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André L Lopes,1 Ana Paula T Fayh,2,3 Luisa G de Souza Campos,4 Bruno C Teixeira,1 Randhall B Kreismann Carteri,1 Jerri L Ribeiro,4 Rogério Friedman,2 Álvaro Reischak-Oliveira1 1Exercise Research Laboratory, School of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; 2Endocrine Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; 3Health Sciences College of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil; 4Centro Universitário Metodista – IPA, Porto Alegre, RS, Brazil Background: Diet and exercise are often prescribed as primary intervention regarding obesity-related disorders. Additionally, recent studies have shown beneficial effects of weight loss through diet and exercise in ghrelin concentrations in obese subjects. The aim of this study was to evaluate the effects of a 5% weight loss on lipid profile, resting metabolic rate (RMR), and acylated ghrelin (AG) using two different methods of intervention (diet or diet plus exercise). Materials and methods: Eighteen subjects (twelve women and six men) aged 20–40 years with a body mass index of 30–34.9 kg/m2 (grade 1 obesity) were randomized into two intervention groups: diet (n=9) or diet plus exercise (n=9). Both groups underwent treatment until 5% of the initial body weight was lost. At baseline and upon completion, RMR and AG were analyzed. Results: Both groups showed a significant decrease in body fat percentage and fat mass. The diet-plus-exercise group showed a decrease in AG (pre: 54.4±25.3 pg/mL and post: 33.2±19.1 pg/mL) and an increase in RMR (pre: 1,363±379 kcal/day, post: 1,633±223 kcal/day). Conclusion: These data suggest that diet plus exercise induced weight loss and had beneficial effects on AG concentration and RMR, essential factors to ensure the benefits of a weight-loss program. Keywords: exercise therapy, diet, energy regulation, obesity, hormones

The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and research settings. Although evidence supports their validity as measures of pain intensity, few studies have compared them with respect to the critical validity criteria of responsivity, and no experiment has directly compared all 4 measures in the same study. The current study compared the relative validity of VAS, NRS, VRS, and FPS-R for detecting differences in painful stimulus intensity and differences between men and women in response to experimentally induced pain. One hundred twenty-seven subjects underwent four 20-second cold pressor trials with temperature order counterbalanced across 1°C, 3°C, 5°C, and 7°C and rated pain intensity using all 4 scales. Results showed statistically significant differences in pain intensity between temperatures for each scale, with lower temperatures resulting in higher pain intensity. The order of responsivity was as follows: NRS, VAS, VRS, and FPS-R. However, there were relatively small differences in the responsivity between scales. A statistically significant sex main effect was also found for the NRS, VRS, and FPS-R. The findings are consistent with previous studies supporting the validity of each scale. The most support emerged for the NRS as being both (1) most responsive and (2) able to detect sex differences in pain intensity. The results also provide support for the validity of the scales for use in Portuguese samples. [ABSTRACT FROM AUTHOR]

Osteoporosis is an important health problem that occurs due to an imbalance between bone formation and resorption. Hormonal deficiency post-menopause is a significant risk factor. The probiotic Limosilactobacillus reuteri has been reported to prevent ovariectomy (Ovx)-induced bone loss in mice and reduce bone loss in postmenopausal women. Despite the numerous health benefits of probiotics, as they are live bacteria, the administration is not risk-free for certain groups (e.g., neonates and immunosuppressed patients). We evaluated the effects of L. reuteri (ATCC PTA 6475) and its heat-killed (postbiotic) form on Ovx-induced bone loss. Adult female mice (BALB/c) were randomly divided into four groups: group C-control (sham); group OVX-C-Ovx; group OVX-POS-Ovx + heat-killed probiotic; group OVX-PRO-Ovx + probiotic. L. reuteri or the postbiotic was administered to the groups (1.3x109 CFU/day) by gavage. Bacterial morphology after heat treatment was accessed by scanning electron microscopy (SEM). The treatment started one week after Ovx and lasted 28 days (4 weeks). The animals were euthanized at the end of the treatment period. Bone microarchitecture and ileum Occludin and pro-inflammatory cytokines gene expression were evaluated by computed microtomography and qPCR techniques, respectively. The Ovx groups had lower percentage of bone volume (BV/TV) and number of bone trabeculae as well as greater total porosity compared to the control group. Treatment with live and heat-killed L. reuteri resulted in higher BV/TV and trabecular thickness than the Ovx group. The heat treatment caused some cell surface disruptions, but its structure resembled that of the live probiotic in SEM analysis. There were no statistical differences in Occludin, Il-6 and Tnf-α gene expression. Both viable and heat-killed L. reuteri prevented bone loss on ovariectomized mice, independently of gut Occludin and intestinal Il-6 and Tnf-α gene expression., Competing Interests: Ana Lia Anbinder reports a relationship with BioGaia AB that includes funding grants. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Ribeiro 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: In March 2020, the outbreak caused by the SARS-CoV-2 virus was declared a pandemic, resulting in numerous fatalities worldwide. To effectively combat the virus, it would be beneficial to involve professionals who specialize in symptom control for advanced illnesses, working closely with other specialties throughout the illness process. This approach can help manage a range of symptoms, from mild to severe and potentially life-threatening. No studies have been conducted in Portugal to analyse the intervention of Palliative Medicine at the end of life of Covid-19 patients and how it differs from other specialties. This knowledge could help determine the importance of including it in the care of people with advanced Covid-19., Objectives: The objective of this study is to examine potential differences in the care provided to patients with Covid-19 during their Last Hours and Days of Life (LHDOL) between those who received care from Palliative Medicine doctors and those who did not., Methods: This is a retrospective cohort study spanning three months (Dec 2020 to Feb 2021), the duration of the Support Unit especially created to deal with Covid-19 patients. The database included clinical files from 181 patients admitted to the Support Unit, 27 of which died from Covid-19., Results: Statistically significant differences were identified in the care provided. Specifically, fewer drugs were administered at the time of death, including drugs for dyspnoea, pain and agitation, suspension of futile devices and use of palliative sedation to control refractory symptoms., Conclusions: End-of-life care and symptomatic control differ when there's regular follow-up by Palliative Medicine, which may translate less symptomatic suffering and promote a dignified and humane end of life., (© 2024. The Author(s).)

Different types of muscle contraction can cause different damage to the musculature and differences in inflammatory responses. Acute increases in circulatory inflammation markers can influence the crosstalk between coagulation and fibrinolysis processes, increasing the risk of thrombus formation and detrimental cardiovascular events. The aim of this study was to analyze the effects of concentric and eccentric exercise on hemostasis markers, C-reactive protein (CRP), and the relationship between these variables. Eleven healthy subjects with a mean age of 25.4 ± 2.8, non-smokers, with no history of cardiovascular disease and blood type O, randomly performed an isokinetic exercise protocol consisting of 75 concentric (CP) or eccentric (EP) contractions of knee extension, divided into five sets of 15 repetitions combined with 30-s rest. Blood samples for analysis of FVIII, von Willebrand factor, tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1), and CRP were collected pre, post, 24 h, and 48 h after each protocol. Increased levels of CRP at 48 h in EP versus CP ( p  = 0.002), increased PAI-1 activity 48 h in EP versus CP ( p  = 0.044), and a reduction in t-PA at 48 h when compared with post-protocol in both protocols ( p  = 0.001). A correlation was found between CRP and PAI-1 at 48 h of PE ( r 2  = 0.69; p  = 0.02). This study showed that both EP and CP increase the clotting process, albeit only the exercise performed eccentrically induces inhibition of fibrinolysis. This is possibly due to the increase in PAI-1 48 h after the protocol, which correlates with the increase in inflammation as demonstrated by the CRP levels.

This study aimed to evaluate the acute effects of aerobic and resistance exercises on blood pressure and endothelial blood markers. We also correlated post-exercise blood pressure response with baseline cardiovascular parameters in middle-aged patients with hypertension. This cross-sectional study randomized 54 volunteers into the aerobic exercise group (AG, n = 27; 45.6 ± 7.7 years) or dynamic resistance exercise group (RG, n = 27; 45.8 ± 8.4 years). Blood marker evaluation, cardiopulmonary exercise tests, resting blood pressure monitoring, ambulatory blood pressure monitoring (ABPM), flow-mediated dilatation monitoring, and body composition evaluation were carried out. Exercise sessions were performed to evaluate post-exercise hypotension (PEH) and endothelial marker responses, in addition to post-exercise ABPM (ABPMex). This study is an arm of the study which was approved by the local ethics committee (No. 69373217.3.0000.5347) in accordance with the Helsinki Declaration and was registered at ClinicalTrials.gov (NCT03282942). The AG performed walking/running at 60% of the reserve heart rate, while the RG performed 10 exercises with two sets of 15-20 repetitions. The mean 24 h ABPM and ABPMex values showed no significant statistical differences. Systolic and diastolic blood pressure hypotension after aerobic and dynamic resistance were -10.59 ± 5.24/-6.15 ± 6.41 mmHg and -5.56 ± 7.61/-6.20 ± 8.25 mmHg, respectively. For an up-to-7 h assessment of resting pressure, there was a positive effect in the aerobic group. The concentrations of nitrites/nitrates (NOx) and endothelin-1 (ET-1) did not change during hypotension. Moreover, PEH and ABPMex were significantly correlated with baseline health variables. Thus, when middle-aged patients with hypertension perform aerobic or resistance exercise, the NOx/ET-1 pathway does not provide the best explanation for PEH. Finally, we found associations between baseline cardiovascular variables and endothelial vasoconstrictors with PEH., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ramis, Boeno, Leal-Menezes, Munhoz, Farinha, Ribeiro and Reischak-Oliveira.)

This in vitro study aimed to evaluate the effect of different bonding strategies on the micro-shear bond strength (μSBS) of luting agents to CAD−CAM composites. Surface scanning electron microscopy (SEM) and spectroscopy by energy-dispersive X-ray spectroscopy (EDS) were performed to analyze the surfaces of the composite before and after bonding treatment. Three CAD−CAM composites were evaluated: Lava Ultimate restorative (LU), Brava Blocks (BR), and Vita Enamic (VE). The LU and BR surfaces were sandblasted using aluminum oxide, while the VE surfaces were etched using a 5% hydrofluoric acid gel according to the manufacturers’ recommendations. All surfaces were subjected to the following bonding strategies (n = 15): adhesive with silane and MDP (ScotchBond Universal, 3M Oral Care, St Paul, MI, USA); adhesive with MDP (Ambar Universal, FGM, Joinville, Brazil); adhesive without silane or MDP (Prime&Bond Elect, Dentsply Sirona, Charlotte, NC, USA), pure silane without MDP (Angelus, Londrina, Brazil), and pure silane with MDP (Monobond N, Ivoclar Vivadent, Schaan, Liechtenstei). Afterwards, tygons were filled with RelyX Ultimate (3M Oral Care), AllCem (FGM), or Enforce (Dentsply Sirona), which were light-cured and subjected to the μSBS test. Data were analyzed using two-way ANOVA and Bonferroni’s post hoc test (α = 0.05). Additional blocks (n = 15) were subjected to scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) before and after the surface treatment. The μSBS values on VE surfaces were higher than those observed on LU and BR surfaces (p < 0.001). Silane without MDP (Allcem) promoted the highest μSBS values, while silane with MDP (RelyX Ultimate) provided the highest values among all bonding strategies (p < 0.001). Enforce promoted no significant difference in μSBS values. SEM and EDS analyses detected noticeable changes to the surface morphology and composition after the surface treatment. The effectiveness of the bonding strategy may vary according not only to the CAD−CAM composite but also to resin cement/bonding agent/silane used.

The oral lymphoepithelial cyst (OLC) is an uncommon lesion whose pathogenesis remains poorly understood. The aim of this study was to report the clinicopathologic features of the OLCs and to verify a possible association between OLCs and subgemmal neurogenous plaque (SNP) in the posterior lateral region of the tongue. A retrospective descriptive cross-sectional study was carried out. A total of 106,282 biopsy records of oral and maxillofacial lesions from six oral pathology services in Brazil were analyzed. All cases of OLCs were reviewed, and clinical and histopathological data were collected. Immunohistochemical reactions for S-100 protein were performed to confirm the diagnosis of SNP. Among all lesions, there were 132 (0.11%) cases of OLCs. The series comprised 83 females (62.9%) and 49 males (37.1%), with a 1.7:1 female-to-male ratio and a mean age of 45.8 ± 17.7 years. Most cases involved the tongue (n = 80; 62.0%) and presented clinically as asymptomatic papules or nodules with a yellow or whitish color. Microscopically, most of the cysts were entirely lined by parakeratinized stratified epithelium (n = 89; 67.4%) and filled with desquamated cells, keratin debris, amorphous eosinophilic material, and inflammatory cells in varying amounts. Connection with the epithelium of oral mucosa was observed in 18 cases (13.6%). SNP was found in 9/80 (11.2%) cases involving the tongue. The clinical and demographic features of OLCs were similar to those described in previous studies. Overall, this lesion has a predilection for the posterior region of the tongue of female adults. Clinicians must include the OLC in the differential diagnosis of yellow/white papules and nodules of the oral cavity., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Pyogenic granuloma (PG) is a lesion characterized by the proliferation of blood vessels, commonly affecting the skin and the mouth. We aimed to compare clinical, microscopic, and immunohistochemical features of the two types of oral PG: lobular capillary hemangioma (LCH) and non-LCH (NLCH)., Methods: Epidemiological and clinical data from 2000 to 2018 were collected from the archives of our institution, and histopathological sections of PG were reviewed. Immunohistochemical analyses (CD34, D2-40, SMA, mast cell, and Ki-67) were performed in 34 cases., Results: Sixty-two LCH and 107 non-LCH samples were included. The mean (±SD) age of the patients was 38.59 ± 16.96 years; 55.62% were female; 39.64% of cases occurred in the gingiva, 44% of the nodules were pedunculated, and 13.02% of patients reported a history of trauma. NLCH was more prevalent among older patients than LCH. The most prevalent site of LCH was the lips, while NLCH occurred more in the gingiva (P < 0.05). Epithelial atrophy, microvessels, SMA-positive areas, and Ki-67-positive nuclei were more prevalent in LCH (P < 0.05)., Conclusions: PG accounted for 2.25% of lesions archived in the pathology service and most cases were NLCH. LCH and NLCH exhibited clinicopathological differences in terms of age, site, epithelial atrophy, vascularization, and proliferation rate., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The current randomized controlled trial tested the hypothesis that both aerobic training and dynamic resistance training will improve inflammation, endothelial function and 24-h ambulatory blood pressure (ABP) in middle-aged adults with hypertension, but aerobic training would be more effective., Methods: Forty-two hypertensive patients on at least one antihypertensive medication (19 men/23 women; 30-59 years of age) were randomly assigned to 12 weeks of supervised aerobic training (n = 15), resistance training (n = 15) or a nonexercise control (n = 12) group. Inflammation, endothelial function, 24-h ABP and related measures were evaluated at pre and postintervention., Results: We found that aerobic training and resistance training were well tolerated. Both aerobic training and resistance training reduced daytime systolic ABP (-7.2 ± 7.9 and -4.4 ± 5.8 mmHg; P < 0.05) and 24-h systolic ABP (-5.6 ± 6.2 and -3.2 ± 6.4 mmHg; P < 0.05). aerobic training and resistance training both improved brachial artery flow-mediated dilation by 1.7 ± 2.8 and 1.4 ± 2.6%, respectively (7.59 ± 3.36 vs. 9.26 ± 2.93 and 7.24 ± 3.18 vs. 8.58 ± 2.37; pre vs. post P < 0.05). However, only aerobic training decreased markers of inflammation (C-reactive protein, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1 and lectin-like oxidized LDL receptor-1) and endothelin-1 and increased nitrite and nitrate levels (P < 0.05)., Conclusion: Healthcare providers should continue to emphasize aerobic training for hypertension management given the established role of nitric oxide, endothelin-1 and chronic low-level inflammation in the pathogenesis of cardiovascular disease. However, our study demonstrates that resistance training should also be encouraged for middle-aged hypertensive patients. Our results also suggest that even if patients are on antihypertensive medications, regular aerobic training and resistance training are beneficial for blood pressure control and cardiovascular disease risk reduction.

Objective: Lactobacillus reuteri is reported as a beneficial adjunct to conventional periodontitis treatment or as monotherapy for gingivitis in several clinical trials. However, probiotics are not free from the risk of adverse effects. We investigated the effects of live and heat-killed (paraprobiotic) L. reuteri during the development of ligature-induced periodontitis in rats., Methods: Thirty-two male rats were divided into four groups-control group: healthy rats, LIP group: rats with ligature induced periodontitis, LIP/PRO group: rats with periodontitis that received live L. reuteri, LIP/PARA group: rats with periodontitis that received heat-killed L. reuteri. Treatment was administered for 30 days prior to ligation and continued for 14 days until euthanasia. The hemimandibles were removed and submitted to radiographic analysis, microcomputerized microtomography (μCT) and histomorphometric analysis., Results: Radiographic analysis revealed that pro- and paraprobiotics enhanced the percentage of mesial bone support. The μCT analysis showed that paraprobiotic treatment increased bone volume and trabecular number while decreasing total bone porosity and trabecular separation. Live probiotic led to higher trabecular thickness. In the histomorphometric analysis, paraprobiotics significantly prevented furcation bone loss and collagen breakdown, although both pro- and paraprobiotics similarly reduced mesial bone loss. There were no significant differences in attachment loss or the number of tartrate-resistant acid phosphatase -positive cells across treatments., Conclusions: Although viable and heat-killed bacteria reduced mesial alveolar bone loss and ameliorated furcation microarchitecture parameters, paraprobiotics presented the most pronounced results preventing periodontitis development. This can contribute to the future use of paraprobiotics in the prevention and treatment of periodontitis., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Some foods are also demonstrated benefits, such as anti-inflammatory, antioxidant, and ergogenic activity, similar to that of sports supplements. Grape juice has been considered an important source of polyphenols and these compounds could promote positive effects to the sports players. In this sense, the objective was to evaluate the effects of purple grape juice consumption on indicators of oxidative stress, inflammation, muscle damage, global histone H4 acetylation levels, and muscle strength and muscle power in volleyball athletes., Methods: This is a randomized double-blind clinical trial in which 12 male volleyball players (16 ± 0.6 years old) participated in three different moments with match simulation: control (without beverage) (WB), grape juice (GJ) and placebo (PLA) (400 mL/day of grape juice or placebo (maltodextrin) for 14 days in a cross-over model). Before and immediately after each match, blood collection for analysis of indicators of systemic redox status, systemic concentrations of Interferon-γ (IFN- γ) and Interleukin-4 (IL-4), muscle damage, by Creatine Kinase (CK-NAC) and levels of global histone H4 acetylation were performed, as well as handgrip strength (HG) and lower limb power tests., Results: Consumption of grape juice significantly reduced lipid peroxidation (p = 0.04) and Deoxyribonucleic Acid (DNA) damage (p = 0.01) after the match. IFN-γ levels, IL-4, CK-NAC, and histone H4 acetylation post-match did not alter with the grape juice consumption. Lower limb power improved after acute exercise in WB and GJ conditions (p < 0.001)., Conclusion: In this pilot trial, the intake of grape juice for two weeks seems to reduce the protein oxidation and DNA damage by intermittent physical exercise, without epigenetics influence., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Ramis, TR, Muller, CHdL, Boeno, FP, Teixeira, BC, Rech, A, Pompermayer, MG, Medeiros, NdS, Oliveira, ÁRd, Pinto, RS, and Ribeiro, JL. Effects of traditional and vascular restricted strength training program with equalized volume on isometric and dynamic strength, muscle thickness, electromyographic activity, and endothelial function adaptations in young adults. J Strength Cond Res 34(3): 689-698, 2020-The purpose of the study was to evaluate and compare the acute and chronic effects of partial vascular occlusion training in young, physically active adults. Neuromuscular, morphological, and endothelial function responses were compared between high-intensity resistance training (HI-RT) and low-intensity resistance training with partial vascular occlusion (LI-BFR), despite the same training volume. The 28 subjects (age, 23.96 ± 2.67 years) were randomly assigned into 2 groups: LI-BFR (n = 15) and HI-RT (n = 13). Both groups performed unilateral exercise of elbow flexion (EF) and knee extension (KE) 3 times per week for 8 weeks. This study was approved by the ethics committee. Flow-mediated dilation showed a significant difference in baseline and post-training in the LI-BFR group (4.44 ± 0.51 vs. 6.35 ± 2.08 mm, respectively). For nitrite/nitrate concentrations only, there was a significant difference when comparing pre- and post-acute exercise in both groups. The torque and rep. Sixty percent 1 repetition maximum had improvements in both groups. There were differences between groups only in isometric delta EF and isokinetic delta KE (EF 3.42 ± 5.09 and 9.61 ± 7.52 N·m; KE 12.78 ± 25.61 and 42.69 ± 35.68 N·m; LI-BFR and HI-RT groups, respectively). There was a significant increase of muscle thickness in both groups. An increase of both isokinetic and isometric electromyography (EMG) of biceps of the HI-RT group was observed. The same was observed for the LI-BFR group regarding isokinetic and isometric EMG of vastus lateralis. Thus, in addition to strength and hypertrophy gains, this study also shows benefits related to vascular function. For practical applications, this study demonstrates a clinical importance of LI-BFR training as an alternative methodology.

Background and aims Endometriosis is a gynecologic recurring persistent condition affecting from 8% to 15% of premenopausal women worldwide. About 80% of women with endometriosis have at least one form of chronic pain - a multidimensional experience influenced by a number of psychosocial factors, including pain-related beliefs. The Survey of Pain Attitudes is the most commonly used measure of pain-related beliefs. This study aims to evaluate the psychometric properties of a Portuguese version of a brief version of the SOPA (the SOPA-35) in a sample of Portuguese women with Endometriosis. Methods A sample of 199 Portuguese women with Endometriosis provided demographic and pain history information, and completed a Portuguese version of the SOPA-35 and measures of pain intensity, disability, and psychological function. Analyses were performed to evaluate the factor structure of the Portuguese SOPA-35 items as well as the internal consistency, composite reliability, convergent validity, and concurrent validity of the scale scores. Results Confirmatory factor analysis supported a six-factor solution for a 19-item version of the Portuguese version of the Survey of Pain Attitudes (SOPA-19-P). The six scales evidenced marginal to good reliability (Cronbach's alphas: between 0.60 and 0.84; composite reliability: between 0.61 and 0.84). Four scales evidenced acceptable to good convergent validity (AVE: between 0.51 and 0.63). The findings also supported the concurrent validity of the SOPA-19-P. Conclusions The results support the use of the Portuguese SOPA-19-P for research and clinical purposes with Portuguese women in chronic pain due to endometriosis. Future research is warranted to further develop a European Portuguese version of SOPA. Implications The findings provide psychometric information about the SOPA-19-P. The results are helpful to researchers wishing to study the role of pain-related beliefs and their association with adjustment and treatment outcomes in women with chronic pain due to endometriosis.

The concept of Developmental Assets links positive features of developmental ecologies with personal skills, competences and values in order to further the understanding of optimal development. The purpose of this research was to explore the relationship between the experience of Developmental Assets and adolescent's perception of Life Satisfaction. A convenience sample of 503 Portuguese students was evaluated, mean age of 15.92 years ( SD = 1.17), 63% female gender. Findings revealed that both external and internal Developmental Assets are experienced differently across gender, grade and age. Results indicate that 74% of the adolescents report their Life Satisfaction to be in the positive range. Boys report significantly higher levels of Life Satisfaction than girls. Results show significant negative correlations between Life Satisfaction and age. The main effect of school grade on Life Satisfaction was not statistically significant. Findings revealed that 32 of the 40 Developmental Assets configured in the model showed a statistically significant positive relationship with Life Satisfaction. Also, results suggest that the greater the experience of Developmental Assets, the greater the Life Satisfaction. Stepwise regression was conducted to determine which Developmental Assets and demographic factors predict Life Satisfaction. Results suggest that the relationship between demographic variables and Life Satisfaction is weak, contributing modestly to the prediction of Life Satisfaction (2%). Nine Developmental Assets emerged as independent and significant predictors of Life Satisfaction: Overall Self-esteem made the largest contribution, with Family Support, Planning and decision Making, Sense of Purpose, Positive Family Communication, Positive Values of Caring, Youth as Resources, School Engagement and Other Adult Relationships also yield significant predictability. The total regression model (Developmental Assets and demographic variables) explained 54% of the variance in Life Satisfaction results. The present findings suggest the applicability and utility of the framework as a strategy to foster positive development in adolescence.

The objective was to evaluate the metric properties of the List of Advanced Activities of the Daily Living. A study quantitative was conducted. The sample comprised 200 older adults from the city of Pouso Alegre, Brazil. The following instruments were employed: 1- Questionnaire sociodemographic and health; 2- Vitor Quality of Life Scale for the Elderly (VITOR QLSE); and 3 - List of Advanced Activities in Daily Life - AAVDs. It was verified through the exploratory factorial analysis that the list possesses three denominated domains of Activities of Leisure, Social Activities and Productive Activities. The three-factor solution explained 58.18% of total variance: 30% by the first factor, 18.03% by the second, and 10.14% by the third. The coefficient alpha for the overall scale was 0.80. The list of AADLs presented reliable and valid metric properties to be applied in the elderly., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Ozone has a broad antimicrobial spectrum and each microorganism species has inherent sensitivity to the gas. The objective of this study was to evaluate the effect of ozone gas on Escherichia coli O157:H7 inoculated on an organic substrate, and the efficacy of ozonated water in controlling the pathogen. For the first experiment, E. coli O157:H7 (ATCC® 43890™) was inoculated in milk with different compositions and in water, which was ozonated at concentrations of 35 and 45 mg L -1 for 0, 5, 15, and 25 min. In the second experiment, water was ozonated at 45 mg L -1 for 15 min. E. coli O157:H7 was exposed for 5 min to the ozonated water immediately after ozonation, and after storage for 0.5, 1.0, 1.5, 3.0, and 24 h at 8 °C. The results showed that the composition of the organic substrate interfered with the action of ozone on E. coli O157:H7. In lactose-free homogenized skim milk, reductions of 1.5 log cycles were obtained for ozonation periods of 25 min at the concentrations tested. Ozonated water was effective in inactivating of E. coli O157:H7 in all treatments. The efficiency of ozone on E. coli O157:H7 is influenced by the composition of the organic substrates, reinforcing the need for adequate removal of organic matter before sanitization. Furthermore, refrigerated ozonated water stored for up to 24 h is effective in the control of E. coli O157:H7.

Background: The social function of individuals with schizophrenia is usually poor and this population exhibits a sedentary lifestyle. Social participation, inclusion in the world of work in particular, might favorably interfere with the lives of these individuals by reducing sedentarism and improving their state of health., Objective: To analyze the lipid profile and endothelial function markers among individuals with schizophrenia enrolled in a supported employment program., Methods: Quantitative quasi-experimental study conducted with 14 individuals with schizophrenia enrolled in a labor inclusion program. Participants were assessed before enrolment (time-point 1) and one year later (time-point 2). Total cholesterol and fractions, triglycerides, serum nitrates and nitrites (endothelial function markers) were measured. The data were analyzed with software SPSS 20., Results: The high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels exhibited significant changes one year after inclusion in the labor market. HDL increased from 82.30 to 98.60 mg/dL (p<0.01) and LDL decreased from 54.50 to 44.45 mg/dL (p<0.02). The triglyceride and total cholesterol levels remained stable. The nitrate and nitrite level exhibited significant reduction from 15.20 to 14.48 µMol (p<0.01)., Conclusion: Participation in the supported employment program might have favorably influenced the participants' lipid profile and endothelial function. Nitrites have been described as mediators in the neural inflammatory process, and reduction of their levels is associated with better prognosis of chronic diseases such as schizophrenia.

Background: Strength training with blood flow restriction (STBFR) provokes similar neuromuscular adaptations to traditional strength training using low training loads. However, there is a need for better understanding of the repercussions for antioxidant parameters and vascular function., Objectives: The objective of the present study was to investigate the effects of a session of low intensity strength training with blood flow restriction, compared with high intensity and low intensity strength training without blood flow restriction, on the levels of nitric oxide products and antioxidant enzyme activity in healthy young men., Methods: Eleven young men performed three strength exercise sessions: low intensity with blood flow restriction (LIBFR), high intensity (HI), and low intensity (LI). Activity of the antioxidant enzymes catalase (CAT) and superoxide dismutase (SOD) was assessed and metabolites of nitric oxide (NOx) were assayed before and after each session., Results: There were no changes to NOx plasma levels under the different exercise conditions (p > 0.05). However, SOD activity exhibited a significant reduction after the LIBFR condition (p < 0.05), while CAT activity reduced significantly after the LI condition (p < 0.05)., Conclusions: The results of this study suggest that one session of low intensity strength training with blood flow restriction does not reduce bioavailability of nitric oxide or induce redox imbalance in healthy young men., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Aggression is one of the core symptoms of antisocial personality disorder (ASPD) with therapeutic and prognostic relevance. ASPD is highly prevalent among inmates, being responsible for adverse events and elevated direct and indirect economic costs for the criminal justice system. The Impulsive/Premeditated Aggression Scale (IPAS) is a self-report instrument that characterizes aggression as either predominately impulsive or premeditated. This study aims to determine the validity and reliability of the IPAS in a sample of Portuguese inmates. A total of 240 inmates were included in the study. A principal component factor analysis was performed so as to obtain the construct validity of the IPAS impulsive aggression (IA) and premeditated aggression (PM) subscales; internal consistency was determined by Cronbach's alpha coefficient; convergent and divergent validity of the subscales were determined analyzing correlations with the Barratt Impulsiveness scale, 11th version (BIS-11), and the Psychopathic Checklist Revised (PCL-R). The rotated matrix with two factors accounted for 49.9% of total variance. IA subscale had 11 items and PM subscale had 10 items. The IA and PM subscales had a good Cronbach's alpha values of 0.89 and 0.88, respectively. The IA subscale is correlated with BIS-11 attentional, motor, and non-planning impulsiveness dimensions ( p  < 0.05). The PM subscale is correlated with BIS-11 attentional, motor impulsiveness dimensions ( p  < 0.05). The PM subscale is correlated with PCL-R interpersonal, lifestyle, and antisocial dimensions ( p  < 0.05). The IA subscale is not correlated with PCL-R. The Portuguese translated version of IPAS has adequate psychometric properties, allowing the measurement of impulsive and premeditated dimensions of aggression.

Objective: With obesity being a major public health epidemic, dietitians are charged with the difficult task to assist clients in modifying their behaviours. Since there are inconsistent data about dietitians' beliefs, attitudes and practices concerning obesity and little is known concerning differences in public and private practice, we conducted the present study to address those gaps., Design: Semi-structured interviews analysed according to thematic analysis procedures., Setting: Public primary-care and private settings., Subjects: Seventeen Portuguese registered dietitians working in public primary-care (n 10) and private settings (n 7)., Results: Regardless of work context, 'persistence of efforts' emerged as the main characteristic of dietitians' action. Besides holding negative attitudes towards obese patients, their practices are not negatively influenced. They perceive themselves as active agents in promoting lifestyle changes, offering as many management strategies as possible to empower patients, feeling positive about the accomplishment of a successful weight loss, believing in their own efficacy and competency in helping patients. However, differences in reimbursement, work environment, perceived barriers, patient characteristics and availability of resources seem to contribute to differences in persistence according to the setting in which dietitians are working, evidenced by an increase of efforts and engagement in private practice and a decrease in public primary-care practice., Conclusions: Portuguese dietitians present a positive mindset and actions about obesity treatment outcomes; however, education in behaviour change strategies should be improved. The public health system requires reorganization to enhance effective obesity management delivery. Motivation driving dietitians' work in private settings should be addressed.

Introduction: We investigated whether MR diffusion tensor imaging (DTI) analysis of the cervical spinal cord could aid the (differential) diagnosis of sensory neuronopathies, an underdiagnosed group of diseases of the peripheral nervous system., Methods: We obtained spinal cord DTI and T2WI at 3 T from 28 patients, 14 diabetic subjects with sensory-motor distal polyneuropathy, and 20 healthy controls. We quantified DTI-based parameters and looked at the hyperintense T2W signal at the spinal cord posterior columns. Fractional anisotropy and mean diffusivity values at C2-C3 and C3-C4 levels were compared between groups. We also compared average fractional anisotropy (mean of values at C2-C3 and C3-C4 levels). A receiver operating characteristic (ROC) curve was used to determine diagnostic accuracy of average fractional anisotropy, and we compared its sensitivity against the hyperintense signal in segregating patients from the other subjects., Results: Mean age and disease duration were 52 ± 10 and 11.4 ± 9.3 years in the patient group. Eighteen subjects had idiopathic disease and 6 dysimmune etiology. Fractional anisotropy at C3-C4 level and average fractional anisotropy were significantly different between patients and healthy controls (p < 0.001 and <0.001) and between patients and diabetic subjects (p = 0.019 and 0.027). Average fractional anisotropy presented an area under the curve of 0.838. Moreover, it had higher sensitivity than visual detection of the hyperintense signal (0.86 vs. 0.54), particularly for patients with short disease duration., Conclusion: DTI-based analysis enables in vivo detection of posterior column damage in sensory neuronopathy patients and is a useful diagnostic test for this condition. It also helps the differential diagnosis between sensory neuronopathy and distal polyneuropathies.

The purpose of this study was to compare the peripheral expression of natural killers and CCR5 in a session of low-intensity strength training with vascular occlusion and in high-intensity training. Young males were randomized into session groups of a high-intensity strength training (HI) and a session group of low-intensity strength training with vascular occlusion (LI-BFR). The exercise session consisted in knee extension and bicep curl in 80% 1RM (HI) and 30% 1RM (LI-BFR) with equalized volumes. Blood collection was made before, immediately after and 24 h after each training session. Immunophenotyping was carried out through CD195+ (CCR5) e CD3-CD16+CD56+ (NK) in peripheral blood and analysed by flow cytometry and presented in frequency (%). Peripheral frequency of NK cells showed no significant difference in LI-BFR group in time effect, while a gradual reduction of NK cells was identified in HI group in before-24 h postexercise and after-24 h postexercise comparison. However, significant differences have been found in relative change of NK cells immediately after exercise between sessions. In addition, HI and LI-BFR groups showed a significant reduction in the cells expressed CCR5 during 24 h postsession compared to the postsession, but CCR5 also differed when comparing before-24 h after session in the HI group. No differences were observed amongst the groups. LIO induced CCR5 response similar to the HI session, while the NK cells remained in similar frequency during the studied moments in LI-BFR, but not in HI group, suggesting that local hypoxia created by the blood flow restriction was able to prevent a change in the frequency of peripheral cells and a possible immunosuppression., (© 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

Background: A deeper understanding of differences and similarities in transcriptional regulation between species can uncover important information about gene functions and the role of genes in disease. Deciphering such patterns between mice and humans is especially important since mice play an essential role in biomedical research., Results: Here, in order to characterize evolutionary changes between humans and mice, we compared gene co-expression maps to evaluate the conservation of co-expression. We show that the conservation of co-expression connectivity of homologous genes is negatively correlated with molecular evolution rates, as expected. Then we investigated evolutionary aspects of gene sets related to functions, tissues, pathways and diseases. Genes expressed in the testis, eye and skin, and those associated with regulation of transcription, olfaction, PI3K signalling, response to virus and bacteria were more divergent between mice and humans in terms of co-expression connectivity. Surprisingly, a deeper investigation of the PI3K signalling cascade revealed that its divergence is caused by the most crucial genes of this pathway, such as mTOR and AKT2. On the other hand, our analysis revealed that genes expressed in the brain and in the bone, and those associated with cell adhesion, cell cycle, DNA replication and DNA repair are most strongly conserved in terms of co-expression network connectivity as well as having a lower rate of duplication events. Genes involved in lipid metabolism and genes specific to blood showed a signature of increased co-expression connectivity in the mouse. In terms of diseases, co-expression connectivity of genes related to metabolic disorders is the most strongly conserved between mice and humans and tumor-related genes the most divergent., Conclusions: This work contributes to discerning evolutionary patterns between mice and humans in terms of gene interactions. Conservation of co-expression is a powerful approach to identify gene targets and processes with potential similarity and divergence between mice and humans, which has implications for drug testing and other studies employing the mouse as a model organism.

Sensory neuronopathies (SN) are a group of disorders characterized by primary damage to the dorsal root ganglia neurons. Clinical features include multifocal areas of hypoaesthesia, pain, dysautonomia, and sensory ataxia, which is the major source of disability. Diagnosis relies upon clinical assessment and nerve conductions studies, but sometimes it is difficult to distinguish SN from similar conditions, such as axonal polyneuropathies and some myelopathies. In this scenario, underdiagnosis is certainly an important issue for SN patients and additional diagnostic tools are needed. MRI is able to evaluate the dorsal columns of the spinal cord and has proven useful in the workup of SN patients. Although T2 weighted hyperintensity restricted to the posterior fasciculi without contrast enhancement is the typical finding, additional abnormalities have been recently reported. The aim of this review is to gather available information on neuroimaging findings of SN, discuss their clinical correlates and the potential impact of novel MRI-based techniques., (Copyright © 2015 by the American Society of Neuroimaging.)

Objectives: Several studies indicate that general practitioners (GPs) are not taking the issue of obesity as seriously as they should. Therefore, the aim of this study was to understand GPs' views about obesity and obese people and how these professionals perceive their role in the treatment of this disease., Study Design: Qualitative study using semi-structured interviews., Methods: Sixteen semi-structured interviews were conducted with Portuguese GPs. Data were analyzed according to thematic analysis procedures., Results: GPs are negative about their own role in obesity treatment. Although they believe it is part of their job to advise obese patients on the health risks of obesity, the majority of doctors think they are not making any difference in getting their patients to make long term lifestyle changes. GPs hold negative attitudes towards these patients blaming them for being unmotivated and non-compliant and are also pessimistic about their ability to lose weight. Doctors are facing a dilemma in their practices: they want to play an active role but, due to a set of negative beliefs and perceived barriers, they are playing a relatively passive role, feeling defeated and unmotivated, which is reflected in a decrease of efforts and a willing to give up on most of the cases., Conclusions: This issue should be taken in to account during physicians' education since doctors should be aware of how their own beliefs and attitudes influence their behaviour and practices, compromising, therefore, the adherence to and the success in obesity treatment. They seem to need more precise guidelines and better tools for screening and management of obesity, more referral options, and improved coordination with other specialities., (Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals., Materials and Methods: Measures of pain intensity and interference, physical and psychological functioning, coping responses, self-efficacy, and satisfaction with social support were administered to a sample of 324 Portuguese patients with chronic musculoskeletal pain. Univariate and multivariate analyses were computed. Findings were interpreted with respect to those from similar studies using English-speaking individuals., Results: Coping responses and perceived social support were significantly associated with pain interference and both physical and psychological functioning; self-efficacy beliefs were significantly associated with all criterion variables. All coping responses, except for task persistence, were positively associated with pain interference and negatively associated with physical and psychological functioning, with the strongest associations found for catastrophizing, praying/hoping, guarding, resting, asking for assistance, and relaxation., Discussion: The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.

This article presents a macroergonomic intervention in a Brazilian footwear company and its evaluation by the workers. Using participatory ergonomics, the traditional Taylor/Ford production system was transformed into a socio-technical one and tested by 100 volunteers working during 3.5 years in a pilot production line. Multiskilling and teamwork were the major changes promoted to enlarge and enrich work and make it more flexible. The workers' evaluation pre- and post-intervention showed an increase in overall satisfaction with the work and more commitment to the results and company targets., Statement of Relevance: This study showed that problems and solutions can be identified through participatory ergonomics, that it is easier to involve workers than the managerial staff, and that a macroergonomic intervention, mainly focusing on work organization, led to positive personnel, health and production outcomes, despite management's resistance to changes., (Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

Purpose: To report our experience of open ureteroneocystostomy after failed endoscopic treatment., Material and Methods: Clinical charts of 787 children who entered our dextranomer/hyaluronic acid copolymer (DxHA) endoscopic injection program for vesicoureteral reflux (VUR) treatment between May 2000 and December 2009 were reviewed. Fifty-one of these patients were submitted to open ureteroneocystostomy for complete resolution of VUR., Results: Twenty-eight patients (55%) were female. Median age at surgery was 65 months (range: 26-182). Median time going from first endoscopic injection until open surgery was 13 months (range 1-58). Surgical ureteral reimplantation was bilateral in 62.7% of the cases. Of a total of 83 operated ureters, nine were duplex ureters, nine were megaureters, six were ectopic, and two had periureteral diverticulum. Mean operative time was 70 min (range 45-120 min). There were no intra-operative complications. Follow-up VCUG showed complete resolution of VUR in 98% of patients. There was only one right-sided grade III VUR that persisted after bilateral reimplantation. It resolved with a single subureteral DxHA injection., Conclusions: Ureteroneocystostomy after a failed endoscopic treatment can achieve successful results in a high percentage of patients with minimal complications., (Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Background and Aims: Vascular disease is the principal cause of death and disability in patients with diabetes, and endothelial dysfunction seems to be the major cause in its pathogenesis. Since L-arginine levels are diminished in conditions such as type 1 and type 2 diabetes, in this work we aimed to verify the effects of L-arginine supplementation (7 g/day) over the endothelial function and oxidative stress markers in young male adults with uncomplicated type 1 diabetes. We also investigated the influences of L-arginine administration on vascular/oxidative stress responses to an acute bout of exercise., Methods: Ten young adult male subjects with uncomplicated type 1 diabetes and twenty matched controls volunteered for this study. We analysed the influence of L-arginine supplementation (7 g/day during 1 week) over lower limb blood flow (using a venous occlusion plethysmography technique), oxidative stress marker (TBARS, Carbonyls), anti-oxidant parameters (uric acid and TRAP) and total tNOx in rest conditions and after a single bout of submaximal exercise (VO₂ at 10 % below the second ventilatory threshold). Data described as mean ± standard error (SE). Alpha level was P < 0.05., Results: Glycaemic control parameters were altered in type 1 diabetic subjects, such as HbA1c (5.5 ± 0.03 vs. 8.3 ± 0.4 %) and fasted glycaemia (94.8 ± 1.4 vs. 183 ± 19 mg/dL). Oxidative stress/damage markers (carbonyls and TBARS) were increased in the diabetic group, while uric acid was decreased. Rest lower limb blood flow was lower in type 1 diabetic subjects than in healthy controls (3.53 ± 0.35 vs. 2.66 ± 0.3 ml 100 ml⁻¹ min⁻¹). L-Arginine supplementation completely recovered basal blood flow to normal levels in type 1 diabetics' subjects (2.66 ± 0.3 to 4.74 ± 0.86 ml 100 ml⁻¹ min⁻¹) but did not interfere in any parameter of redox state or exercise., Conclusion: Our findings highlight the importance of L-arginine for the improvement of vascular function in subjects with diabetes, indicating that L-arginine supplementation could be an essential tool for the treatment for the disease complications, at least in non-complicated diabetes. However, based on our data, it is not possible to draw conclusions regarding the mechanisms by which L-arginine therapy is inducing improvements on cardiovascular function, but this important issue requires further investigations.

Objective: With the assumption that circadian rhythms influence human performance, the work of live line electricians was reorganized and evaluated. The hypothesis was that in highly physical and attention-demanding work, the organization of tasks, according to the ideal period of day and day of week, should diminish stress and consequent work risks., Background: There are only a few studies reporting the work of electricians and even fewer approaching work organization. Moreover, these investigations often do not consider human physiological limitations and capabilities as well as task demands., Method: A new work system was proposed with consideration of (a) the circadian cycles and homeostatic processes; (b) the effect of heat, which is a zeitgeber (synchronizer) for the biological clocks; and (c) the degree of physical and mental demands of the different performed tasks, which was assessed on the basis of opinions of the electricians and physiological markers of stress that are controlled by circadian rhythms. The traditional and new systems were compared on the basis of two cognitive indices (the arrangement of matchsticks and the perception of a minute) and three physiological markers of mental-to-physical loads (heart frequency and the level of adrenaline and noradrenaline)., Results: Both physical and mental loads were reduced in the new system., Conclusion: Work organization should include consideration of human circadian rhythms, mainly when stressful and high-risk tasks are involved., Application: The findings can be applied in any work design, but they are especially suited for highly demanding work carried out outdoors.

The aim of the study is to adapt and then discuss the appropriateness of the Life Orientation Test as a one or two dimension scale. The research includes two studies; one is composed of a sequential sample of 280 people with multiple sclerosis, 71% female, and another includes a convenience sample of 615 individuals from the community, 51.1% female. Because the construct is built upon a theoretical assumption that has one dimension, we examine the hypothesis of one or two factor solutions through confirmatory factor analysis, and the two-dimension solution premise demonstrates better adjustment for both samples. The other psychometric properties explored show appropriate results for the Portuguese sample, and similar to the original ones; the Test therefore seems appropriate for use in cross cultural studies. Based on our results, we discuss whether the questionnaire is a one or two dimension instrument, concluding that it appears appropriate to accept the recommendations of the original authors to use it as a one-dimensional tool and, when necessary, to use both dimensions.

The rapid disruption of tropical forests probably imperils global biodiversity more than any other contemporary phenomenon. With deforestation advancing quickly, protected areas are increasingly becoming final refuges for threatened species and natural ecosystem processes. However, many protected areas in the tropics are themselves vulnerable to human encroachment and other environmental stresses. As pressures mount, it is vital to know whether existing reserves can sustain their biodiversity. A critical constraint in addressing this question has been that data describing a broad array of biodiversity groups have been unavailable for a sufficiently large and representative sample of reserves. Here we present a uniquely comprehensive data set on changes over the past 20 to 30 years in 31 functional groups of species and 21 potential drivers of environmental change, for 60 protected areas stratified across the world’s major tropical regions. Our analysis reveals great variation in reserve ‘health’: about half of all reserves have been effective or performed passably, but the rest are experiencing an erosion of biodiversity that is often alarmingly widespread taxonomically and functionally. Habitat disruption, hunting and forest-product exploitation were the strongest predictors of declining reserve health. Crucially, environmental changes immediately outside reserves seemed nearly as important as those inside in determining their ecological fate, with changes inside reserves strongly mirroring those occurring around them. These findings suggest that tropical protected areas are often intimately linked ecologically to their surrounding habitats, and that a failure to stem broad-scale loss and degradation of such habitats could sharply increase the likelihood of serious biodiversity declines.

This article presents a costs-benefits analysis of a macroergonomic intervention in a Brazilian footwear company. Comparing results of a pilot line (composed by 100 multiskilled workers organized in teams) with eight traditional lines (still working in a one human being/one task model) the intervention showed to be worth pursuing since achieved gains were higher than intervention costs: there was a reduction in human resource costs (80% reduction in industrial accidents, 100% reduction in work-related musculoskeletal disorders or WMSD, medical consultations and turnover, and a 45.65% reduction in absenteeism) and production improvement (productivity increased in 3% and production waste decrease to less than 1%). The net intervention value of the intervention was around U$ 430,000 with a benefit-to-cost ratio of 7.2. Moreover, employees who worked in the pilot line understood that their quality of work life improved, compensating the anxiety brought up by the radical changes implemented., (Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

Background: Open dismembered pyeloplasty remains the preferred surgical technique for ureteropelvic junction syndrome (UPJS) in most paediatric urology units. The authors present their experience of 230 patients and describe their form of presentation, treatment and early and long-term results., Materials and Methods: Retrospective analysis of clinical records of 230 patients submitted to dismembered pyeloplasty in an 8-year period, from 1999 until 2007. Pre-operative data, early and long-term complications were registered. Image studies included renopelvic ultrasonography, mercapto-acetyl triglycine (MAG3) renal scan with furosemide test and, in some cases, elimination urography and retrograde cystography. Pre-operative and post-operative results were compared., Results: Median age of our patients at time of surgery was 14.9 months (range: 21 days until 16.6 years). The majority of patients were male (72%, n = 166) and 74% (n = 120) had pre-natal diagnosis. The majority of hydronephrosis were in the left side (61%, n = 141). There were only 3% of complications in early post-operative period: four had acute pyelonephritis, two had renocutaneous fistula and one died due to respiratory failure. Mean follow-up period was 5 years, ranging from 12 months to 9.7 years. There was only one case of recurrence with the need of reoperation. Comparing pre-operative and post-operative imaging results, we found that 89% had normal renal function, 7% diminished but better than before and 2% equal as before surgery., Conclusion: Open dismembered pyeloplasty is a safe and effective treatment in paediatric UPJS.

Superspace symmetry has been for many years the standard approach for the analysis of non-magnetic modulated crystals because of its robust and efficient treatment of the structural constraints present in incommensurate phases. For incommensurate magnetic phases, this generalized symmetry formalism can play a similar role. In this context we review from a practical viewpoint the superspace formalism particularized to magnetic incommensurate phases. We analyse in detail the relation between the description using superspace symmetry and the representation method. Important general rules on the symmetry of magnetic incommensurate modulations with a single propagation vector are derived. The power and efficiency of the method is illustrated with various examples, including some multiferroic materials. We show that the concept of superspace symmetry provides a simple, efficient and systematic way to characterize the symmetry and rationalize the structural and physical properties of incommensurate magnetic materials. This is especially relevant when the properties of incommensurate multiferroics are investigated.

Despite the implementation of various intervention measures, the number of obese individuals remain high; thus, it is important to consider what is contributing to this scenario. Authors have been striving to understand the role healthcare providers, especially in primary healthcare, seem to play in this context. The present review aims to synthesize the main investigation results regarding beliefs, attitudes, and practices of healthcare providers, as they seem to negatively influence the practitioner's actions. The words "obesity", "beliefs", "healthcare professionals", "general practitioners", "attitudes", "practices", "health physicians", and "family practitioners" were entered into databases, such as EBSCOHost, ScienceDirect, Psychlnfo, PubMed, and SciELO. Thirteen studies from 1991 to 2011 were reviewed. The data indicate a lack of appropriate understanding and adequate competence regarding obesity, which likely contributes to ambivalent belief development and negative attitudes toward obese individuals, who are described as unmotivated, lazy, and lacking self-control. These professionals consider it hard to deal with obesity, manifesting low expectations of success regarding weight loss, thus considering themselves unsuccessful. Their practices are inconsistent, mirroring a certain skepticism towards the efficacy of available interventions. Either during graduation or as active practitioners, it is imperative to make healthcare providers aware of the impact their beliefs regarding obesity can exert on their practices, as these may impair appropriate and effective treatment delivery to obese individuals.

The temperature versus magnetic field phase diagram of the 2D triangular lattice and multiferroic compound RbFe(MoO(4))(2) is analysed from the point of view of symmetry. The paramagnetic space group and its irreducible representations are used in order to obtain the magnetic symmetry of the possible modulated phases and characterize the restrictions imposed by this symmetry on the corresponding magnetic structures. Superspace symmetry is considered in the case of incommensurate phases. It is shown that the experimentally observed phases correspond to different isotropy subgroups originating in the same irreducible representation of the paramagnetic symmetry group. The relevant couplings between the primary transverse spin modulation and the electric polarization, the in-plane magnetization and the secondary longitudinal magnetic modulation are discussed. The mechanisms for the destabilization of the improper ferroelectric chiral phase and the origin of the different orientation of the spins with respect to the external field in the two collinear phases are analysed from a symmetry based perspective., (© 2011 IOP Publishing Ltd)

Objectives: In this observational study, we evaluated the effects of chest and neck mobilization on spirometric parameters in healthy subjects., Methods: We conducted an observational, quantitative, and experimental study in a sample of 100 healthy subjects. We evaluated spirometric parameters before and after pompage mobilization techniques. Three techniques were used, and each technique was performed 6 times., Results: Forced vital capacity (3.4 ± 0.1 L vs 3.5 ± 0.1 L), forced expiratory volume at the first second (3.2 ± 0.09 L vs 3.3 ± 0.09 L), and peak expiratory flow (6.4 ± 0.27 L/s vs 6.6 ± 0.25 L/s) were significantly increased after mobilization (P < .0001), whereas Tiffeneau index (94% ± 1% vs 6% ± 0.2%) was decreased (P < .0001)., Conclusion: Chest and neck mobilization techniques used in this study improved spirometric parameters in a group of young and healthy subjects., (Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.)

Objective: The aim of this study was to examine the associations between coping and adjustment to chronic pain in a sample of patients from Portugal and to discuss the findings with respect to published findings from two studies using patients from the United States., Design: Two brief measures of pain coping were translated and administered with measures of physical and psychological functioning to a sample of Portuguese patients. Analyses examined the associations among the study variables and compared the results with published data from two patient samples from the United States., Participants: One hundred seventeen individuals with chronic musculoskeletal pain., Outcome Measures: Portuguese translations of brief versions of the Coping Strategies Questionnaire and Chronic Pain Coping Inventory and criterion measures of pain intensity, pain interference, and depression., Results: Statistically significant positive associations were found between measures of patient dysfunction and catastrophizing, praying/hoping, guarding, asking for assistance, and support seeking; and negative associations were found between the criterion measures and ignoring sensations, coping self-statements, and increasing behavioral activities. Mean differences between the Portuguese and US samples in the coping scales were found for nine of the 15 coping scales., Conclusions: The results support the reliability and validity of the translated Coping Strategies Questionnaire and Chronic Pain Coping Inventory and also indicate a number of similarities, but also some interesting differences, in the findings from the Portuguese vs US samples, suggesting that there may be cultural differences in how people cope with pain., (Wiley Periodicals, Inc.)

Aims: This study sought to translate and evaluate the psychometric properties of a European Portuguese version of the Pain Self-Efficacy Questionnaire (P-PSEQ), in order to enable its use in clinical and cross-cultural studies., Material and Methods: The Pain Self-Efficacy Questionnaire was translated into European Portuguese and then back-translated into English. A consensus version of the translated version was pre-tested with a pilot sample, followed by cognitive debriefing, resulting in a final version of the measure. A convenience sample of 174 Portuguese adults with chronic musculoskeletal pain completed the Portuguese Pain Self-Efficacy Questionnaire (P-PSEQ) and criterion measures of pain intensity (Numerical Ratings Scale), pain interference (Portuguese Brief Pain Inventory Interference Scale), quality of life and general health (SF-12), and psychological functioning (Hospital Anxiety and Depression Scale). Cronbach's alpha and composite reliability coefficients were computed as measures of reliability, and confirmatory factor analysis was performed. Pearson correlation coefficients between the P-PSEQ score and the criterion measures were computed to evaluate the construct validity of the scale., Results: The P-PSEQ demonstrated good to excellent reliability (Cronbach's alpha = 0.88 and Composite reliability = 0.92), and showed moderately strong associations with the criterion measures in the hypothesized directions, supporting its construct validity. Additionally, the confirmatory factor analysis supported a single factor solution, as hypothesized., Conclusions: The findings provide strong support for the reliability and validity of the P-PSEQ. Research is needed to determine the responsivity of the P-PSEQ and to establish the generalizability of the results in other samples of Portuguese patients with chronic pain.

The systematic use of symmetry arguments, with inclusion of magnetic symmetry, is scarce in the investigation of magnetic materials. This is an unfortunate situation particularly when multiferroics are being studied. The lack of a consistent complete symmetry framework often prevents the distinction of what is the signature of a specific atomic mechanism and what is symmetry-forced and therefore common to any possible underlying microscopic model. Here the recently reported magnetoelectric properties of Ba(2)CoGe(2)O(7) [Murakawa et al. (2010). Phys. Rev. Lett. 105, 137202] are discussed as an extreme example of this situation, and it is shown how three of the four magnetoelectric responses that have been reported for this compound can be predicted by symmetry considerations without appealing to any specific atomic mechanism.

The present study describes the psychometric properties of the Portuguese version of the Mental Health Inventory-5 for use with young adolescents. A sample of 367 Portuguese students (aged 10-15 years) completed the Portuguese-language versions of Mental Health Inventory-5 (MHI-5; Berwick et al., 1991), Children's Hope Scale (CHS; Snyder et al., 1997), Students' Life Satisfaction Scale (SLSS; Huebner, 1991a), and Global Self-Worth Sub-scale (Harter, 1985). Analysis of readability, reliability (internal consistency and 1-year stability), factor structure, and criterion-related validity suggested that the MHI-5 can be appropriately used in this age group. Implications of the findings are discussed.

Background: Treatment of varicocoele is aimed at eliminating the retrograde reflux of venous blood through the internal spermatic veins. The purpose of this investigation was to compare laparoscopic varicocoelectomy (LV) with open high ligation technique in the adolescent population., Materials and Methods: We retrospectively evaluated 33 adolescents who underwent varicocoelectomy at our paediatric hospital, between May 2004 and September 2008. Patients were divided into two groups depending on the technique: those who had an LV and those submitted to an open varicocoelectomy (OV). We analysed side, age of surgery, follow-up period and the incidence of recurrence/persistence, hydrocoele formation and wound complication., Results: There were 24 patients in the LV group and 9 in the OV group. All varicocoeles were in the left side. Mean age was 12 years in both groups. Mean follow-up time was 32 months for the LV group and 38 months for the OV group (P = 0.49). There was no significant difference in the incidence of hydrocoele in both the groups (25% versus 22%, P = 0.626). There was no recurrence/persistence on the LV group, while in the OV group there were three cases (P = 0.015)., Conclusion: LV seems more efficient than open high ligation technique in the treatment of adolescents' varicocoeles. Larger series are necessary to draw more reliable conclusions.