Ideação Suicida em Estudantes do Ensino Superior Politécnico: Influência de Algumas Variáveis Sociodemográficas, Académicas e Comportamentais

Resumo Introdução: Este artigo procede à divulgação de alguns resultados obtidos, a partir de um estudo mais alargado, desenvolvido no âmbito do doutoramento em Ciências de Enfermagem, e nele se pretende avaliar a prevalência da ideação suicida em estudantes do ensino superior politécnico e conhecer quais os fatores, eventualmente associados, com o intuito de definir o perfil de risco para a presença de elevada ideação suicida/risco suicida. Durante a frequência do ensino superior ocorrem múltiplas mudanças na vida dos estudantes, pois trata-se de um período marcado por um conjunto de transições desenvolvimentais e académicas que podem originar algumas crises situacionais e problemas de saúde mental, tornando estes estudantes potencialmente mais vulneráveis e com risco aumentado para os comportamentos suicidários. Os comportamentos suicidários constituem, atualmente, um problema de saúde pública, sendo o suicídio a segunda causa de morte na população jovem na maioria dos países europeus. Objetivos: Determinar a prevalência da ideação suicida nos estudantes do ensino superior politécnico e analisar a sua relação com algumas variáveis sociodemográficas, académicas e comportamentais. Métodos: Estudo quantitativo, descritivo e correlacional, realizado numa amostra do tipo não probabilístico intencional, constituída por 1074 estudantes de uma instituição de ensino superior da região centro de Portugal. A colheita de dados foi efetuada através de uma plataforma online e teve por base um questionário com questões relativas à caracterização sociodemográfica e académica dos estudantes e um Questionário de Ideação Suicida (QIS) de (Ferreira & Castela, 1999). Resultados: A idade dos estudantes da amostra oscila entre os 17 e os 49 ( = 23,9 anos ± 6,107 dp), a grande maioria (64.7%) é do sexo feminino. Os resultados mostram que a presença/gravidade de pensamentos suicidas é de ( = 13.84; ± 20.29 Dp) numa escala de 0 a 180 e ponto de corte > 41 para valores sugestivos de potencial risco suicida, com base no qual foram identificados 84 estudantes (7,8%). As variáveis que produziram significância estatística com a ideação/risco de suicídio nos estudantes foram: Sexo (feminino); Estado civil (solteiro); Coabitação em tempo de aulas (viver sozinho); Desempenho académico (reprovações); Comportamentos aditivos (consumo de drogas e psicofármacos). Conclusões: Embora a prevalência de ideação suicida nos estudantes não seja elevada, encontramos na nossa amostra 84 estudantes (7,8%) com potencial risco de suicídio. Não poderemos ficar indiferentes a esta problemática pelas suas repercussões individuais, familiares e sociais. Todas as instituições de ensino superior deveriam possuir gabinetes de apoio aos estudantes e desenvolver programas de promoção da saúde mental e prevenção do suicídio em meio académico.Abstract Introduction: This article aims to give away some of the results obtained from a larger study developed under a PhD in Nursing Sciences, whose main purpose was to assess suicidal ideation prevalence on higher education students, as well as any associated factors. While attending to higher education, multiple changes occur in the lives of young students. It is a period characterized by a set of developmental and academic changes that might lead to some crisis and mental health problems. These changes make higher education students particularly more exposed and vulnerable and more likely to present suicidal behaviours. Currently, suicidal behaviours constitute a public health issue, being suicide the second cause of death in the majority of the European countries. Objectives: To determine suicidal ideation prevalence on students of higher education and to assess its relation with some sociodemographic, academic and behavioural variables. Methods: Exploratory, quantitative and descriptive study, with a sample of 1074 students of a higher education institution in Portugal. The data collection was made through an online platform, which included a survey with questions related to the sociodemographic and academic profile of students and the Suicide Ideation Questionnaire - SIQ (Ferreira & Castela, 1999). Results: the sampled students' age oscillates between 17 and 49 years old ( = 23,9 anos ± 6,107 sd) and the majority are females (64.7%). The results obtained on SIQ show that the presence/gravity of suicidal thoughts is low ( = 13.84; ± 20.29 sd), on a scale from 0 to 180 and cut-off point > 41, however we found 84 students (7,8% of the whole sample) with suggestive values of potential suicidal risk. The variables that present statistical significance regarding suicidal ideation/suicide risk on students were: Gender (female); Marital status (single); Cohabitation during classes (living alone); Academic failure, Addictive behaviours (drugs and/or psychopharmacs abuse) Conclusions: Although the prevalence of suicidal ideation among our students sample was not high, we identified 84 students (7.8%) with potential suicide risk. Considering the individual, familiar, social and clinic repercussions of suicidal behaviours, we believe that every higher education institution must develop mental health promotion programs as well as suicide prevention in academic environments

Condensações superficiais interiores : avaliação do risco

Tese de mestrado integrado. Engenharia Civil (Especialização em Construções). Faculdade de Engenharia. Universidade do Porto. 201

Proof-of-Principle That Cellular Automata Can Be Used to Predict Infestation Risk by Reticulitermes grassei (Blattodea: Isoptera)

Over the past few decades, species distribution modelling has been increasingly used to monitor invasive species. Studies herein propose to use Cellular Automata (CA), not only to model the distribution of a potentially invasive species but also to infer the potential of the method in risk prediction of Reticulitermes grassei infestation. The test area was mainland Portugal, for which an available presence-only dataset was used. This is a typical dataset type, resulting from either distribution studies or infestation reports. Subterranean termite urban distributions in Portugal from 1970 to 2001 were simulated, and the results were compared with known records from both 2001 (the publication date of the distribution models for R. grassei in Portugal) and 2020. The reported model was able to predict the widespread presence of R. grassei, showing its potential as a viable prediction tool for R. grassei infestation risk in wooden structures, providing the collection of appropriate variables. Such a robust simulation tool can prove to be highly valuable in the decision-making process concerning pest managementinfo:eu-repo/semantics/publishedVersio

Construction and Validation of the Positive Mental Health Literacy Assessment Scale in Adults

Low mental health literacy levels have a profound negative effect on healthcare outcomes, usage of healthcare services and healthcare expenditure. To date, there is little research and a lack of instruments available to address and assess positive mental health literacy levels in community-dwelling adults. Thus, this study sought to develop an instrument to assess positive mental health literacy in adults and to evaluate its psychometric properties. A scale developed in European Portuguese and composed of 32 items was designed to assess positive mental health literacy among community-dwelling adults and was validated using exploratory factor analysis. Five latent factors were identified (decision making, prosocial attitudes, perception of resources, community involvement, and problem solving), whose hypothesised structure was confirmed by confirmatory factor analysis using structural equation modelling. Evidence showed that the scale’s factor structure is reliable and valid and adequately represents the theorised constructs. Thus, this may be a useful assessment tool for clinical practice since it will allow a more rigorous assessment of positive mental health literacy and better mental health promotion interventions in the population.info:eu-repo/semantics/publishedVersio

Alfabetización en salud mental: una revisión sistemática de los instrumentos de medición

Background: Mental health literacy has become increasingly important as an empowerment tool in the field of mental health. Any intervention should always be preceded by a clear diagnosis of the situation. Objectives: To identify mental health literacy measurement instruments among adults living in a given community. Methods: An integrativereview of theliterature wasconducted using the PICOD method bysearching thefollowing scientific databases: PubMed, SciELO, LILACS, MEDLINE, EBSCO, Cochrane Library and EMBASE. The JBI critical appraisal checklist for methodological quality was used and the PRISMA guidelines were taken into account to critically assess the quality of the studies included in this work. Three articles met the inclusion criteria and were therefore included in the study. Results: Three instruments for assessing mental health literacy were identified: the MHLS, the MHKQ and the MAKS. The assessment of the methodological and psychometric quality of each of these instruments demonstrated that one of the studies showed a very good level of reliability, another study showed an acceptable level of reliability, whereas the last one showed a poor level of reliability. Conclusion: These results show that the MHLS is the best validated assessment tool for health care professionals. Given the limited number of primary studies identified, the construction of an instrument to assess the level of positive mental health literacy in the community is crucial. Antecedentes: La alfabetización en salud mental ha adquirido una importancia creciente como herramienta de empoderamiento en el ámbito de la salud mental. Cualquier intervención debe ir siempre precedida de un diagnóstico claro de la situación. Objetivos: Identificar los instrumentos de medición de la alfabetización en salud mental entre los adultos que viven en una comunidad determinada. Métodos: Se realizó una revisión integradora de la literatura utilizando el método PICOD mediante la búsqueda en las siguientes bases de datos científicas: PubMed, SciELO, LILACS, MEDLINE, EBSCO, Cochrane Library y EMBASE. Se utilizó la lista de comprobación de la calidad metodológica del JBI y se tuvieron en cuenta las directrices PRISMA para evaluar críticamente la calidad de los estudios incluidos en este trabajo. Tres artículos cumplieron los criterios de inclusión y, por tanto, se incluyeron en el estudio. Resultados: Se identificaron tres instrumentos para evaluar la alfabetización en salud mental: el MHLS, el MHKQ y el MAKS. La evaluación de la calidad metodológica y psicométrica de cada uno de estos instrumentos demostró que uno de los estudios mostró un nivel de fiabilidad muy bueno, otro estudio mostró un nivel de fiabilidad aceptable, mientras que el último mostró un nivel de fiabilidad pobre. Conclusión: Estos resultados muestran que el MHLS es el mejor instrumento de evaluación validado para los profesionales de la salud. Dado el limitado número de estudios primarios identificados, es crucial la construcción de un instrumento para evaluar el nivel de alfabetización en salud mental positiva en la comunidad

Vitiligo Instabilizado em Contexto de Hipermelanose Difusa: Uma Apresentação Inusitada de uma Síndrome de Schmidt

Vitiligo is an acquired prevalent pigmentary disorder characterized by its chronicity, refractoriness and significant psychosocial burden. Concerning its pathogenesis, several genetic, environmental, oxidative stress mechanisms and immune disturbances combine in an intricate, complex way. Diverse immunemediated comorbidities do occur in a variable yet significant manner, so as to fully justify the careful approach and follow-up of these patients. polyglandular autoimmune syndrome type II – Schmidt`s syndrome – is defined by the association of Addison`s disease with immunemediated thyroid disease and/or type 1 diabetes mellitus. The case of a 64year old Caucasian female patient with a long lasting history of several immunemediated disorders (namely Hashimoto thyroiditis and hypothyroidism, atrophic gastritis, lichen planus and stable acrofacial vitiligo) is reported. who For the last 3 months her vitiligo had suffered significant extension and morphologic changes – confettilike lesions, trichromic vitiligo and Koebner`s phenomenon – along with discrete and subtle generalized hypermelanosis. Laboratory work up disclosed a state of hypocortisolism –further confirmed by functional, immunological and image studies: autoimmune Addison`s disease in the context of Schmidt`s syndrome. An effective endocrine insufficiency correction prompted for a quick patient`s recovery as far as hydroelectrolytic and metabolic metabolism, with a concomitant reversion of the hypermelanosis and a stabilization of the vitiligo. In this case it is noteworthy the rapid expansion of a previous stable vitiligo along with the acquisition of peculiar new morphologic features, in the context of a subtle diffuse hypermelanosis in a patient with a past history of several immunemediated disorders. We underline the need to acknowledge the possible association of vitiligo with immunemediated comorbidities, particularly whenever atypical semiological or evolutive features are present.O vitiligo, uma leucodermia adquirida particularmente prevalente, caracteriza-se pelo impacto psicossocial, cronicidade e resistência aos tratamentos. Na sua génese intervêm de forma intrincada mecanismos genéticos, ambientais, stress oxidativo e autoimunidade. As comorbilidades imunologicamente mediadas ocorrem com frequência variável mas significativa e devem justificar uma atenção redobrada por parte dos Dermatologistas. A síndrome de Schmidt – síndrome poliglandular autoimune do tipo II é definida pela ocorrência de doença de Addison e patologia autoimune da tiroideia e/ou diabetes mellitus tipo 1. Relatamos caso de uma doente com 64 anos de idade, com antecedentes de doenças imunologicamente mediadas, incluindo história de tiroidite autoimune e de vitiligo acrofacial estável o qual, nos últimos 3 meses, sofrera uma modificação impressiva nas suas extensão e morfologia, no contexto de uma melanodermia difusa recém-instalada. A avaliação laboratorial efectuada documentou hipocortisolismo, ulteriormente confirmado por provas funcionais, bem como marcadores imunológicos e imagiologia compatíveis: doença de Addison autoimune enquadrável numa síndrome de Schmidt. A correcção da insuficiência endócrina permitiu equilibrar a doente nos planos hidroelectrolítico e metabólico, tendo sido observados uma reversão da hipermelanose e estabilização do vitiligo. Salientamse a progressão importante de um vitiligo até então estável; as novas particularidades morfológicas da dermatose – lesões em confetti, vitiligo tricrómico e fenómeno de Koebner – e a hipermelanose difusa numa doente com história de múltiplas manifestações de autoimunidade. Conclui-se pela necessidade de reconhecer e, logo, suspeitar de comorbilidades imunologicamente mediadas do vitiligo, em particular quando na presença de atipias semiológicas ou evolutivas e no contexto de história clínica sugestiva

Candida auris in Intensive Care Setting: The First Case Reported in Portugal

(This article belongs to the Special Issue Genomic Epidemiology of Fungal Diseases 2023)Candida auris is an opportunistic human pathogen that has rapidly spread to multiple countries and continents and has been associated with a high number of nosocomial outbreaks. Herein, we report the first case of C. auris in Portugal, which was associated with a patient transferred from Angola to an ICU in Portugal for liver transplantation after a SARS-CoV-2 infection. C. auris was isolated during the course of bronchoalveolar lavage, and it was subjected to antifungal susceptibility testing and whole-genome sequence analysis. This isolate presents low susceptibility to azoles and belongs to the genetic clade III with a phylogenetic placement close to African isolates. Although clade III has already been reported in Europe, taking into account the patient’s clinical history, we cannot discard the possibility that the patient’s colonization/infection occurred in Angola, prior to admission in the Portuguese hospital. Considering that C. auris is a fungal pathogen referenced by WHO as a critical priority, this case reinforces the need for continuous surveillance in a hospital settingThis work was supported by funding from the European Union EU4Health Programme under grant agreement no. 101113460 (GENEO) and by national funds through the Foundation for Science and Technology (FCT), I.P., under Individual CEEC 2022.00851.CEECIND/CP1748/CT0001.info:eu-repo/semantics/publishedVersio

Diabetes insipidus and hypopituitarism in HIV: an unexpected cause

Central diabetes insipidus (DI) is a rare clinical entity characterized by low circulating levels of antidiuretic hormone (ADH) presenting with polyuria and volume depletion. Pituitary surgery is the most common cause of central DI in adults. Pituitary and hypothalamic disease, particularly invasive neoplasms, rarely cause DI, being idiopathic cases responsible for the majority of non-surgical cases. HIV patients, especially those with poor virulogical control, are prone to the development of CNS neoplasms, particularly lymphomas. These neoplasms usually become manifest with mass effects and seizures. Central DI and hypopituitarism are uncommon initial manifestations of primary CNS lymphomas. The authors describe the case of 29-year-old female, HIV-positive patient whose CNS lymphoma presented with DI

Padronização da avaliação laboratorial do perfil lipídico: um apelo à ação com foco especial nas recomendações europeias de dislipidemia da ESC/EAS de 2016 – sumário executivo: Um consenso endossado pelo Grupo de Prevenção e Risco Cardiovascular da Sociedade Portuguesa de Medicina Interna, Sociedade Portuguesa de Cardiologia, Sociedade Portuguesa de Medicina Laboratorial e Associação Portuguesa de Analistas Clínicos

Even with improvements in lifestyle interventions, better control of cardiovascular (CV) risk factors, and improvements in CV outcomes, cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in Portugal and Europe. Atherogenic dyslipidemias, particularly hypercholesterolemia, have a crucial causal role in the development of atherosclerotic CVD. The clinical approach to a patient with dyslipidemia requires an accurate diagnosis, based on harmonized and standardized lipid and lipoprotein laboratory assessments. Results and reports of these tests, together with assessment of total CV risk and the respective therapeutic targets, will help ensure that clinical guidelines and good clinical practices are followed, increasing the reliability of screening for lipid disorders, producing more accurate diagnoses and CV risk stratification, and improving CV prevention. To this end, this consensus aims to provide clinicians with practical guidance for the harmonization and standardization of laboratory lipid tests, focusing on the most recent dyslipidemia management guidelines.info:eu-repo/semantics/publishedVersio

a cohort study based on data-linkage of national registries February-September 2021

Publisher Copyright: © 2022 Machado et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background Using data from electronic health registries, this study intended to estimate the COVID-19 vaccine effectiveness (VE) in the population aged 65 years and more, against symptomatic infection, COVID-19-related hospitalizations, and deaths, overall and by time since complete vaccination for the period February to September 2021 Methods We established a cohort of individuals aged 65 and more years old, resident in Portugal mainland, using the National Health Service User number to link eight electronic health registries. Outcomes included were symptomatic SARS-CoV-2 infections, COVID-19-related hospitalizations or deaths. The exposures of interest were the mRNA vaccines (Comirnaty or Spikevax) and the viral vector (Vaxzevria) vaccine. Complete schedule VE was estimated as one minus the confounder adjusted hazard ratio, for each outcome, estimated by time-dependent Cox regression with time-dependent vaccine exposure. Results For the cohort of individuals aged 65–79 years, complete scheme VE against symptomatic infection varied 43 (95%CI: 37–49) (Vaxzevria) and 65 (95%CI: 62–68) (mRNA vaccines). This estimate was slightly lower in the ≥80 years cohort (53, 95%CI: 45–60) for mRNA vaccines). VE against COVID-19 hospitalization varied between 89% (95%CI: 52–94) for Vaxzevria and 95% (95%CI: 93–97) for mRNA vaccines for the cohort aged 65–79 years and was 76% (95%CI: 67–83) for mRNA vaccines in the ≥80 years cohort. High VE against COVID-19-related deaths was estimated, for both vaccine types, 95% and 81 (95%CI:76–86) for the 65–79 years and the ≥80 years cohort, respectively. We observed a significant waning of VE against symptomatic infection, with VE estimates reaching approximately 34% for both vaccine types and cohorts. Significant waning was observed for the COVID-19 hospitalizations in the ≥80 years cohort (decay from 83% (95%CI:68 to 91) 14–41 days to 63% (95%CI:37 to 78) 124 days after mRNA second dose). No significant waning effect was observed for COVID-19-related deaths in the period of follow-up of either cohort. Conclusions In a population with a high risk of SARS-CoV-2 complications, we observed higher overall VE estimates against more severe outcomes for both age cohorts when compared to symptomatic infections. Considering the analysis of VE according to time since complete vaccination, the results showed a waning effect for both age cohorts in symptomatic infection and COVID-19 hospitalization for the 80 and more years cohort.publishersversionpublishe