Terapia cognitiva : aplicações de uma técnica para qualidade de vida e saúde

Esta pesquisa teve por objetivo geral aplicar e avaliar uma técnica específica de terapia cognitiva - organizada em 12 sessões grupais e denominada Tomada de Decisão e Qualidade de Vida -, destinada a promover saúde e incrementar qualidade de vida. No total, participaram 18 servidores de uma instituição pública de ensino superior. Nas etapas de admissão e de encerramento, aplicaram-se : Questionário de Qualidade de Vida, Inventário Beck de Ansiedade e Inventário Beck de Depressão. Foram identificadas melhoras significativas nos domínios físico, psicológico, meio ambiente, geral e saúde, relacionados à qualidade de vida. Não se verificaram alterações significantes nos escores de ansiedade (p=0,26). Em contrapartida, os escores de depressão indicaram melhora (p=0,02). Os resultados sugerem que a técnica pode ser empregada para promover saúde e qualidade de vida.In this study we implemented and assessed a specific cognitive therapy technique - Decision Making and Quality of Life, which is used to promote health and improve quality of life. Eighteen employees from a higher education institution participated in the study, which was organized into 12 group sessions. At the admission and concluding phases, we asked participants to complete the World Health Organization Quality of Life - Bref Questionnaire, the Beck Anxiety Inventory and the Beck Depression Inventory. Results showed significant improvement in five of the domains that measure quality of life: physical, psychological, environmental, general, and health. There were no significant changes (p=0.26) in anxiety scores. In contrast, the depression scores got significantly better (p=0.02). The results suggest that the proposed technique is conducive to health promotion and quality of life

Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies

The impact of socioeconomic inequalities on health is well-documented. Despite the links of periodontal disease with cardiovascular diseases, adverse pregnancy outcomes and diabetes, no meta-analysis of socioeconomic variations in periodontal disease exists. This meta-analytic review was conducted to determine the extent to which education attainment influences risk of periodontitis in adults aged 35+ years in the general population.The authors searched studies published until November 2010 using EMBASE and MEDLINE databases. References listed were then scrutinised, our own files were checked, and, finally, we contacted experts in the field. The authors included only general population-based studies conducted in adults aged 35 years and more. All articles were blind reviewed by two investigators. In the case of disagreement, a third investigator arbitrated. Using PRISMA statement, two reviewers independently extracted papers of interest.Relative to the higher education group, people with low education attainment experience a greater risk of periodontitis (OR: 1.86 [1.66–2.10]; p<0.00001). The association was partially attenuated after adjustment for covariates (OR: 1.55 [1.30–1.86]; p<0.00001). Sensitivity analyses showed that methods used to assess periodontitis, definition of cases, study country and categorization of education are largely responsible for the heterogeneity between studies. No significant bias of publication was shown using both the Egger (p = 0.16) and rank correlation tests (p = 0.35).In the studies reviewed, low educational attainment was associated with an increased risk of periodontitis. Although this evidence should be cautiously interpreted due to methodological problems in selected studies, efforts to eliminate educational inequalities in periodontitis should focus on early life interventions

Psicología Y educación a distancia : una revisión de la literatura

O presente estudo investigou as contribuições da Psicologia para a educação a distância – EAD. Para isso, realizou-se revisão bibliográfica de publicações nacionais, entre 1999 e 2009, nas bases de dados SciELO, Lilacs, PsycINFO, BVS e Google Acadêmico. Foram selecionados 69 estudos, dos quais se excluíram 15, por não serem compatíveis com a pesquisa. Os resultados evidenciaram nove eixos temáticos: (1) tecnologia educacional a distância com fundamentos psicológicos, (2) afeição, (3) papel do tutor/professor, (4) teorias psicológicas, (5) interatividade, (6) evasão, (7) relatos de experiências, (8) avaliação de treinamento, desenvolvimento e educação a distância e (9) outros. Os temas tecnologia educacional a distância com fundamentos psicológicos e afeição obtiveram maior frequência nas publicações. Neste estudo, registrou-se, também, que, embora em ascensão desde 2006, os anos de maiores publicações da Psicologia na educação a distância foram 2008 e 2009. Sugere-se que estudos futuros ampliem esta pesquisa para incluir bases de dados internacionais.This study investigated the contributions of Psychology to Distance Learning. A literature review of national publications between 1999 to 2009 was made in the electronic databases SciELO, LILACS, PsycINFO, BVS and Google Scholar. From the 69 studies selected, 15 were excluded because they were not compatible with the research. The results showed nine themes: (1) the distance learning technology with psychological grounding, (2) affection, (3)the role of the tutor/professor, (4) psychological theories, (5) interactivity, (6) dropout, (7) reports of experiences, (8) assessment of distance training, development and education and (9) others. The topics distance education technology with psychological grounding and affection had a larger frequency in the publications. Since 2006, there was an increasing number of publications in psychology distance education, but the years of major publications were from 2008 to 2009. It is suggested that future studies expand this research including international databases.El presente estudio investigó las contribuciones de la Psicología para la Educación a Distancia – EAD. Para eso, fue realizada una revisión bibliográfica de publicaciones nacionales, entre 1999 y 2009 en las bases de datos SciELO, Lilacs, PsycINFO, BVS y Google Académico. Fueron seleccionados 69 estudios, de los cuales se excluyeron 15, por no ser compatibles con la pesquisa. Los resultados evidenciaron nueve ejes temáticos (1) tecnología educacional la distancia con fundamentos psicológicos; (2) afección; (3) papel del tutor/profesor; (4) teorías psicológicas; (5) interactividad; (6) evasión; (7) relatos de experiencias, (8) evaluación de entrenamiento, desarrollo y educación distancia y (9) otros. Los temas tecnología educacional a distancia con fundamentos psicológicos y afección obtuvieron mayor frecuencia en las publicaciones. En ese estudio se registró, también, que, aunque en ascensión desde 2006, los años de mayores publicaciones de la psicología en la educación a distancia, fueron 2008 y 2009. Se sugiere que estudios futuros amplíen esa pesquisa para incluir bases de datos internacionales

Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)

La gouvernance locale des ressources naturelles. Un besoin de légitimation des autorités et des territoires

International audienc

National French Registry of Spontaneous Coronary Artery Dissections: Prevalence of Fibromuscular Dysplasia and Genetic Analyses

International audienceAIMS: Obtain European data on SCAD, determine the prevalence of FMD and enable genetic analyses in this population. METHODS AND RESULTS: Data from a national French registry of SCAD cases, were analysed prospectively and retrospectively. Clinical and angiographic data and management strategy were collected. Major adverse cardiovascular events (MACE) were analysed after one-year follow-up. Subjects were screened for fibromuscular dysplasia (FMD) and blood was collected for DNA extraction. From June 2016 to August 2018, 373 SCAD cases were confirmed by the core lab. Mean age was 51.5 years. Patients were mostly women (90.6%) and 54.7% of cases had less than two cardiovascular risk factors. At 1 year, 295 patients (79.1%) were treated conservatively and the MACE rate was 12.3%, and no case of mortality. Recurrence rate of SCAD was 3.3%. FMD was found at ³ 1 arterial site in 45.0% of cases. We also confirmed the genetic association between the PHACTR1 locus and SCAD (odds ratio=1.66, P=7.08×10 -8 ). CONCLUSIONS: Here we describe the largest European SCAD cohort where FMD was found in 45% of cases and the genetic association with PHACTR1 was confirmed. This nationwide cohort is a valuable resource for future clinical and genetic investigation to understand SCAD aetiology