Abstract. Background: Police officers, as first responders to difficult situations with ready access to firearms, are frequently considered to be at increased suicide risk. Aims: We aimed to calculate the suicide rate for male officers of the Portuguese National Police (PSP) and compare it with the Portuguese general population. Method: Retrospective review of the PSP male officers' suicides between 2005 and 2014 and comparison with the suicide rate for the general Portuguese population, adjusted for sex and age. Results: A total of 39 suicides were identified, with 34 using a firearm – mostly the service one (30 cases). The average truncated (20–59 years) suicide rate for male officers was 20.6 per 100,000 person-years (95% CI =14.2–27.1). Over the same period, the rate for the general Portuguese population was 13.9 per 100,000 person-years (95% CI = 13.5–14.3). The standardized rate ratio was 1.5 (95% CI = 0.9–2.4). Limitations: Despite the 10-year period of observation, this is a small sample and there are issues with missing data, such as lack of information for retired or dismissed police officers. Denominators were converted to estimates of person-years observations and we should be mindful of the limitations in the validity of the reported rates. Conclusion: Portuguese male police officers mostly die by suicide using service firearms. The suicide rates among them were not statistically different from those of the sex- and age-adjusted general population. However, given that police officers are healthy workers, we would expect lower rates – thus, similar rates could suggest an increased risk in the study sample.
Biological, sociocultural, demographic and environmental factors are major contributors to the contemporary burden of oncological diseases. Although cancer's current epidemiological landscape is fairly well known, its past occurrence and history seem more obscure. In order to test the hypothesis that paleopathological diagnosis is an adequate measure of the prevalence of malignant neoplasms in human remains, 131 skeletons (78 females, 53 males, age-at-death range: 15-93 years) from Coimbra and Lisbon Identified Skeletal Collections, 19th/20th century (Portugal), were examined. The cause of death for all of the selected skeletons was a malignant neoplasm, as recorded in the collection's documental files. Through the application of standard paleopathological protocols, it was determined that 17.6% (n = 23) of the skeletons had unequivocal osseous signs of metastatic and/or neoplastic lesions. Forty-five percent (n = 59) had manifest osseous lesions, however the lesional patterns were not clearly pathognomonic. Although all of the analyzed individuals were documented as having succumbed to malignant neoplastic disease, a total of 37.4% (n = 49) of the individuals did not exhibit osseous abnormalities. Individuals with breast cancer often exhibited lesions. This study presents a quantitative estimate of the accuracy of paleopathological diagnosis; as well as a theoretical reflection on the burden of cancer in the past. We emphasize the need for a paradigm shift while thinking about the future of paleo-oncology.
Introduction: The aim of this study was to conduct a systematic review in order to examine the effectiveness of ozone therapy on knee osteoarthritis. The objectives were to evaluate the effect over time of ozone therapy in terms of knee pain, functional improvement and radiographic progression.Material and Methods: A search was carried out on PubMed, Embase, Cochrane Library, Scopus and Web of Science databases to identify randomized and controlled studies focusing on this association. The following descriptors were used in English: ozone therapy, knee osteoarthritis. A descriptive summary and quality assessment was made of all studies included for analysis.Results: Six randomized and controlled studies were identified. The risk of bias assessment demonstrated that one study was considered as having a moderate risk of bias and the remainder a high risk of bias. No quantitative analysis of the data was performed, as the studies included were not sufficiently homogeneous. The participants in the studies were generally elderly patients with mild to moderate knee osteoarthritis.Discussion: The variability of ozone therapy and the comparators demonstrates that there is no standardized therapy. Few studies reported adverse effects, and where they occurred, they were mild and associated with the procedure.Conclusion: Ozone therapy proved effective in the short-term in relation to placebo and when combined with hyaluronic acid, but it was not superior to other current treatments. More randomised and controlled studies are needed to evaluate the risks/benefits of ozone therapy, both in the short term and the medium/long term.
A better training in psychotherapy is needed for psychiatry trainees. Online Cognitive Behavioural Therapies (CBT) could be a good solution. Free and wide audience course like Massive Open Online course (MOOCs) increase dissemination and accessibility of the training. However, the engagement needs to be improved. A hybrid approach seems relevant with the MOOC as an incentive. Beyond the promotion of the topic, a MOOC can be a promotion tool for the provider. The economic model of the MOOC needed to be taken into account to allow sustainability. To explore these elements, we take into account a survey taken during the 1st European Psychiatric Association MOOC about CBT.
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