Tobacco and first-episode psychosis : a systematic review

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019O primeiro episódio psicótico é uma síndrome variável que se define pela presença de sintomas positivos e negativos com uma duração contínua mínima de uma semana. Tipicamente tem início na adolescência e idade adulta jovem. A prevalência do uso de tabaco em doentes com primeiro episódio psicótico é marcadamente elevada, cerca de 59%, superior comparativamente à da população em geral. A maioria dos estudos existentes atualmente refere-se a doentes com doença psicótica crónica. Desta forma, tem-se manifestado interesse em entender a origem concreta da relação entre o tabaco e o primeiro episódio psicótico. Esta revisão sistemática reuniu os estudos publicados até março de 2018, através da pesquisa nas bases de dados Pubmed e Web of Knowledge, sobre a relação referida de forma a estudar três tópicos principais que poderão contribuir para a associação entre o tabaco e o primeiro episódio psicótico: 1)Tabaco como fator de risco do primeiro episódio psicótico; 2)A exposição à nicotina, através do tabaco, como comportamento de auto-medicação, e 3)Tabaco como marcador de gravidade da doença. Foram incluídos dez artigos originais, dos quais: um estudou o primeiro tópico acima referido; quatro estudaram o segundo; e os restantes cinco estudaram a terceira hipótese. Esta revisão permite concluir que a relação entre o tabaco e o primeiro episódio psicótico é inegável, e, apesar de ser dificil de alcançar a verdadeira génese da mesma, houve uma tendência para mostrar uma maior contribuição da hipótese “Tabaco como fator de risco do primeiro episódio psicótico” em relação à hipótese “A exposição à nicotina, através do tabaco, como comportamento de auto-medicação”. A última hipótese “Tabaco como marcador de gravidade da doença” foi aquela que mais foi corroborada, com quatro dos cinco estudos incluídos neste tópico a apoiar esta hipótese. Num dos estudos, sugere-se que a fraca adesão à medicação possa ser um fator causal que medeia a associação entre o tabaco e uma maior severidade da doença. Constatou-se, desta forma, que, apesar de serem necessários mais estudos sobre estas associações, no caso de serem totalmente provadas, poderão ter uma utilidade clínica muito vantajosa, primeiramente, numa perspetiva de prevenção e ainda no estadiamento da doença.The first episode psychosis is a variable syndrome defined by the presence of positive and negative symptoms with a continuous duration of at least one week. Typically it begins in adolescence or young adulthood. The prevalence of tobacco use in patients with first episode psychosis is markedly high, about 59%, higher than in the general population. Most of the existing studies currently refer to patients with chronic psychotic disorders. Thus, there has been crescent interest in understanding the concrete origin of the relationship between tobacco and the first psychotic episode. This systematic review reunites the studies published until March 2018, through a search in Pubmed and Web of Knowledge databases, in order to study three main aims that could contribute to the existence of the relationship between tobacco and first psychotic episode: 1)Tobacco smoking as a potential risk factor to first episode psychosis; 2)Nicotine use in the form of tobacco smoking in first episode psychosis: the self-medication hypothesis; and 3)Tobacco use as a marker of greater illness severity in first episode psychosis. Ten original articles were included, of which: one studied the first topic mentioned above; four studied the second; and the remaining five studied the third hypothesis. This review concludes that the relationship between tobacco and the first psychotic episode is undeniable, and, in spite of being difficult to reach the nature of this association, there was a trend towards a greater contribution of the hypothesis “Tobacco smoking as a potential risk factor to first episode psychosis” comparative to the “Nicotine use in the form of tobacco smoking in first episode psychosis: the self-medication hypotheses”. The last hypothesis "Tobacco as a marker of disease severity" was the one that was most corroborated, with four of the five studies included in this topic supporting this hypothesis. In one study, it is suggested that poor adherence to medication may be a causal factor that mediates the association between smoking and increased severity of the disease. It was found that, although further studies on this associations are necessary, if fully tested, it may be very useful in clinical practice, primarily in a view of prevention and also in the staging of the disease

Accounting as a tool of state ideology to control captive workers from a House of Correction

The purpose of this paper is to interpret the use of accounting information relating to the House of Correction, a public safety institution established in Rio de Janeiro for the control of workers under a tutelage system (1831-1864). The aim of the House of Correction was to develop a disciplined workforce of former slaves and other "Free Africans". Various control and information procedures were put in place to monitor its achievement of this goal.Design/methodology/approachThis study is based on historical archival research, mainly conducted at the National Archive of Rio de Janeiro and at the Brazilian National Library. The study uses Althusser's ideology concept and the Marxist concept of reproduction of labour to show how accounting information enabled the administrator of the House of Correction to exercise control over the "Free Africans" consistent with the ideologies of the period and place.FindingsThe authors find that the House of Correction pursued a policy of ensuring "Free Africans" were docile, obedient and familiar with State ideology.Originality/valueThis paper extends our knowledge of the use of accounting for the control of workers, who were either captive or repressed due to their ethnical differences; and it shows how ideology can be imposed through the use of accounting information. The authors extend theory by applying the Marxist and Althusserian concept of reproduction of labour to the case of "Free Africans".- This paper was financed by National Funds of the FCT - Portuguese Foundation for Science and Technology within the project "UID/ECO/03182/2019". This work also received funding provided by the CAPES - Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Grant No. BEX 0579/12-2) and by the 2018 Margit F. and Hanns Martin Schoenfeld Scholarship from the Academy of Accounting Historians Section of the American Accounting Association. The authors acknowledge with gratitude the helpful comments of the Accounting, Auditing & Accountability Journal referees and for the constructive comments received from attendees at the ninth Accounting History International Conference, University of Verona, Italy, 6-8 September 2017

Melanocortin signalling in fat cells

[resumo]Melanocortin peptides and their receptors have long been known to affect the central control of food intake and body weight, thus playing a critical role in the development of obesity [1]. The melanocortin 5 receptor (MC5R) has been directly linked with lipid metabolism in peripheral tissues: MC5R deletion in mouse generates defects in sebaceous gland secretion [1] and MC5R stimulation increases fatty acid oxidation in muscle cells [2]. In this study, we tackled the role of MC5R in lipolysis and adipocyte function using the well established model of differentiated mouse 3T3-L1 adipocytes. Cell-signalling based experiments were performed after adipocyte treatment with alpha-melanocyte-stimulating hormone (alpha-MSH) and compared with the MC5R specific activation previously described in HEK293 [3] and HeLa cells stably transfected with MC5R-GFP. Adipocyte response to alpha-MSH resulted in a loss of cytoplasmatic lipid content and release of glycerol into the cell medium by an ERK1/2 dependent mechanism. Moreover, downstream of ERK1/2, alpha-MSH induces p90RSK and CREB phosphorylation and c-Fos expression. The correlation between alpha-MSH action in 3T3-L1 adipocytes and the specific signalling pathways underlying MC5R activation, strongly suggests that lipolysis is mediated by this receptor.[1] Cone RD (2006) Endocr Rev 27(7):736:49[2] An et al (2007) J Biol Chem 282(5):2862-70[3] Rodrigues et al (2009) Mol Cell Endocrinol 303:74-8

Fidelidade da versão em Português do Sistema de Classificação dos Construtos Pessoais

We aim to analyze the reliability of the Portuguese version of the Classification System for Personal Constructs - CSPC (Feixas, Geldschläger & Neimeyer, 2002). That is a system of 53 content categories divided into six basic areas (moral, emotional, relational, personal, intellectual/operational, and values/interests) and two supplemental areas (existential and concrete descriptors). In this study, we adapt to Portuguese language the CSPC, using a sample of 448 constructs extracted from 32 repertory grids, and we analyze the reliability of this classification system. The degree of agreement achieved was excellent. Our findings are similar to those found by the versions of the CSPC in other languages, which demonstrates the reliability of the Portuguese version of the CSPC.Neste estudo pretendemos analisar a fidelidade da versão em português do Sistema de Classificação dos Construtos Pessoais (SCCP), desenvolvido por Feixas, Geldschläger e Neimeyer (2002). Este sistema permite codificar construtos pessoais em 53 categorias agrupadas em áreas temáticas: seis áreas básicas (moral, emocional, relacional, pessoal, intelectual/operacional e valores e interesses) e duas áreas suplementares (existencial e descritores específicos). Para tal, adaptámos para a Língua Portuguesa o SCCP, recorrendo a uma amostra de 448 construtos, extraídos de 32 grelhas de repertório de 32 alunos do Ensino Superior, e analisámos a fiabilidade do sistema de classificação. O acordo inter-juízes encontrado foi considerado excelente. Os resultados deste estudo são similares aos das restantes versões do SCCP, o que reforça a fiabilidade desta versão.(undefined

Errors in preparation and medication management in nursing professionals

The preparation and administration of medications is one of the most common and relevant functions of nurses, demanding great responsibility. Incorrect administration of medication, currently constitutes a serious problem in health services, and is considered one of the main adverse effects suffered by hospitalized patients. Objectives: Identify the major errors in the preparation and administration of medication by nurses in hospitals and know what factors lead to the error occurred in the preparation and administration of medication. Methods: A systematic review of the literature. Deined as inclusion criteria: original scientiic papers, complete, published in the period 2011 to May 2016, the SciELO and LILACS databases, performed in a hospital environment, addressing errors in preparation and administration of medication by nurses and in Portuguese language. After application of the inclusion criteria obtained a sample of 7 articles. Results: The main errors identiied in the pr eparation and administration of medication were wrong dose 71.4%, wrong time 71.4%, 57.2% dilution inadequate, incorrect selection of the patient 42.8% and 42.8% via inadequate. The factors that were most commonly reported by the nursing staff, as the cause of the error was the lack of human appeal 57.2%, inappropriate locations for the preparation of medication 57.2%, the presence of noise and low brightness in preparation location 57, 2%, professionals untrained 42.8%, fatigue and stress 42.8% and inattention 42.8%. Conclusions: The literature shows a high error rate in the preparation and administration of medication for various reasons, making it important that preventive measures of this occurrence are implemented

Needs of older persons undergoing cardiac surgery: exploring the perceptions of nurses, patients waiting for and patients having had surgery

© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aims: The purpose of this research was to identify the needs of older persons waiting for elective open-heart surgery. Design: A qualitative exploratory design methodology, using Focus Groups. Methods: A purposive sampling technique was used. Three interviews were conducted with experienced nurses, individuals waiting for open-heart surgery (≥65years) and individuals having had open-heart surgery (≥65years); enrolling up to 17 participants from October 2019 to January 2020. Qualitative data analysis was conducted using the iteractive model and MaxQDA® software, and EQUATOR COREQ guidelines were followed. Results: Three themes were identified from the analysis of all three Focus Groups: (i) Needing health information; (ii) Needing emotional support; and (iii) Needing access to care.info:eu-repo/semantics/publishedVersio

Real time in situ x-ray diffraction study of the crystalline structure modification of Ba0.5Sr0.5TiO₃ during the post-annealing

We report about an in situ study of crystalline structural changes during thermal treatment of a Ba0.5Sr0.5TiO3 (BSTO) film grown on MgO. The study covers the complete cycle of heating, annealing and cooling and reveals simultaneous phenomena of phase transitions and strain evolution, which have been characterized by in situ 2D reciprocal space mapping (2D-RSM) using high-resolution synchrotron x-ray diffraction in coplanar and grazing incidence geometries. In this way, temperature induced phase transformation from the BSTO2 to the BSTO1 phase has been monitored and the appearance of a further crystalline phase was detected. Moreover, for both BSTO phases, transitions between in-plane compressive and tensile states have been determined during thermal treatment. Furthermore, a contraction of the out-of-plane lattice components has been observed during the annealing phase while the in-plane lattice components remain leading to the change of the residual in-plane strain towards tensile state. The in situ 2D-RSM findings provide valuable and versatile insights into strain engineering and structure modification upon thermal treatment