The Association of Life Events Outside the Workplace and Burnout: A Cross-Sectional Study on Nursing Assistants.

BACKGROUND: Burnout, by definition, is related to adverse chronic workplace stressors. Life events outside the workplace have been associated with an increased risk of psychiatric morbidity. However, it is unknown whether life events outside the workplace increase the severity of burnout. PURPOSE: The aim of the study was to investigate the association between burnout and life events outside the workplace in nursing assistants. METHODS: In an observational, cross-sectional, single-site study of 521 nursing assistants at a university hospital, we assessed burnout with the Maslach Burnout Inventory-Human Services Survey, and life events with the Social Readjustment Rating Scale. We constructed equations of multiple linear regression analyses that included each burnout subscale as the dependent variable and a domain of life events as the independent variable. Results were adjusted for potential confounders, including gender, no religion or faith, years of work, and depression. RESULTS: An increase in the number of life events in the domain of personal changes or difficulties (e.g., personal injury or illness, sexual difficulties, change in recreation, church activities, social activities, sleeping habits, eating habits and revision of personal habits) was associated with increased severity of emotional exhaustion. An increase in the number of life events in the domain of changes in familial situation and in the domains of death of relatives or friends were associated with increased severity of depersonalization. Those associations were independent of work-related life events and other potential confounders. CONCLUSIONS: Life events outside the workplace may increase the levels of burnout in nursing assistants.

Neuropsychological Assessment of 412 HIV-Infected Individuals in São Paulo, Brazil.

HIV-associated neurocognitive disorders (HAND) remain frequent even among individuals receiving combined antiretroviral therapy (cART). In addition, HAND may adversely affect the quality of life and adherence to cART. There is scarce epidemiological information about HAND in Latin America. This cross-sectional study recruited HIV-infected patients from a tertiary teaching institution in São Paulo, Brazil, between May 2013 and February 2015. The patients were adults with at least 4 years of education and patients with current neurological or psychiatric diseases were excluded. HAND remain frequent even among individuals receiving cART, use of psychoactive substance, or inability to understand the content for neuropsychological evaluation. We used standardized tools to evaluate depression, use of psychoactive substances, and daily life activities, and we performed a comprehensive neuropsychological examination. HAND was classified using the Frascati criteria. Prevalence of HAND was estimated, and an associated variable of symptomatic HAND was identified by logistic regression. Four-hundred twelve HIV-infected patients were included [male: 281 (68%), mean age of 45.3 years]. Most of them [n = 340 (83.7%)] had an undetectable viral load. The prevalence of HAND was 73.6% (n = 303): 210 (50.9%) had asymptomatic neurocognitive involvement (ANI), 67 (16.2%) had mild neurocognitive disorder (MND), and 26 (6.3%) had HIV-associated dementia (HAD). The univariate logistic regression analysis showed that female gender, age older than 50 years, <11 years of schooling, CD4 count below 200 cells/mm3, presence of previous illnesses (e.g., diabetes, hypertension), opportunistic disease history, and a Beck Depression Inventory (BDI) score between 13 and 19 points were factors associated with symptomatic HAND (MND and HAD). However, a BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND. HAND was highly prevalent in São Paulo, Brazil, and ANI was the more frequent category of HAND. However, 22.5% of participants had symptomatic HAND. This finding constitutes a challenge in clinical practice. A BDI score between 13 and 19 points was the single independent variable associated with symptomatic HAND.

Impact of sociodemographic variables on executive functions.

Executive functions (EFs) regulate human behavior and allow individuals to interact and act in the world. EFs are sensitive to sociodemographic variables such as age, which promotes their decline, and to others that can exert a neuroprotective effect. OBJECTIVE: To assess the predictive role of education, occupation and family income on decline in executive functions among a sample with a wide age range. METHODS: A total of 925 participants aged 18-89 years with 1-28 years' education were submitted to assessment of executive functions using the Card Sorting Test (CST), Phonemic Verbal Fluency (FAS) Task and Semantic Verbal Fluency (SVF) Task. Data on income, occupation and educational level were collected for the sample. The data were analyzed using Linear Regression, as well as Pearson's and Spearman's Correlation. RESULTS: Age showed a significant negative correlation (p<0.001) with performance on the CST, FAS and SVF, whereas education, income and occupation were positively associated (p<0.001) with the tasks applied. After application of the multivariate linear regression model, a significant positive relationship with the FAS was maintained only for education (p<0.001) and income (p<0.001). The negative relationship of age (p<0.001) and positive relationship of both education (p<0.001) and income (p<0.001and p=0.003) were evident on the CST and SVF. CONCLUSION: Educational level and income positively influenced participants' results on executive function tests, attenuating expected decline for age. However, no relationship was found between occupation and the cognitive variables investigated.

Funções executivas regulam o comportamento humano e permitem ao indivíduo interagir e agir no mundo. Elas são sensíveis a variáveis sociodemográficas como a idade, que promove seu declínio, e a outras que podem ter ação neuroprotetora. OBJETIVO: Avaliar o papel preditivo da escolaridade, atividade ocupacional e renda familiar sobre o declínio das funções executivas em uma amostra de ampla variação de idade. MÉTODOS: 925 participantes saudáveis com idades de 18 a 89 anos e escolaridade de 1 a 28 anos foram submetidos ao exame de funções executivas com uma Tarefa de Classificação de Cartas (TCC) e de Fluência Verbal nominal (FVN) e semântica (FVS). Foram obtidas a renda, atividade ocupacional e escolaridade da amostra. Os dados foram analisados com Regressão Linear, Correlação Pearson e Spearman. RESULTADOS: Idade apresentou correlação significativa (p<0,001) negativa com o desempenho em TCC, FVN e FVS, enquanto educação, renda e ocupação se relacionaram de forma positiva (p<0,001) com as tarefas utilizadas. Após modelo de regressão linear multivariada, apenas educação (p<0,001)e renda (p<0,001) mantiveram relação significativa positiva com FVN. A relação negativa da idade (p<0,001) e positiva de educação (p<0,001) e renda (p<0,001 e p=0,003) foi evidente em TCC e FVS. CONCLUSÃO: Escolaridade e renda influenciaram positivamente os resultados dos participantes nos testes de função executiva, tendo um efeito contrário ao declínio esperado para a idade. Por outro lado a ocupação não manteve relação com as variáveis cognitivas.

Presence of eating disorders and its relationship to anxiety and depression in pregnant women.

BACKGROUND: women who have inadequate nutrient intake are more likely to develop a risky pregnancy. The purpose of this study was to determine the presence of eating disorders and its association with anxiety and depression symptomatology in high-risk pregnancies. METHODS: this is a cross-sectional and prospective study conducted at the tertiary university hospital in the city of São Paulo, Brazil. 913 pregnant women waiting for the Obstetrics' outpatient appointment were invited to participate in the study on their 2nd and 3rd trimester of pregnancy. Structured interviews were carried out and the Structured Clinical Interview for DSM Disorders and Hospital Anxiety and Depression Scale were applied. FINDINGS: prevalence of eating disorder (ED) during pregnancy was 7.6% (n=69) (95% CI: 5.84% -9.28%), 0.1% (n=1) for anorexia nervosa; 0.7% (n=6) for bulimia nervosa; 1.1% (n=10) for binge eating disorder, and 5.7% (n=52) for pica. A statistically significant difference was found between the anxiety (p<0.01) and depressive symptoms (p<0.01). CONCLUSIONS: the prevalence of ED (7.6%) and its association with anxiety and depression symptoms during pregnancy highlights the need for specialist care for prevention, diagnosis and treatment. Given the importance of proper nutrition during pregnancy, both with regard to maternal health and fetal development, it is necessary to have specific predetermined evaluation protocols implemented by health care professionals for the diagnosis of ED during pregnancy.

Transcranial Direct Current Stimulation for Post-Concussion Syndrome: Study Protocol for a Randomized Crossover Trial.

BACKGROUND: Mild traumatic brain injury (MTBI) represents 70-80% of all treated brain injuries. A considerable proportion of MTBI patients experience post-concussion symptoms for a prolonged period after MTBI, and these symptoms are diagnosed as persistent post-concussion syndrome (PPCS). PPCS is defined as a range of physical, cognitive, and emotional symptoms. However, memory and executive dysfunction seems to be one of the most debilitating symptoms. Recently, non-invasive brain stimulation has been studied as a potential treatment method for traumatic brain injury (TBI) patients. Therefore, our primary goal is to verify the effects of transcranial direct current stimulation (tDCS) in patients with PPCS who demonstrate cognitive deficits in long-term episodic memory, working memory, and executive function following MTBI. METHODS/DESIGN: This is a randomized crossover trial of patients with a history of MTBI with cognitive deficits in memory and executive function. Thirty adult patients will be randomized in a crossover manner to receive three weekly sessions of anodal tDCS (2 mA) at left dorsolateral prefrontal cortex, left temporal cortex, and sham stimulation that will be performed at 7-day intervals (washout period). The clinical diagnosis of PPCS will be determined using the Rivermead Post-Concussion Symptoms Questionnaire. Patients who meet the inclusion criteria will be assessed with a neuropsychological evaluation. A new battery of computerized neuropsychological tests will be performed before and immediately after each stimulation. Statistical analysis will be performed to determine trends of cognitive improvement. DISCUSSION: There is paucity of studies regarding the use of tDCS in TBI patients, and although recent results showed controversial data regarding the effects of tDCS in such patients, we will address specifically patients with PPCS and MTBI and no brain abnormalities on CT scan other than subarachnoid hemorrhage. Moreover, due to the missing information on literature regarding the best brain region to be studied, we will evaluate two different regions to find immediate effects of tDCS on memory and executive dysfunction. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT02292589 (https://register.clinicaltrials.gov).

Visuospatial memory improvement in patients with diffuse axonal injury (DAI): a 1-year follow-up study.

OBJECTIVE: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), and is often associated with poor outcomes and cognitive impairment, including memory deficits. Few studies have explored visual memory after TBI and its relationship to executive functioning. Executive functioning is crucial for remembering an object's location, operating devices, driving, and route finding. We compared visual memory performance via the Rey-Osterrieth Complex Figure (ROCF) test 6 and 12 months after DAI. METHOD: In total, 40 patients (mean age 28.7 years; 87.5% male) with moderate-to-severe DAI following a road traffic accident completed the 1-year follow-up. There was a three-phase prospective assessment. In phase 1 (1-3 months after trauma), patients completed the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI). In phases 2 (6 months) and 3 (12 months), they completed the BDI, STAI, and a neuropsychological battery [ROCF copy and recall, digit span forward/backward, Grooved Pegboard test, intelligence quotient (IQ) by Wechsler Adult Intelligence Scale-III (WAIS-III)]. RESULTS: There was an improvement in ROCF recall over time (p=0.013), but not ROCF copy (p=0.657).There was no change in executive function (Savage scores) copy (p=0.230) or recall (p=0.155). Age, years of education, severity of the trauma, and IQ did not influence ROCF recall improvement. CONCLUSION: There are time-dependent improvements in visual memory in patients with DAI. Neuroplasticity in the 1st months after trauma provides an opportunity for visuospatial memory learning. The present findings may be useful to formulate management plans for long-term TBI rehabilitation.

Updates and Current Perspectives of Psychiatric Assessments after Traumatic Brain Injury: A Systematic Review.

Neuropsychological and psychiatric disorders represent a major concern and cause of disabilities after the trauma, contributing to worse recovery after traumatic brain injury (TBI). However, the lack of well-defined parameters to evaluate patient's psychiatric disorders leads to a wide range of diagnoses and symptoms. The aim of this study was to perform a review of literature in order to gather data of the most common scales and inventories used to assess and diagnose depression, anxiety, and posttraumatic stress disorder (PTSD) after TBI. We conducted a literature search via MEDLINE, PubMed, and Web of Science. We included reviews, systematic reviews, and meta-analysis studies, and we used the following keywords: "traumatic brain injury OR TBI," "depression OR depressive disorder," "anxiety," and "posttraumatic stress disorder OR PTSD." From 610 titles, a total of 68 systematic reviews or meta-analysis were included in the section "Results" of this review: depression (n = 32), anxiety (n = 9), and PTSD (n = 27). Depression after TBI is a more established condition, with more homogeneous studies. Anxiety and PTSD disorders have been studied in a heterogeneous way, usually as comorbidity with other psychiatric disorders. Some scales and inventories designed for the general community may not be appropriate for patients with TBI.

The influence of depressive symptoms on quality of life after stroke: a prospective study.

BACKGROUND: Poststroke depressive symptoms have prospectively predicted impairment of health-related quality of life (HRQOL). However, it is not known whether such predictive effect is independent of HRQOL at 1 month after stroke. This study aimed to investigate the impact of depressive symptoms at 1 and 3 months after stroke on the 3-month poststroke HRQOL and to investigate the influence of the HRQOL measured at 1 month after stroke on these relationships. METHODS: We prospectively evaluated 67 patients at 1 and 3 months after a first-ever ischemic stroke from 106 eligible patients who have been consecutively admitted to the neurology ward of a teaching hospital. A psychiatrist assessed the presence of depressive symptoms using the 31-item version of the Hamilton Rating Scale for Depression and the HRQOL was assessed with the 36-item Short-Form Health Survey from the Medical Outcomes Study. We used linear regression to measure the impact of depressive symptoms, HRQOL at 1 month, and potential confounders on HRQOL at 3 months. RESULTS: We found an association between depressive symptoms at 1 month and HRQOL at 3 months after the stroke; however, this association was not significant when adjusting for the 1 month poststroke HRQOL. Depressive symptoms at 3 months were associated with HRQOL at 3 months after stroke, independently of the poststroke HRQOL at 1 month and potential confounders. CONCLUSIONS: Current depressive symptoms at 3 months are important for HRQOL at 3 months after stroke; however, regarding the prospective prediction, HRQOL at 1 month is the most relevant factor.

Improvement of verbal fluency in patients with diffuse brain injury over time.

BACKGROUND: Diffuse axonal injury (DAI), a common cause of neurological sequelae in patients with traumatic brain injury (TBI), is considered one of the most prevalent forms of primary neuronal injury in patients with severe TBI. Cognitive deficits induced by DAI can persist over time, especially following moderate or severe injuries. The aim of the present study was to compare verbal fluency (VF) performance at 6 and 12 months after the trauma in a same group of patients with DAI. METHODS: Eighteen patients with moderate to severe DAI and 17 healthy volunteers were enrolled. All DAI participants had sustained a TBI at least 6 months prior to the start of the study, were between 18 and 50 years of age, and had at least 4 years of education. The VF test was administered within an extensive neuropsychological test battery. We evaluated the same patients at 6 months (DAI1 group) and 12 months (DAI2 group) and compared the results of neuropsychological tests with a control group of healthy volunteers who were matched to patients for sex, age, and educational level. RESULTS: In comparison to controls, the DAI1 group produced significantly fewer words. The DAI2 group produced significantly more semantic words than DAI1 (P<0.05) and demonstrated a trend towards the production of more clusters for letter A (P=0.09) and total words generated in a phonemic test (P=0.09). No significant differences were observed between DAI2 and the control group in the total number of words generated in phonetic FAS or semantic fluency scores. CONCLUSION: The present findings may be useful in the construction of a management plan for long-term TBI rehabilitation that considers the trauma of each patient. Further, our results suggest the VF test is a suitable instrument for the assessment of cognitive difficulties following TBI.

Performance of an adult Brazilian sample on the Trail Making Test and Stroop Test.

OBJECTIVE: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. METHODS: We recruited 1447 healthy subjects aged ≥18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. RESULTS: Among the participants, mean intellectual efficiency was 103.20 (SD: 12.0), age 41.0 (SD: 16.4) years and education 11.9 (SD: 5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. CONCLUSION: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples.

OBJETIVO: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. MÉTODOS: Recrutamos 1447 sujeitos saudáveis com idade ≥18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. RESULTADOS: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD: 12,0), de idade 41,0 (SD: 16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. CONCLUSÃO: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas.

[Preference in the process of parturition: a comparison between primiparous and nulliparous women]. / Preferência pela via de parto: uma comparação entre gestantes nulíparas e primíparas.

PURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.

[Perception influence of professionals regarding unsafe in attention to women's health]. / Influência da percepção dos profissionais quanto ao aborto provocado na atenção à saúde da mulher.

PURPOSE: To identify the knowledge and awareness of health professionals regarding the Brazilian legislation on induced abortion. METHODS: Unidentified sealed envelopes containing the questionnaires were sent to all professionals (n=149) working in the Obstetrics Department of a university hospital and public hospital at the periphery of São Paulo (SP), Brazil. A total of 119 professionals responded to the questionnaire. The 0.05 confidence interval and the Fisher exact test and χ² test were used for data analysis. RESULTS: Of the respondents, 48.7% were physicians, 33.6% were nursing professionals and 17.6% were professionals from other fields (psychologists, nutritionists, physiotherapists, laboratory technicians and administrators). There was a significant difference (p=0.01) in the proportion of professionals who believe that abortion for non-lethal fetal malformation and due to unplanned pregnancies should be included in the Brazilian legislation. It was observed that the knowledge about the law and the description of the circumstances allowed by law on abortion was significantly different when comparing health professionals (p=0.01). When asked about the situations in which Brazilian law allows abortion, 32.7% of physicians, 97.5% of nursing professionals and 90.5% of other professionals were unaware of the law. CONCLUSION: This study demonstrated the lack of of knowledge of Brazilian law among health professionals, to a lesser extent among obstetricians and a to a greater extent among nursing professionals. Attitudes of discrimination and prejudice were observed regarding the care provided to women who induce an abortion.

Insatisfação corporal em estudantes universitários da área de saúde nos Estados de Alagoas e Sergipe / Body dissatisfaction among health sciences students in the brazilian states of Alagoas and Sergipe / Insatisfacción Corporal en Estudiantes Universitarios del Área de Salud en los Estados de Alagoas Y Sergipe

O objetivo do presente estudo foi analisar o nível de insatisfação corporal de estudantes universitários. Foram entrevistados 757 estudantes universitários da área de saúde provenientes de instituições de ensino públicas e privadas dos estados de Alagoas e Sergipe, de ambos os sexos. Foram utilizados questionário contendo dados sóciodemográficos para caracterização da amostra e a Escala de Satisfação com a Imagem Corporal (ESIC). Os resultados demonstraram que 58% concordaram que a aparência ajuda a conseguir um emprego, 51% dos pesquisados mudariam sua aparência, 64% gostariam que a aparência fosse melhor; 21% estão satisfeitos com o seu peso, 11% estão preocupados em parecer gordos, 11% dessa população está fazendo dieta atualmente, e 7% tentam perder mais peso provocando vômitos. Constatou-se altos índices de insatisfação corporal e risco para o desenvolvimento de Transtornos Alimentares. (AU)

The present study’s goal was to analyze the degree of body dissatisfaction among university students. 757 students from every discipline in healthcare from both sexes were interviewed, from both private and public institutions in the states of Alagoas and Sergipe. Questionnaires containing social-demographic data were used to characterize the research sample and the Body Image Satisfaction Scale was applied. The results showed that 58% of those interviewed agreed that a good appearance contributes positively to obtaining a job; 51% of interviewees would change their appearance if given the chance; 64% would like to have better appearances; 21% are satisfied with their current weight; 11% are worried about looking fat; 11% of that population is currently on a diet and 7% try to lose more weight by self-provoking vomit. High levels of body dissatisfaction and of risk for the development of eating disorders were assessed. (AU)

El objetivo del presente estudio fue analizar el nivel de insatisfacción corporal de estudiantes universitarios. Fueron entrevistados 757 estudiantes universitarios del área de salud venidos de instituciones de enseño públicas y privadas de los estados brasileños de Alagoas y Sergipe, de ambos los sexos. Se hizo uso de cuestionarios onteniendo dados socio-demográficos para caracterización de la amuestra y la Escala de Satisfacción con el Imagen Corporal (ESIC). Los resultados demostraron que 58% están de acuerdo que la apariencia contribuye para en la obtención de un trabajo; 51% de los investigados cambiarían su apariencia. A 64% de los investigados, les gustaría que su apariencia fuera mejor; 21% están satisfechos con su peso; 11% se sienten preocupados en parecer gordos; 11% de esa población hace dieta actualmente y 7% han intentado perder más peso provocando vómitos. Se han constatado altos niveles de insatisfacción corporal y riesgo para el desarrollo de trastornos alimentarios. (AU)

Insatisfação corporal em estudantes universitários da área de saúde nos Estados de Alagoas e Sergipe / Body dissatisfaction among health sciences students in the brazilian states of Alagoas and Sergipe / Insatisfacción Corporal en Estudiantes Universitarios del Área de Salud en los Estados de Alagoas Y Sergipe

O objetivo do presente estudo foi analisar o nível de insatisfação corporal de estudantes universitários. Foram entrevistados 757 estudantes universitários da área de saúde provenientes de instituições de ensino públicas e privadas dos estados de Alagoas e Sergipe, de ambos os sexos. Foram utilizados questionário contendo dados sóciodemográficos para caracterização da amostra e a Escala de Satisfação com a Imagem Corporal (ESIC). Os resultados demonstraram que 58% concordaram que a aparência ajuda a conseguir um emprego, 51% dos pesquisados mudariam sua aparência, 64% gostariam que a aparência fosse melhor; 21% estão satisfeitos com o seu peso, 11% estão preocupados em parecer gordos, 11% dessa população está fazendo dieta atualmente, e 7% tentam perder mais peso provocando vômitos. Constatou-se altos índices de insatisfação corporal e risco para o desenvolvimento de Transtornos Alimentares.

The present study’s goal was to analyze the degree of body dissatisfaction among university students. 757 students from every discipline in healthcare from both sexes were interviewed, from both private and public institutions in the states of Alagoas and Sergipe. Questionnaires containing social-demographic data were used to characterize the research sample and the Body Image Satisfaction Scale was applied. The results showed that 58% of those interviewed agreed that a good appearance contributes positively to obtaining a job; 51% of interviewees would change their appearance if given the chance; 64% would like to have better appearances; 21% are satisfied with their current weight; 11% are worried about looking fat; 11% of that population is currently on a diet and 7% try to lose more weight by self-provoking vomit. High levels of body dissatisfaction and of risk for the development of eating disorders were assessed.

El objetivo del presente estudio fue analizar el nivel de insatisfacción corporal de estudiantes universitarios. Fueron entrevistados 757 estudiantes universitarios del área de salud venidos de instituciones de enseño públicas y privadas de los estados brasileños de Alagoas y Sergipe, de ambos los sexos. Se hizo uso de cuestionarios onteniendo dados socio-demográficos para caracterización de la amuestra y la Escala de Satisfacción con el Imagen Corporal (ESIC). Los resultados demostraron que 58% están de acuerdo que la apariencia contribuye para en la obtención de un trabajo; 51% de los investigados cambiarían su apariencia. A 64% de los investigados, les gustaría que su apariencia fuera mejor; 21% están satisfechos con su peso; 11% se sienten preocupados en parecer gordos; 11% de esa población hace dieta actualmente y 7% han intentado perder más peso provocando vómitos. Se han constatado altos niveles de insatisfacción corporal y riesgo para el desarrollo de trastornos alimentarios.

Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: a review of the literature.

Neuropsychological rehabilitation is related to the treatment or optimization of disabilities, handicaps and cognitive deficiencies including emotional, behavioral and personality alterations, aiming at the best cognitive, neurobiological and social re-adaptation. OBJECTIVE: The main aim of this paper is to review scientific studies published over the last five years on cognitive training with rehabilitation, focusing on elderly subjects with cognitive complaints and patients diagnosed with MCI. METHODS: Data were generated from Medline, PsychoInfo and EMBASE including publications from 2002 to 2007 using the search terms "Mild Cognitive Impairment", "Cognitive Complaints", "Rehabilitation" and "Intervention Studies". Data collection criteria were restricted to the quality of evidence Class I. RESULTS: Eight articles out of sixty eight previously selected were chosen because of their randomized studies, including techniques of cognitive rehabilitation in patients with cognitive complaints, MCI and neuropsychological training. CONCLUSIONS: The studies showing generalization of rehabilitation techniques to practical real life situations and use of an errorless learning approach were considered more effective in terms of maintaining treatment follow up, although further studies are recommended.

A reabilitação cognitiva se ocupa do tratamento e otimização das incapacidades, desvantagens e deficiências cognitivas, bem como de alterações emocionais, comportamentais e de personalidade. Visa a melhor readaptação neuropsicológica, neurobiológica e social. OBJETIVO: Realizar revisão literária sobre os estudos científicos publicados nos últimos cinco anos em reabilitação cognitiva, em sujeitos com queixas cognitivas e pacientes idosos diagnosticados com TCL. MÉTODOS: As informações foram obtidas nas bases de dados Mediline, PsychoInfo e EMBASE com recomendações baseadas na qualidade de evidência Classe I. RESULTADOS: Foram encontrados 68 artigos. Destes, selecionados oito, por caracterizarem estudos randomizados, incluir técnicas de reabilitação cognitiva em pacientes com queixas cognitivas e TCL e por documentarem avaliações neuropsicológicas. CONCLUSÕES: As pesquisas que demonstraram técnicas de reabilitação com abordagens capazes de generalização para as atividades práticas da vida e uso da abordagem aprendizagem sem erro se mostraram mais efetivas quanto à manutenção no seguimento, contudo, são necessários estudos mais detalhados.

Dismorfia corporal: sintomas da realidade? / Body dismorphy: Symptoms of reality?

O Distúrbio Dismórfico Corporal (DDC) insere-se na classificação do DSM-IV no grupo das desordens somatoformes e é caracterizado como a preocupação com um defeito imaginário na aparência física, acarretando prejuízos afetivos e sociais na vida da pessoa. Com o objetivo de investigar sintomas de insatisfação com a imagem corporal, aparência e possíveis prejuízos sociais, foi auto-aplicado o Questionário de Sinais de Distúrbio Dismórfico Corporal (Pope et al, 2000) por 346 adultos normais, do estado de São Paulo. As autoras discutem a caracterização do DDC e as influências da cultura pós-moderna no surgimento dos distúrbios dismórficos a partir de um modelo ideal do corpo gerando insatisfação constante, entendendo a dismorfia corporal enquanto um sintoma que pode pertencer a qualquer estrutura, neurótica ou psicótica. Tal sintoma poderia significar a crença suspeitosa que busca o impossível, ou seja: que realidade e identidade coincidam. (AU)

Tudo na vida tem remédio? Comportamento auto-referido de adesão, estratégias de enfrentamento e percepção da doença entre pacientes infectados pelo virus HIV em tratamento ambulatorial

Apesar dos avanços na luta contra HIV/Aids após o advento da terapia anti-retroviral combinada (ARV), o seu uso é ainda muito complexo, por tempo prolongado e apresentando vários efeitos colaterais. Este estudo teve como objetivos investigar o grau de adesão pela avaliação auto-referida, a percepção dos pacientes sobre a doença e os mecanismos de enfrentamento (coping). A partir do estudo de 30 pacientes infectados pelo HIV, encontrou-se um grau de adesão referida de 50 por cento aos ARV, o que condiz com outros estudos. Há percepção do HIV/Aids com uma doença crônica e não foi possível estabelecer o emprego de mecanismos de coping específicos nesses pacientes. Apresentou-se também um caso clínico, baseado na abordagem psicanalítica, de um paciente de 63 anos com problemas gástricos e dificuldade na adesão aos ARV (AU)