Images that speak: A Portuguese Photovoice study on the psychosocial experience of a migrant population from Cape Verde after a first episode of psychosis.

Several migrant populations have been identified worldwide as high-risk groups for psychosis because of their experience of social adversity. Recent evidence suggests that the local contexts in which these populations live should be addressed in their complexity to take into account individual and larger societal environmental aspects. This study aimed to assess the lived experiences of a group of migrant Cape Verdean patients, who had been recently hospitalized for a first episode of psychosis in a mental health service on the outskirts of Lisbon, Portugal. The study used Photovoice, a qualitative participatory research method in which people's experiences are documented through photography. Six individuals were recruited, and five weekly sessions were conducted to collect data that were analyzed thematically. Emergent themes addressed two main categories of well-being and illness. Participant concepts of well-being were rooted in a definition of freedom encompassing cultural expression, conveyed by familiar environments and supporting communities. Cultural differences may be experienced as important obstacles for well-being and can be associated with feelings of oppression and guilt. Participants' accounts focused on positive aspects of life despite illness and on personal concepts of recovery. The study findings contribute to knowledge of the dynamics of migrants' social experience and underscore the importance of socially and culturally informed mental healthcare institutions.

A non-destructive X-ray fluorescence method of analysis of formalin fixed-paraffin embedded biopsied samples for biomarkers for breast and colon cancer.

In this work we present a methodology for the non-destructive elemental determination of formalin-fixed paraffin-embedded (FFPE) human tissue samples based on the Fundamental Parameters method for the quantification of micro Energy Dispersive X Ray Fluorescence (micro-EDXRF) area scans. This methodology intended to overcome two major constraints in the analysis of paraffin embedded tissue samples - retrieval of optimal region of analysis of the tissue within the paraffin block and the determination of the dark matrix composition of the biopsied sample. This way, an image treatment algorithm, based on R® tool to select the regions of the micro-EDXRF area scans was developed. Also, different dark matrix compositions were evaluated using varying combinations of H, C, N and O until the most accurate matrix was found: 8% H, 15% C, 1% N and 60% O for breast FFPE samples and 8% H, 23% C, 2% N and 55% O for colon. The developed methodology was applied to paired normal-tumour samples of breast and colon biopsied tissues in order to gauge potential elemental biomarkers for carcinogenesis in these tissues. The obtained results showed distinctive biomarkers for breast and for colon: there was a significant increase of P, S, K and Fe in both tissues, while a significant increase of Ca an Zn concentrations was also determined for breast tumour samples.

Pulsed electromagnetic fields promote repair of focal articular cartilage defects with engineered osteochondral constructs.

Articular cartilage injuries are a common source of joint pain and dysfunction. We hypothesized that pulsed electromagnetic fields (PEMFs) would improve growth and healing of tissue-engineered cartilage grafts in a direction-dependent manner. PEMF stimulation of engineered cartilage constructs was first evaluated in vitro using passaged adult canine chondrocytes embedded in an agarose hydrogel scaffold. PEMF coils oriented parallel to the articular surface induced superior repair stiffness compared to both perpendicular PEMF (p = .026) and control (p = .012). This was correlated with increased glycosaminoglycan deposition in both parallel and perpendicular PEMF orientations compared to control (p = .010 and .028, respectively). Following in vitro optimization, the potential clinical translation of PEMF was evaluated in a preliminary in vivo preclinical adult canine model. Engineered osteochondral constructs (∅ 6 mm × 6 mm thick, devitalized bone base) were cultured to maturity and implanted into focal defects created in the stifle (knee) joint. To assess expedited early repair, animals were assessed after a 3-month recovery period, with microfracture repairs serving as an additional clinical control. In vivo, PEMF led to a greater likelihood of normal chondrocyte (odds ratio [OR]: 2.5, p = .051) and proteoglycan (OR: 5.0, p = .013) histological scores in engineered constructs. Interestingly, engineered constructs outperformed microfracture in clinical scoring, regardless of PEMF treatment (p < .05). Overall, the studies provided evidence that PEMF stimulation enhanced engineered cartilage growth and repair, demonstrating a potential low-cost, low-risk, noninvasive treatment modality for expediting early cartilage repair.

Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General Hospital.

INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included. RESULTS: Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients and include pulmonary embolism (n = 6), acute stroke (n = 3), cardiac arrhythmia (n = 2), acute myocardial infarction (n = 1), abdominal aortic aneurysm rupture (n = 1) and heart failure (n = 1). Two patients died with pneumonia and in four cases the cause of death was undetermined. Only one case of suicide was registered. DISCUSSION: Circulatory conditions were the most frequent causes of death in our inpatient unit. Albeit a relatively rare event, inpatient suicide does occur and, in addition to its complex consequences on staff, family and patients should remain a focus for continued prevention. CONCLUSION: Mortality studies are important for determining quality of health care and to create recommendations for preventive measures.

Introdução: Os doentes afectos de patologia psiquiátrica apresentam maior risco de morte, tanto por causas naturais como não naturais. Este estudo avalia as causas de morte de todos os doentes de uma unidade de internamento de agudos de Psiquiatria num hospital geral em Portugal, ao longo de dezasseis anos (de 1998 a 2013). Material e Métodos: Vinte e um doentes morreram na unidade de internamento de doentes agudos entre 1998 e 2013 (média 1,3 por ano). As características demográficas, os diagnósticos médicos e psiquiátricos foram recolhidos através de um estudo retrospectivo que consistiu na análise dos processos clínicos da amostra selecionada. Os doentes transferidos para outras enfermarias durante o internamento não foram incluídos no estudo. Resultados: As doenças do sistema circulatório foram as causas de morte mais prevalentes, ocorrendo em 2/3 dos doentes, incluindo embolismo pulmonar (n = 6), acidente vascular cerebral (n = 3), arritmia cardíaca (n = 2), enfarte agudo do miocárdio (n = 1), rutura de aneurisma da aorta abdominal (n = 1) e insuficiência cardíaca (n = 1). Dois doentes morreram de pneumonia e em quatro casos a causa de morte foi indeterminada. Apenas um caso de suicídio foi registado. Discussão: As doenças do aparelho circulatório foram as causas de morte mais frequentes nesta unidade de agudos. O suicídio em doentes internados, apesar de constituir um evento raro, é uma realidade que comporta consequências complexas para os profissionais de saúde, familiares e restantes doentes, devendo permanecer como foco de prevenção continuada. Conclusão: Os estudos de mortalidade são importantes para determinar a qualidade dos cuidados de saúde e criar recomendações para medidas preventivas.

The use of sensory perception indicators for improving the characterization and modelling of total petroleum hydrocarbon (TPH) grade in soils.

This paper proposes a multistep approach for creating a 3D stochastic model of total petroleum hydrocarbon (TPH) grade in potentially polluted soils of a deactivated oil storage site by using chemical analysis results as primary or hard data and classes of sensory perception variables as secondary or soft data. First, the statistical relationship between the sensory perception variables (e.g. colour, odour and oil-water reaction) and TPH grade is analysed, after which the sensory perception variable exhibiting the highest correlation is selected (oil-water reaction in this case study). The probabilities of cells belonging to classes of oil-water reaction are then estimated for the entire soil volume using indicator kriging. Next, local histograms of TPH grade for each grid cell are computed, combining the probabilities of belonging to a specific sensory perception indicator class and conditional to the simulated values of TPH grade. Finally, simulated images of TPH grade are generated by using the P-field simulation algorithm, utilising the local histograms of TPH grade for each grid cell. The set of simulated TPH values allows several calculations to be performed, such as average values, local uncertainties and the probability of the TPH grade of the soil exceeding a specific threshold value.

Tratamiento de la no unión ósea con clavo colchero / Treatment with Colchero's nail for bone nonunion

Se presentan 722 casos de no unión ósea (en tibia 344, en fémur 292 y en húmero 86) tratados por medio del clavo Colchero intramedular con pernos. En 382 pacientes el padecimiento fue aséptico y en 340 infectados por lo cual hubo que retirar la sepsis por el método de escarificación, para convertir la falta de unión en aséptica y dejarla preparada para la osteosíntesis. En las no uniones atróficas se utilizó hueso esponjoso autólogo y en las hipertróficas no hubo que recurrir a este procedimiento. La unión se logró con una cirugía en 720 casos, existiendo 2 no uniones que se volvieron a operar por el mismo método y se resolvieron. La marcha con apoyo total se inició a los tres días de la cirugía; con ello, la consolidación fue rápida, el enfermo pudo volver al trabajo pronto y a una vida social activa