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Learn about the state-of-the-art at the interface between information theory and data science with this first unified treatment of the subject. Written by leading experts in a clear, tutorial style, and using consistent notation and definitions throughout, it shows how information-theoretic methods are being used in data acquisition, data representation, data analysis, and statistics and machine learning. Coverage is broad, with chapters on signal acquisition, data compression, compressive sensing, data communication, representation learning, emerging topics in statistics, and much more. Each chapter includes a topic overview, definition of the key problems, emerging and open problems, and an extensive reference list, allowing readers to develop in-depth knowledge and understanding. Providing a thorough survey of the current research area and cutting-edge trends, this is essential reading for graduate students and researchers working in information theory, signal processing, machine learning, and statistics.
The fibrous scaffolds for bone tissue engineering that mimic the extracellular matrix with bioactive and bactericidal properties could provide adequate conditions for regeneration of damaged bone. Electrospun ultrathin fiber covered with nano-hydroxyapatite is a favorable fibrous scaffold design. We developed a fast and reproducible strategy to produce polyvinylidene fluoride (PVDF)/nano-hydroxyapatite (nHAp) nanofibrous scaffolds with bactericidal and bioactive properties. Fibrous PVDF scaffolds were obtained first by the electrospinning method. Then, their surfaces were modified using oxygen plasma treatment followed by electrodeposition of nHAp. This process formed nanofibrous and superhydrophilic PVDF fibers (133.6 nm, fiber average diameter) covered with homogeneous nHAp (202.6 nm, average particle diameter) crystals. Energy-dispersive X-ray spectrometry demonstrated the presence of calcium phosphate, indicating a Ca/P molar ratio of approximately 1.64. X-ray diffraction, Fourier transform infrared spectroscopy, and Raman spectroscopy spectra identified β-phase of nHAp. Thermal analysis indicated a slight reduction in stability after nHAp electrodeposition. Bactericidal assays showed that nHAp exhibited 99.8% efficiency against Pseudomonas aeruginosa bacteria. The PVDF/Plasma and PVDF/nHAp groups had the highest cell viability, total protein, and alkaline phosphatase activity by 7 days after exposure of the scaffolds to MG63 cell culture. Therefore, the developed scaffolds are an exciting alternative for application in bone regeneration.
Background: Loss of a spouse is a frequent occurrence in later life, with about 10% of the individuals finding themselves unable to cope and progressing to prolonged grief, risking further mental and physical problems.
Objective: The development and implementation of an online grief program, such as LEAVES (optimizing the menta L hEalth and resilience of older Adults that haVe lost th Eir spou Se via blended, online therapy), intends to improve prevention and treatment of prolonged grief, so that elderly mourners can continue to lead an active, meaningful and dignified life.
Methods: The LEAVES program, a project under AAL (Active and Assisted Living) 2019 Call for Sustainable Smart Solutions for Ageing Well, is in development by an international consortium and integrates academical, clinical and technical experts. The project will take place between February 2020 and January 2023 and involve real-life evaluation of 315 end-users. The Psychiatric Department at the Health Unit of Baixo Alentejo (ULSBA) will offer the service to its primary users, blending online services with telephone, video calls and face-to-face sessions. Widowed older adults >65 that express the need for help in mourning their spouse will be recruited in the community as well as via the geriatric psychiatry team and primary care.
Results: With LEAVES program we aim for older adults to process the loss of a spouse in a blended online/presential environment, detecting olders at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The evaluation will focus on wellbeing and involve several measures to assess grief symptoms, loneliness, hopelessness, satisfaction and quality of life. Conclusions: ULSBA will use LEAVES to improve clinical practice on preventing and managing prolonged grief as well as, after testing and validating it in this project, to save economical costs and improve effectiveness, both to hospital and patients.
This is a cross-sectional analysis of data obtained in the baseline of the Longitudinal Study on the Lifestyle and Health of University Students (n 685) carried out in a public Brazilian university. Food intake was assessed using a 24-h dietary recall. Dietary patterns (DP) for breakfast, lunch and dinner were identified using principal component analysis. Generalised linear models were used to analyse the variables associated with each DP. Three DP were extracted for each meal: breakfast: ‘White bread and butter/margarine’, ‘Coffee and tea’ and ‘Sausages, whole wheat bread and cheese’; lunch: ‘Traditional’, ‘Western’ and ‘Vegetarian’ and dinner: ‘Beans, rice and processed juice’, ‘White bread and butter/margarine’ and ‘White meat, eggs and natural juice’. Students who had meals at the campus showed greater adherence to the ‘White bread and butter/margarine’ (exp (βadj) = 1·15, 95 % CI 1·11, 1·19) and ‘Coffee and tea’ (exp (βadj) = 1·06, 95 % CI 1·02, 1·10) breakfast patterns; ‘Western’ lunch pattern (exp (βadj) = 1·04, 95 % CI 1·01, 1·08) and to the ‘Beans, rice and processed juice’ dinner pattern (exp (βadj) = 1·10, 95 % CI 1·06, 1·14). Having meals at the campus was associated with lower adherence to the ‘Sausages, whole wheat bread and cheese’ breakfast pattern (exp (βadj) = 0·93, 95 % CI 0·89, 0·97), ‘Traditional’ lunch pattern (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) and to the ‘White bread and butter/margarine’ (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) and ‘White meat, eggs and natural juice’ (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) dinner pattern. The food environment at campus may influence students’ DP. Recognising meal eating patterns is important to support healthy eating promotion strategies on campus. Adjustments in the University Canteen menu could contribute to healthier eating choices among students.
The production of beef cattle in the Atlantic Forest biome mostly takes place in pastoral production systems. There are millions of hectares covered with pastures in this biome, including degraded pasture (DP), and only small area of the original Atlantic Forest has been preserved in tropics, implying that actions must be taken by the livestock sector to improve sustainability. Intensification makes it possible to produce the same amount, or more beef, in a smaller area; however, the environmental impacts must be assessed. Regarding climate change, the C dynamics is essential to define which beef cattle systems are sustainable. The objectives of this study were to investigate the C balance (t CO2e./ha per year), the intensity of C emission (kg CO2e./kg BW or carcass) and the C footprint (t CO2e./ha per year) of pasture-based beef cattle production systems, inside the farm gate and considering the inputs. The results were used to calculate the number of trees to be planted in beef cattle production systems to mitigate greenhouse gas (GHG) emissions. The GHG emission and C balance, for 2 years, were calculated based on the global warming potential (GWP) of AR4 and GWP of AR5. Forty-eight steers were allotted to four grazing systems: DP, irrigated high stocking rate pasture (IHS), rainfed high stocking rate pasture (RHS) and rainfed medium stocking rate pasture (RMS). The rainfed systems (RHS and RMS) presented the lowest C footprints (−1.22 and 0.45 t CO2e./ha per year, respectively), with C credits to RMS when using the GWP of AR4. The IHS system showed less favorable results for C footprint (−15.71 t CO2e./ha per year), but results were better when emissions were expressed in relation to the annual BW gain (−10.21 kg CO2e./kg BW) because of its higher yield. Although the DP system had an intermediate result for C footprint (−6.23 t CO2e./ha per year), the result was the worst (−30.21 CO2e./kg BW) when the index was expressed in relation to the annual BW gain, because in addition to GHG emissions from the animals in the system there were also losses in the annual rate of C sequestration. Notably, the intensification in pasture management had a land-saving effect (3.63 ha for IHS, 1.90 for RHS and 1.19 for RMS), contributing to the preservation of the tropical forest.
Accurate estimates of methane (CH4) production by cattle in different contexts are essential to developing mitigation strategies in different regions. We aimed to: (i) compile a database of CH4 emissions from Brazilian cattle studies, (ii) evaluate prediction precision and accuracy of extant proposed equations for cattle and (iii) develop specialized equations for predicting CH4 emissions from cattle in tropical conditions. Data of nutrient intake, diet composition and CH4 emissions were compiled from in vivo studies using open-circuit respiratory chambers, SF6 technique or the GreenFeed® system. A final dataset containing intake, diet composition, digestibility and CH4 emissions (677 individual animal observations, 40 treatment means) obtained from 38 studies conducted in Brazil was used. The dataset was divided into three groups: all animals (GEN), lactating dairy cows (LAC) and growing cattle and non-lactating dairy cows (GCNL). A total of 54 prediction equations available in the literature were evaluated. A total of 96 multiple linear models were developed for predicting CH4 production (MJ/day). The predictor variables were DM intake (DMI), gross energy (GE) intake, BW, DMI as proportion of BW, NDF concentration, ether extract (EE) concentration, dietary proportion of concentrate and GE digestibility. Model selection criteria were significance (P < 0.05) and variance inflation factor lower than three for all predictors. Each model performance was evaluated by leave-one-out cross-validation. The Intergovernmental Panel on Climate Change (2006) Tier 2 method performed better for GEN and GCNL than LAC and overpredicted CH4 production for all datasets. Increasing complexity of the newly developed models resulted in greater performance. The GCNL had a greater number of equations with expanded possibilities to correct for diet characteristics such as EE and NDF concentrations and dietary proportion of concentrate. For the LAC dataset, equations based on intake and animal characteristics were developed. The equations developed in the present study can be useful for accurate and precise estimation of CH4 emissions from cattle in tropical conditions. These equations could improve accuracy of greenhouse gas inventories for tropical countries. The results provide a better understanding of the dietary and animal characteristics that influence the production of enteric CH4 in tropical production systems.
The research described in this technical research communication examines the hypothesis that sublethal stress conditions can improve the survival of Lactococcus lactis subsp. lactis during drying and subsequent storage. After drying, the L. lactis that had adapted to acid or osmotic stresses did not differ statistically in terms of cell viability loss compared to the control samples tested (~0.38 log cycles). However, the cells that had adapted to oxidative conditions demonstrated a cell viability loss of only 0.01 log cycles. After 45 d of storage at temperatures of 4 and 25 °C, the final L. lactis sample populations were shown to be higher (112.5%) when they had been submitted to sublethal conditions of oxidative stress. When the cell samples were exposed to acid stress conditions, they exhibited a viability loss (0.82 log cycles) that was statistically different from the control sample (0.58 log cycles) after 45 d. Osmotic stress conditions did not demonstrate any influence over cell survival rates. Thus, submitting cells to oxidative stress conditions prior to storage has been shown to be a potential strategy for producing dehydrated cultures of L. lactis strains that are less sensitive to oxygen exposure.
Persistent methicillin-resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis (CF) patients has been associated with a more rapid decline in lung function, increased hospitalisation and mortality. The aim of this study was to evaluate the clonal relationships among 116 MRSA isolates from 12 chronically colonised CF pediatric patients over a 6-year period in a Rio de Janeiro CF specialist centre. Isolates were characterised by antimicrobial resistance, SCCmec type, presence of Panton-Valentine Leukocidin (PVL) genes and grouped according to DNA macrorestriction profile by pulsed-field gel electrophoresis (PFGE) and spa gene type. High resistance rates were detected for erythromycin (78%) and ciprofloxacin (50%) and SCCmec IV was the most common type (72.4%). Only 8.6% of isolates were PVL positive. High genetic diversity was evident by PFGE (39 pulsotypes) and of nine that were identified spa types, t002 (53.1%) and t539 (14.8%) were the most prevalent. We conclude that the observed homogeneity of spa types within patients over the study period demonstrates the persistence of such strain lineages throughout the course of chronic lung infection.
Microencapsulation of functioning cells for transplantation therapies is particularly promising, but the cells must retain their proper physiology and viability after being encapsulated. K-562 cells are multipotential and exhibit erythroid, megakaryocytic, or granulocytic properties that can be exploited by using an array of physiologically differentiating factors. The potential for cell differentiation makes it attractive the use of K-562 cells as functional model to the assessment of the effects of encapsulation on cell viability and physiology. Thus, alginate and hybrid alginate matrices were produced by extrusion technique for K-562 cell encapsulation. The produced systems were composed of bare alginate (1–3 wt%) and alginate in combination with chitosan or silica. The resulting materials were characterized by dynamic laser scattering, zeta potential measurements, small-angle X-ray scattering, and Fourier transform infrared spectroscopy. To assess viability, the encapsulated cells were subjected to the Trypan blue exclusion technique and NAD(P)H-dependent oxidoreductase (MTT) assays; hemin-induced erythroid differentiation capacity was also evaluated. The encapsulated alginate-based systems were shown to be monomodal and bimodal, depending on the nature of the capsule, with mean sizes in the range between 414 and 4.129 nm. Encapsulated cells exhibited viability ratios compatible with their use for prolonged cell cultures. Erythroid differentiation occurred in the range between 39 and 44%. The present results allow the consideration of the viability of therapeutic cells encapsulated in both bare alginate and in hybrid matrices.
Constitutive heterochromatin typically exhibits low gene density and is commonly found adjacent or close to the nuclear periphery, in contrast to transcriptionally active genes concentrated in the innermost nuclear region. In Triatoma infestans cells, conspicuous constitutive heterochromatin forms deeply stained structures named chromocenters. However, to the best of our knowledge, no information exists regarding whether these chromocenters acquire a precise topology in the cell nuclei or whether their 18S rDNA, which is important for ribosome function, faces the nuclear center preferentially. In this work, the spatial distribution of fluorescent Feulgen-stained chromocenters and the distribution of their 18S rDNA was analyzed in Malpighian tubule cells of T. infestans using confocal microscopy. The chromocenters were shown to be spatially positioned relatively close to the nuclear periphery, though not adjacent to it. The variable distance between the chromocenters and the nuclear periphery suggests mobility of these bodies within the cell nuclei. The distribution of 18S rDNA at the edge of the chromocenters was not found to face the nuclear interior exclusively. Because the genome regions containing 18S rDNA in the chromocenters also face the nuclear periphery, the proximity of the chromocenters to this nuclear region is not assumed to be associated with overall gene silencing.
Social Anxiety Disorder (SAD) is a psychiatric co-morbidity commonly related to Parkinson's disease (PD). However, the real nature of this association is still unknown. The objective of the present study was to determine the prevalence of SAD in patients with a diagnosis of PD.
Eighty-seven consecutive patients with a diagnosis of PD and no associated dementia were evaluated at a movement disorder outpatient clinic. The patients were independently interviewed using the SCID-IV for DSM-IV.
Patient age ranged from 24 to 85 years (mean: 60.7 years) (+13.2). Forty-five patients (51.7%) were women and 42 (48.3%) were men. The lifelong prevalence of SAD was 32.2%. However, only 16.1% presented this anxiety disorder before the beginning of PD. The prevalence of SAD with onset after PD, i.e., secondary to a movement disorder, was 16.1%, with no sex differences in SAD prevalence among PD patients.
The high rate of SAD among PD patients detected in the present study (32.1%) is comparable to those reported in other countries. However, the prevalence of patients who presented SAD before the onset of PD (16.1%) was similar to that reported for the general population. Thus, the present results suggest that the high rates of SAD among PD patients reported in the literature are due to afraid to be judged in a negative manner in public due to their tremors and other aspects of PD, rather than being related to a specific neurobiological process occurring in this movement disorder.
The progressive aging of the population in contemporary societies leads to the necessary adjustment to the responses of health care services. The project The Oldest Old: Coimbra aging study (PTDC/CS-SOC/114895/2009) assesses an elderly population enrolled in Health Centres of Coimbra - Portugal. The QAFMI/OARS is recognized as the first elderly multidimensional assessment, being one of the areas the mental health.
Assess the use/need of health and social services by the elderly, related with their functional status in five areas (social resources, economic resources, mental health, physical health and activities of daily living).
Assess the use/need felt for health and social services by the elderly, related with the functional status in mental health.
Quantitative methodology using the QAFMI/OARS. The sample consisted of individuals aged 75, or more, randomly selected and representative of Coimbra’s elder residents (N=11279; n=1128). Mental health status was evaluated using the Short Portable Mental Status Questionnaire, the Short Psychiatric Evaluation Schedule and a self-evaluation.
Preliminary results showed that in physical health, ADL and economic resources there are significant differences between age groups. In mental health, there is a significant difference classification between genders, with a tendentiously lower score in women. In social resources, there is a significant difference classification between gender and age group.
The work developed with OARS/QAFMI lead us to consider this instrument very useful to define functional status of the elders in specific evaluation areas as mental health, becoming right to the planning of older care services.
Mental health literacy is an emergent research area in the fields of health promotion and mental illness prevention in communitarian environment, considered one relevant variable in the professional help-seeking behavior.
Evaluate the mental health literacy of Portuguese adolescents and youth concerning depression and schizophrenia; - Identify the contribute of the social demographic variables in mental health literacy.
Characterize the mental health literacy of adolescents and youth with the aim of create health promotion and mental illness prevention programs.
Descriptive-correlational study. Sample of 671 students, randomly selected of Portuguese schools. 294 of male gender and 323 of female gender, with an average age of 15,20 (sd = 1,84 years). The data were collected with the Mental Health Literacy Evaluate Questionnaire (Loureiro, Pedreiro and Correia, 2011). The data were analyzed using the IBM-SPSS 20.
Only 47,81% correctly identifies depression and 22,04% schizophrenia. Besides gender (p = 0,002), the familiarity with the mental illness and the socio demographic variables weren?t related to the recognition of the disorders.
The low levels of mental health literacy are a problem and a challenge, since they are associated with prejudiced and stigmatizing visions of the diseases and the ill with implications in the professional help-seeking behavior. The planning of programs should be alert since the adolescents and youth are the group with less interaction with the health system.
Barahona Fernandes (1907-1992) is considered one of the most distinguished portuguese psychiatrists and perhaps the most known outside the country. He did part of his studies in Germany, under orientation of prominent professors such as Carl Kleist and Kurt Schneider, and got contact with the philosophic theories of Karl Jaspers and Nicolai Hartmann. In Portugal, he leaded the Lisbon University Clinic where he developed his countless studies on mental health.
The authors shortly revisit the biography and some aspects of Barahona Fernandes’ works.
This communication points out the singularities of his personality and work, and draws attention to the importance of his contributions on mental health.
Review of the literature concerning the author’s publications and biography.
Through his whole work emerges the effort in a “converging view” that tries to integrate different influences and perspectives, in order to better achieve a coherent explanation of the human being. One of his theoretical models discusses the Personality - “Personalidade em Situaao” - in which he describes a complex organization based on comunicating hierarchical layers (from a biological foundation to a more noologic apex), subject to the interaction with the environmental features, in a homeostatic balance that can be disturbed.
The unique work of Barahona Fernandes constitutes an important material to apprehend the psychic experience. His “converging” theories try to capture a multi-dimensional structure of the human being and help clinicians to get a deeper understanding on the process of getting mentally ill
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
In the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
Fifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
Results show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
The World Health Organization recognizes the gender as an ageing determinant. Thus, apart from biological differences, there is a need of a gender approach in health that includes an analysis of how differences in gender roles affect the health status.
To assess the functional status in two areas of the elderly's life (mental and physical health), analyzing the impact of gender as a determinant of health in aging.
Quantitative and descriptive study. Probabilistic sample stratified by age, gender and area of residence, constituted by 1153 older persons aged ≥75 years (N=16474), consisting of 422 men (36.6%) and 731 women (63.4%). The instrument for data collection was the Questionário de Avaliação Funcional Multidimensional para Idosos/Older Americans Resources and Services (QAFMI/OARS).
With regard to gender differences in the areas of physical and mental health the results evaluated with the QAFMI/OARS model stand women with worse scores in this two functional areas. Although men, and especially the older age group, mentioned that have had more need for a physician visit. Related to mental health the self-evaluation is worse in women, and also in the assessment of the QAFMI/OARS model, were it was a notorious difference between genders, observing a decline in mental health among women.
The feminization of aging implies an adequate public policies and the organization of health services, and social support, based on the understanding of the differences between aging as a man and as woman.
Compassion can be defined as an intentional sensitivity to the suffering, with a motivation and commitment to try to relieve it, which can have a positive impact on individuals’ emotional and psychological well-being. The relevance of compassion focused therapies is well established and this makes the development of reliable instruments for the assessment of the different facets of compassion targeting different age groups crucial for research and clinical practice. The Compassionate Attributes and Actions Scale (CAAS) aims to assess compassion on three directions: self-compassion, compassion for others or compassion received from others. Each of the scales assesses one's compassionate attributes and compassionate actions separately when dealing with difficult or painful situations.
This study aimed to adapt the CAAS for adolescents and to explore its factor structure and psychometric properties in a sample of Portuguese adolescents.
A total of 336 Portuguese adolescents with ages ranging from 12 to 19 years old participated in the study. Several exploratory factor analyses were conducted.
Exploratory factor analysis showed that, except for the attributes section of the self-compassion scale (that showed to be bi-factorial), all the other scales (and their sections) presented a single-factor structure. The three scales, and its sections, demonstrated a good reliability and excellent test-retest reliability and good convergent and discriminant validity.
Results were in line with the factor structure found in the adults’ version. The scales and its sections have shown good psychometric characteristics and constitute a useful instrument to assess and investigate the three directions of the compassion.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Erotomania, or De Clerambault's Syndrome, was first described in 1921. However, cases of Insane Love were long known before. Presently, this condition is classified as a delusional disorder typically affecting women. However, in forensic samples, most of these reports relate to men with violent behaviour, associated to harassing or stalking of a woman.
To present the case of a man, diagnosed with Erotomania and literature review of similar cases.
To bring awareness to the infrequent diagnosis of this condition in males and the legal implications this condition may have.
Consultation of the patient's clinical process and published articles focusing on Erotomania in men.
A 50-year-old man was referred from Court for persistently stalking a woman on the past few years. He revealed erotomanic and persecutory delusions, believing these accusations were all part of a scheme to restrain his alleged relationship.
There was a clinical improvement during hospitalization and treatment with antipsychotics. Due to the legal process in court, a forensic examination was also performed.
On the follow-up, the patient remained stabilized. He would not verbalize any delusional content, and calmly deny any inadequate behaviour. However, some of his stalking attitude remains. As many of these patients, we believe his delusion is still present, although his behaviour is more controlled with treatment. Recognizing the characteristics and course of this disorder in our patients, grants a better chance of intervention and attentiveness towards the legal implications that may arise.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Lyme disease, caused by the spirochete Borrelia burgdorferri as recognized as a possible cause of multisystemic signals and symptoms, including symptomatology of the central as well as the peripheral nervous system.
Identification of neuropsychiatric symptoms associated with Lyme disease.
Literature review in the light of researched articles published in Pubmed/Medline as well as related bibliography.
Since the identification of the etiology of syphilis in the early twentieth century, mental health professionals consider the fact that serious psychiatric symptoms can be caused by infections of the central nervous system and that early antibiotic treatment can prevent permanent neurological/psychiatric damage. Syphilis was known as “the great imitator” because its multiple manifestations mimic other known diseases. In recent years, a new epidemic, also with multiple manifestations emerged–Lyme disease, also known as the “new great imitator”. Like syphilis, Lyme disease may be associated with neuropsychiatric symptoms, which means that often these cases are initially referred for psychiatric services, before another diagnosis is made. The incorrect assessment of these patients as individuals with functional psychiatric disease can result in a delay in the start of antibiotic treatment and may cause serious neurological and psychiatric damage.
According to the review, the authors propose that in the evaluation of acute psychiatric disease or atypical chronic disease, with poor therapeutic response, Lyme disease should be considered and ruled out, especially if there is epidemiological context and absence of psychiatric family antecedents.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Population aging is an issue increasingly gaining more prominence, as evidenced by the number of inquiries regarding the “problems” that this entails for society. This leads to a need to understand the role of caregiver for the elderly as the central figure of support in old age.
The purpose of this study was to describe formal caregivers’ perceptions of working conditions, difficulties and factors associated with quality of care in a Portuguese home-based care for elderly.
The participants were 8 formal caregivers whose profession falls under the categories of Direct Action Helper and Auxiliary Workers. The data were collected through individual face-to-face interviews and analysed using a content analysis following Bardin's method.
The results show that the sample is female, aged from 32 to 53 years, with a professional exercise time between 8 and 16 years. Regarding the main conclusions of our research, we can say that our group of participants has a strong sense of team work which contributes to avoid situations of physical and emotional exhaustion; mostly caregivers can separate their personal and professional lives; there are some difficulties in communication between the caregivers and the elderly, however the most difficult situations are usually overcome due to the caregiver's understanding of the characteristics of institutionalized elderly; the matter of death is frequently seen as the most difficult situation to face.
The caregivers should have an awareness of the importance of kindness and respect, supporting positive thoughts and help the older people to retain control over their lives.
Disclosure of interest
The authors have not supplied their declaration of competing interest.