricultura, especialmente em plantas. É uma importante tecnologia a ser adotada para reversão de quadros de estresse salino, pois os procedimentos atuais são pouco conhecidos, possuem custos elevados e os recursos não são renováveis. O presente estudo objetivou avaliar o efeito do preparado homeopático Natrum muriaticum (Nat-m) no desempenho agronômico e parâmetros fisiológicos do tomateiro-cereja submetido à estresse salino. O delineamento estatístico utilizado foi inteiramente casualizado, com oito tratamentos e cinco repetições. Os tratamentos consistiram na aplicação de Nat-m 3cH, 5cH, 7cH, 9cH, 11cH, 13cH e duas testemunhas: etanol 70% e água destilada. Foram conduzidos em casa de vegetação e a aplicação dos tratamentos realizada semanalmente. Resultados satisfatórios foram obtidos com as aplicações de Nat-m 11cH e 13cH, com incremento significativo nas características altura, diâmetro de colo, número de folhas, número de flores por cacho, número de frutos, massa fresca de frutos, bem como na produtividade do tomateiro. Médias inferiores do teor de prolina foram obtidas com a aplicação destes preparados homeopáticos, tal resposta pode estar associada ao ajuste osmótico promovido pelo uso das ultradiluições. Natrum muriaticum atuou positivamente no desenvolvimento vegetativo e reprodutivo das plantas de tomate-cereja submetidas ao estresse salino

SATISFAÇÃO PROFISSIONAL DA EQUIPE DE ATENDIMENTO DOMICILIAR TERAPÊUTICO DE UMA UNIDADE DE REFERÊNCIA AO PORTADOR DE HIV/AIDS DO ESTADO DO PARÁ

The study was developed in a specialized health unit that is reference on health care for HIV/AIDS patientsin Pará State, Brazil. Objectives: to identify environmental and psychosocial factors that might influence the level ofprofessional satisfaction of a Therapeutic Home Care team, and to know the strategies used by the team to promote thisprofessional satisfaction. Nine professionals of the Therapeutic Home Care team joined the study. Data were gatheredthrough interviews with open questions. Data analysis was developed by the content analysis technique. As main results,it was unveiled that there is a balance between satisfaction and dissatisfaction among the workers, as well as a diversityof environmental and psychosocial factors that influence the professional’s level of satisfaction. The adoption of preventiveand health promotion measures is necessary once suffering and death are routinely faced in their daily work, which mayfoster stress and other mental health problems.Investigación realizada en una unidad de referencia especializada en la atención al portador de HIV/SIDA enel Estado de Pará/BR. Objetivos: identificar factores ambientales y psicosociales que pueden influenciar en el nivel desatisfacción profesional de un equipo de Atención Domiciliar Terapéutico y conocer las estrategias utilizadas por elequipo para la promoción de su satisfacción profesional. Participaron nueve profesionales del equipo de Atención DomiciliarTerapéutico. Los datos fueron colectados por medio de entrevista con preguntas abiertas. Para el análisis de los datos fueutilizada la técnica de análisis de contenido. Como principales resultados se verificó un equilibrio existente entre satisfaccióne insatisfacción de los profesionales, bien como una diversidad de factores ambientales y psicosociales que influencian elnivel de satisfacción de los profesionales. Se considera necesaria la adopción de medidas de prevención y promoción dela salud del equipo, en vista de las peculiaridades de su trabajo en que el sufrimiento y la muerte hacen parte de la rutinadiaria de estos trabajadores, generando estrés y otros problemas de salud mental.Pesquisa realizada em uma unidade de referência especializada no atendimento ao portador de HIV/AIDS noEstado do Pará. Objetivos: identificar fatores ambientais e psicossociais que podem influenciar no nível de satisfaçãoprofissional de uma equipe de Atendimento Domiciliar Terapêutico e conhecer as estratégias utilizadas pela equipe para apromoção da sua satisfação profissional. Participaram nove profissionais da equipe de Atendimento Domiciliar Terapêutico.Os dados foram coletados mediante entrevista com questões abertas. Para a análise dos dados foi utilizada a técnica deanálise de conteúdo. Como principais resultados verificou-se um equilíbrio existente entre satisfação e insatisfação dosprofissionais, bem como uma diversidade de fatores ambientais e psicossociais que influenciam o nível de satisfação dosprofissionais. Considera-se necessário a adoção de medidas de prevenção e promoção da saúde da equipe, haja vista aspeculiaridades de seu trabalho em que o sofrimento e a morte fazem parte da rotina diária desses trabalhadores, gerandoestresse e outros problemas de saúde mental

Addressing ageism : be active in aging: study protocol

Ageism refers to stereotyping (how we think), prejudice (how we feel), and discrimination (how we act) against people based on their age. It is a serious public health issue that can negatively impact older people’s health and quality of life. The present protocol has several goals: (1) adapt the Ambivalent Ageism Scale for the general Portuguese population and healthcare professionals; (2) assess the factorial invariance of the questionnaire between general population vs. healthcare professionals; (3) evaluate the level of ageism and its predictors in the general population and evaluate the level of ageism and its predictors in healthcare professionals; (4) compare the levels of ageism between groups and the invariance between groups regarding the explanatory model of predictors of ageism. This quantitative, cross-sectional, descriptive, observational study will be developed in partnership with several Healthcare Professional Boards/Associations, National Geriatrics and Gerontology Associations, and the Universities of the Third Age Network Association. The web-based survey will be conducted on a convenience sample recruited via various social media and institutional channels. The survey consists of three questionnaires: (1) Demographic data; (2) Ambivalent Ageism Scale; (3) Palmore-Neri and Cachioni questionnaire. The methodology of this study will include translation, pilot testing, semantic adjustment, exploratory and confirmatory factor analysis, and multigroup analysis of the Ambivalent Ageism Scale. Data will be treated using International Business Machines Corporation (IBM®) Statistical Package for the Social Sciences (SPSS) software and Analysis of Moment Structures (AMOS). Descriptive analysis will be conducted to assess the level of ageism in the study sample. The ageism levels between the two groups will be compared using the t-student test, and two Structural Equation Modeling will be developed to evaluate the predictors of ageism. Assessing ageism is necessary to allow healthcare professionals and policymakers to design and implement strategies to solve or reduce this issue. Findings from this study will generate knowledge relevant to healthcare and medical courses along with anti-ageism education for the Portuguese population.info:eu-repo/semantics/publishedVersio

An update on wastewater multi-resistant bacteria : identification of clinical pathogens such as Escherichia coli O25b:H4-B2-ST131-producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Wastewater treatment plants (WWTPs) are significant reservoirs of bacterial resistance. This work aims to identify the determinants of resistance produced by Gram-negative bacteria in the influent and effluent of two WWTPs in Portugal. A total of 96 wastewater samples were obtained between 2016 and 2019. The numbers of total aerobic and fecal contamination bacteria were evaluated, and genomic features were searched by polymerase chain reaction (PCR) and Next-Generation Sequencing (NGS). Enterobacteriaceae corresponded to 78.6% (n = 161) of the 205 isolates identified by 16sRNA. The most frequent isolates were Escherichia spp. (57.1%, n = 117), followed by Aeromonas spp. (16.1%, n = 33) and Klebsiella spp. (12.7%, n = 26). The remaining 29 isolates (14.1%) were distributed across 10 different genera. Among the 183 resistant genes detected, 54 isolates produced extended spectrum β-lactamases (ESBL), of which blaCTX-M-15 was predominant (37 isolates; 68.5%). A KPC-3 carbapenemase-producing K. oxytoca was identified (n = 1), with blaKPC-3 included in a transposon Tn4401 isoform b. A higher number of virulence genes (VG) (19 genes) was found in the E. coli 5301 (O25b-ST131-B2) isolate compared with a commensal E. coli 5281 (O25b-ST410-A) (six genes). Both shared five VG [Enterobactin; Aerobactin, CFA/1 (clade α); Type1 (clade γ1); Type IV]. In conclusion, this work highlights the role of relevant clinical bacteria in WWTPs, such as KPC-3-producing K. oxytoca, and, for the first time, a CTX-M-15-producing Ochromobactrum intermedium, a human opportunistic pathogen, and a SED-1-producing Citrobacter farmeri, an uncommon CTX-M-type extended-spectrum beta-lactamase.This work was supported by the European Union LIFE Programme under Grant Agreement LIFE14 ENV/PT/000739—LIFE Impetus (https://life-impetus.eu/), accessed on 1 February 2021.info:eu-repo/semantics/publishedVersio

Deciduous molar hypomineralization in twins: A case report / Hipomineralização de molares decíduos em gêmeos: Um relato de caso

Deciduous molar hypomineralization (DMH) is an enamel defect of multifactorial origin that affects the second deciduous molar and may be associated with canines and first deciduous molars. Clinically, these defects appear as white, yellow, or brown spots, which may progress to a posteruptive enamel breakdown, increasing sensitivity and caries risk. Children with DMH are more prone to develop MIH in permanent dentition. The aim is to present a clinical case of monozygotic twins with severe DMH, showing evidence of its manifestation as well as clinical characteristics and aetiological factors involved. Although DMH etiology remains unclear, clinical manifestations in twins suggest a possible genetic susceptibility to the disease, which may be associated with the shared environmental factors. Also, teeth affected with DMH require an increased need for restorative care. Aetiological risk factors and different treatments’ knowledge regarding this condition are of substantial importance to improve patients’ quality of life. More studies involving monozygotic and dizygotic twin pairs will be required to improve this case report data

As boas práticas da Biblioteca Lúcio Craveiro da Silva como espaço público inclusivo

O presente artigo pretende expor as práticas levadas a cabo pela Biblioteca Lúcio Craveiro da Silva, em Braga, no desenvolvimento de diferentes literacias na comunidade local. Sabemos que estas importantes literacias ajudam a aumentar os níveis de informação e conhecimento, a desenvolver o pensamento crítico e a combater a infoexclusão. Articulada com a educação dos cidadãos, a educação não-formal volta-se para a formação de cidadãos livres, emancipados, portadores de um leque diversificado de direitos, assim como de deveres. A Biblioteca funciona como espaço público de inclusão e de cidadania. Apresentam-se neste artigo casos de boas práticas levadas a cabo na Biblioteca Lúcio Craveiro da Silva, dando destaque ao serviço Biblioteca no Apoio à Inclusão, o qual foca as suas iniciativas nas pessoas com necessidades especiais. As ações desenvolvidas na Biblioteca passam pelo acolhimento e atendimento personalizado a este público, pela disponibilização e formação em equipamentos e softwares que apoiam o desenvolvimento de competências de escrita, de leitura, em formatos digitais multimédia. O serviço Biblioteca no Apoio à Inclusão contribui para a construção de espaços de socialização e integração de saberes, desenvolvimento de capacidades comunicativas e de autonomização. Para estas ações exigem-se recursos e equipamentos específicos (tecnologias de apoio), bem como pessoal qualificado. Para que tal seja possível, é premente proporcionar espaços de reflexão e sensibilização junto da comunidade científica e técnica para mostrar que as bibliotecas são e podem ser ainda mais espaços inclusivos, desde que desenvolvido o seu potencial educador, fortalecido o seu papel social e reforçadas as redes de parceria. Todos os cidadãos são desafiados nas bibliotecas à promoção de uma educação cidadã, participativa e emancipatória