Cognitive-behavioral therapy for treating hypertension: a systematic review and meta-analysis.

The aim of the study is to investigate whether cognitive behavioral therapy (CBT) can help in reducing blood pressure (BP) in patients with hypertension, both systolic blood pressure (SBP) and diastolic blood pressure (DBP), this being the primary outcome. This was a systematic review with a meta-analysis that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The keywords used for the searches were CBT and hypertension and their respective synonyms, and were applied to the Pubmed, EMBASE and Web of Science databases. Eligibility and data extraction were performed by two independent researchers. They assessed the risk of bias using the Cochrane's RoB 2 tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of the evidence. The data was pooled on the basis that all the analyses had a random effects model. Twenty-two studies were included in this review. In the meta-analysis, 11 studies were included in the analyses of the BP outcomes (SBP and DBP), five studies were included in the follow-up evaluation, and two studies in the body mass index (BMI) analysis. The searches included a total of 2897 patients. The studies presented a high risk of bias and very low quality of evidence. We observed an effect of -0.65 (95% CI: -0.91; -0.39) for CBT-based interventions on SBP with high heterogeneity (I2 85%) and a higher effect of -0.78% (95% CI: -1.13; -0.43) on DBP with even greater heterogeneity (I2 92%). We observed that CBT did have an effect on reducing BP and BMI in hypertensive adults. However, due to the considerable heterogeneity between the studies, the high risk of bias, and the low overall quality of evidence, confidence in these findings should be limited.

Evaluating the complete (44-item), short (20-item) and ultra-short (10-item) versions of the Big Five Inventory (BFI) in the Brazilian population.

The Big Five Inventory (BFI) is an instrument designed to assess the personality of individuals aged 18 and above. The original version consists of 44 items divided into five sub-scales representing each of the five personality factors: agreeableness, neuroticism, conscientiousness, openness, and extraversion. The main purpose of this study was to assess the factorial structure of the 44-item BFI and the reliability of two shorter versions with 20 and 10 items. The study also aimed to present normative data for interpreting scores from the short and ultrashort versions of the BFI for the Brazilian population. A total of 3565 individuals with a mean age of 33.3 years (SD = 13.0) from all Brazilian states participated in the study, with 44.2% from the State of Rio Grande do Sul. Participants completed a sociodemographic questionnaire and the BFI. Confirmatory factor analysis showed poor adaptation of the original 44-item model, but the short and ultrashort versions with 20 and 10 items respectively had good adaptation indexes and reliability, with Omega coefficients above 0.70. Normative data for the shorter versions were presented using mean, standard deviation, and percentiles (lower, medium, and higher). The study concluded that the short and ultrashort versions of the BFI have good reliability and can be used in surveys requiring a brief personality assessment.

Positive attributes in elderly people with different degrees of depression: a study based on network analysis.

INTRODUCTION: Depression in aging may lead to loss of autonomy and worsening of comorbidities. Understanding how positive attributes contribute to healthier and happier aging has been one of the purposes of Positive Psychology. However, the literature still lacks studies that evaluate how depression in the elderly is related to constructs considered positive. OBJECTIVE: The present study aimed comparing scores of constructs of spiritual well-being, social support, self-esteem, life satisfaction, affection, optimism, and hope in the elderly with minimal, mild, moderate, and severe depression and healthy controls in order to investigate possible indirect and mediated relationships between positive constructs and depression. METHODS: A cross-sectional study was conducted with elderly, 62 of whom were diagnosed with different severity of Major Depression (DSM-V) (minimum, mild, moderate, and severe according to the Beck Depression Inventory - BDI) and 66 healthy controls matched by age, sex and schooling. The instruments used were adapted and validated versions of the Spirituality Self-Rating Scale, the Rosenberg Self-Esteem Scale, the Medical Outcomes Social Scale of Support, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, the Revised Life Orientation Test, and the Adult Dispositional Hope Scale. After comparing the means of scores between groups, an analysis of normalized partial association networks was performed to investigate the direct and mediated relationships between depression and other evaluated constructs. RESULTS: Scores of spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affects, and hope differed significantly between the control group and the degrees of depression (p < 0.001). The analysis of normalized partial association networks has shown that the relations of depression with the constructs of life satisfaction, self-esteem, and social support are mediated, while the constructs of dispositional hope, positive affect, spiritual well-being, and optimism are indirectly related to depression. The social class was also positively related to depression. CONCLUSION: Depression in different degrees is associated with a reduction in the scores of instruments that evaluate positive attributes. The constructs directly associated with depression are spiritual well-being, optimism, positive affect, and dispositional hope. The others had mediated relationship. These results may contribute to the planning of future interventions for the prevention of depression among the elderly.

Internal Structure, Invariance, and Rasch Analyses: A Work-Life Integration-Blurring Scale.

The aim of the study was to develop a role blurring (RB) tool to measure work-life integration in different contexts. A final number of 19 items was examined. Psychometric properties in both Spanish and Brazilian Portuguese versions were analysed, comparing the invariance of the measure between the two countries, and setting the difficulty parameter of the items. Thus, a total of two incidental samples volunteered to participate in the study: a Spanish sample of n = 498 and a Brazilian sample of n = 379 were recruited. Confirmatory factor analysis (CFA), as well as an invariance analysis, were performed between the two countries, in order to test the homogeneity structure of the measure. In addition, the item response theory (IRT) was used to establish the probability of response and difficulty of the items through a Rasch analysis. The confirmatory factor analysis pointed to a unifactorial structure. There were no statistically significant alterations in the model fit indices, and the Rasch rating scale model (RSM) showed adequate infit and outfit values, as well as successive response categories located in the expected order for all items.

Smart Check - COVID-19 triage system: Evaluation of the impact on the screening time and identification of clinical manifestations of SARS-CoV-2 infection in a public health service.

INTRODUCTION: Most patients with COVID-19 have mild or moderate manifestations; however, there is a wide spectrum of clinical presentations and even more severe repercussions that require high diagnostic suspicion. Vital sign acquisition and monitoring are crucial for detecting and responding to patients with COVID-19. OBJECTIVE: Thus, we conducted this study to demonstrate the impact of using a tool called Smart Check on the triage time of patients with suspected COVID-19 and to identify the main initial clinical manifestations in these patients. METHODOLOGY: We assessed triage times before and after the use of Smart Check in 11 466 patients at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil, from 1 June to 31 July 2020. In this group, we identified 220 patients for the identification of COVID-19 clinical manifestations in a case-control analysis. RESULTS: Smart Check was able to decrease the triage time by 33 seconds on average (P < .001), with 75% of the exams being performed within 5 minutes, whereas with the usual protocol these steps were performed within 6 minutes. A range of clinical presentations made up the COVID-19 initial manifestations. Those with the highest frequency were dry cough (46.4%), fever (41.3%), dyspnoea (35.8%), and headache (31.8%). Loss of appetite was the manifestation that had a statistically significant association with the SARS-CoV-2 presence (univariate analysis). When analysed together, loss of appetite associated with dyspnoea and/or ageusia and/or fever was related to the diagnosis of COVID-19. CONCLUSIONS: Smart Check, a simple clinical evaluation tool, along with the targeted use of rapid PCR testing, can optimise triage time for patients with and without COVID-19. In triage centres, a number of initial signs and symptoms should be cause for SARS-CoV-2 infection suspicion, in particular the association of respiratory, neurological, and gastrointestinal manifestations.

A novel scale for suspicion of psychogenic nonepileptic seizures: development and accuracy.

OBJECTIVE: The differential diagnosis between epileptic and psychogenic nonepileptic seizures (PNES) is challenging, yet suspicion of PNES is crucial to rethink treatment strategies and select patients for diagnostic confirmation through video EEG (VEEG). We developed a novel scale to prospectively suspect PNES. METHODS: First, we developed a 51-item scale in two steps, based upon literature review and panel expert opinion. A pilot study verified the applicability of the instrument, followed by a prospective evaluation of 158 patients (66.5% women, mean age 33 years) who were diagnosed for prolonged VEEG. Only epileptic seizures were recorded in 103 patients, and the other 55 had either isolated PNES or both types of seizures. Statistical procedures identified 15 items scored between 0 and 3 that best discriminated patients with and without PNES, with a high degree of consistency. RESULTS: Internal consistency reliability of the scale for suspicion of PNES was 0.77 with Cronbach's Alpha Coefficient and 0.95 with Rasch Item Reliability Index, and performance did not differ according to the patient's gender. For a cut-off score of 20 (of 45) points, area under the curve was 0.92 (95% IC: 0.87-0.96), with an accuracy of 87%, sensitivity of 89%, specificity of 85%, positive predictive value of 77%, and negative predictive value of 94% (95% IC) for a diagnosis of PNES. CONCLUSIONS: The scale for suspicion of PNES (SS-PNES) has high accuracy to a reliable suspicion of PNES, helping with the interpretation of apparent seizure refractoriness, reframing treatment strategies, and streamlining referral for prolonged VEEG.

Findings on the relationship between Internet addiction and psychological symptoms in Brazilian adults.

This study evaluated the prevalence of Internet addiction (IA) and its association with negative psychological symptoms in Brazilian adults. A network analysis was conducted to estimate specific variables and their expected influence on IA. In this cross-sectional study, 15,476 adults (Mage  = 37.5, SD = 9.59) completed an open web-based survey. Three questionnaires were used: the Internet Addiction Test (IAT), Depression Anxiety and Stress Scale (DASS-21) and Satisfaction With Life Scale (SWLS). Based on IAT scores, participants were classified as No-Risk user (NRU), Low-Risk user (LRU) or High-Risk user (HRU). We observed that 4.8% of the participants were classified in the HRU group. In addition, their risk for severe symptoms of depression was 10 times higher and, for anxiety, seven times higher than that in the NRU group (p < .001). Time spent using smartphones was also significantly higher in the HRU group (Mhours  = 5.1, p < .001). The main factors associated with IA were depression, gender and anxiety, but the variable "having children" was the most influential in the IA network. These findings suggest that psychiatric symptoms are the main factors associated with IA among the adult population.

Validation Study of the Revised Version of the Scale of Prejudice Against Sexual and Gender Diversity in Brazil.

In Brazil, there is a deficit of culturally adapted tools to assess prejudice against sexual and gender diversity with empirically demonstrable validity and reliability. Prejudice against non-heterosexual orientations is a strong problem within Brazilian culture and is particularly related to nonnormative expressions of gender. To address these issues, a scale was created. The objective of this article is to validate the revised version of this instrument developed for the specificities of Brazilian culture and establish its reliability. The revised version of Scale of Prejudice Against Sexual and Gender Diversity (PASGD) was completed by 8,184 undergraduate students from southern Brazil. Analysis was conducted using the item response theory (IRT) model for rating scale data, criterion validity, and confirmatory factor analysis (CFA). The scale showed good validity and reliability. The results indicate that the PASGD is a useful tool for assessing prejudice in the Brazilian context, adapted for the local Brazilian reality.

Self-regulatory processes as mediators of the relationship between perceived partner responsiveness and prosocial organizational behaviors / Los procesos de autorregulación como mediadores de la relación entre la sensibilidad percibida en la pareja y comportamientos organizacionales prosociales

INTRODUCTION: The number of publications related to prosocial organizational behaviors (POB) increased in the past years. However, only a small number of studies focus on the intrapersonal process associated with these individual differences. GOALS: The present article investigated the mediation role that three self-regulatory processes (SRP) play on the relationship between POB and perceived partner responsiveness (PPR). METHOD: Participants were 206 Brazilian professionals (56 % women), with mean age of 34.4 years (SD = 9.16 years), hired in different organizations, who answered an online survey. Most participants worked in the services (31.1%) and industry (27.7%) fields. Data provided was analyzed using Structural Equation Modeling. Results: SRP help to understand the interpersonal relationships at the work place in their complexity. They also stress the need to help professionals to be aware of the existence of SRP and the ways in which they influence their behaviors. DISCUSSION: SRP might interfere significantly, for example, on how the PPR contributes to promote POB. CONCLUSIONS: Our findings encourage researchers to pay closer attention to the relationship between the constructs of PPR and POB in the future, and to explore other possible mediating or moderating variables within the larger social network of organizations.

INTRODUCCIÓN: El número de publicaciones relacionadas con los comportamientos organizacionales prosociales (POB) aumentó en los últimos años. Sin embargo, sólo un pequeño número de estudios se centran en el proceso intrapersonal asociado a las diferencias individuales. OBJETIVOS: El presente artículo investigó el papel de mediación que los procesos de autorregulación (SRP) juegan en la relación entre POB y la sensibilidad percibida en la pareja (PPR). MÉTODO: Fueron participantes 206 profesionales brasileños (56% mujeres), con edad media de 34,4 años (SD = 9.16 años), contratados por diferentes organizaciones, que respondieron a una encuesta en línea. La mayoría trabajaban en servicios (31,1%) e industria (27,7%). Los datos fueron analizados con modelos de ecuaciones estructurales. RESULTADOS: SRP ayudan a entender las relaciones interpersonales en el lugar de trabajo en su complejidad. También afirman la necesidad de ayudar a los profesionales a ser conscientes de la existencia de SRP y la forma en que influyen en sus comportamientos. DISCUSIÓN: SRP puede interferir significativamente, por ejemplo, sobre cómo el PPR contribuye a promover POB. CONCLUSIONES: Es necesario prestar más atención a la relación entre los constructos de PPR y POB en el futuro, y explorar otros de sus mediadores y moderadores en las organizaciones.