Cuidar na "Entrada na reforma": uma intervenção conducente à promoção da saúde de indivíduos e de famílias

ENQUADRAMENTO: Ao longo do ciclo vital, os indivíduos e as suas famílias estão em constante desenvolvimento. Os acontecimentos de vida transicionais, pelos fenómenos de mudança e adaptação que envolvem, são em grande parte responsáveis por esse processo e dada a vulnerabilidade em saúde a que os poderá expor; constituem momentos cruciais de intervenção para a Enfermagem (Meleis, 2010). A “entrada na reforma” constitui um desses acontecimentos que, quando não devidamente preparado, poderá pôr em causa o processo de envelhecimento activo (Fonseca, 2004a; Veríssimo, 2008). Estudar os efeitos que esta transição exerce nas vivências dos indivíduos e das suas famílias, ajudará a compreender a forma como esta poderá comprometer o envelhecimento e, simultaneamente, poderá trazer um conhecimento mais profícuo para aquele que deverá ser o cuidar de indivíduos e famílias num período da “entrada na reforma”. OBJECTIVO: Conhecer as vivências percepcionadas pelos indivíduos e suas famílias durante o processo de transição originado pela “entrada na reforma”, de forma a apresentar estratégias e linhas orientadoras de intervenção de Enfermagem, conducentes à promoção do seu estado de saúde. MÉTODO: O estudo foi desenvolvido em duas fases. Uma primeira, de carácter quantitativo, na qual foi aplicado um questionário a 432 indivíduos, que se encontravam aposentados há menos de cinco anos. A selecção da amostra foi conseguida pelo método “bola de neve” e os dados obtidos foram analisados com recurso ao programa SPSS17 e à técnica de análise de conteúdo de Bardin. Uma segunda fase, de carácter qualitativo, na qual foram entrevistadas 14 famílias de indivíduos que tinham percepcionado alterações e/ou dificuldades, na primeira fase deste estudo. A análise da informação sustentou-se num referencial teórico de interaccionismo simbólico e numa metodologia de investigação narrativa, contando com o auxílio do Nvivo8. RESULTADOS E DISCUSSÃO: As características sócio-demográficas, os motivos da aposentação e as expectativas que detinham relativamente à “entrada na reforma”, interferiram na forma como os indivíduos viveram a transição. Para os protagonistas, as principais alterações e/ou dificuldades percepcionadas na referida vivência foram a adaptação à alteração das rotinas diárias (26,5%), a dificuldade em ocupar o tempo (14,7%) e a diminuição do poder económico (14,0%) e as famílias constituíram a principal fonte de apoio (71,5%), para fazer face às mesmas. As famílias percepcionaram uma idêntica mudança e traduziram-na por uma dualidade de significados que se identificou com percepções de ganho e de perda, para as suas vidas. Os significados reaprender a “estar”, a “sentir” e a “ser”, traduziram o processo de adaptação a que estiveram sujeitos. IMPLICAÇÕES PARA A PRÁTICA DA ENFERMAGEM: Cuidar no período da “entrada na reforma” deverá obedecer a um modelo de intervenção muito próprio que se harmonize, não apenas com a singularidade dos indivíduos e famílias que protagonizam este acontecimento de vida, mas, também, e de forma muito particular, com a especificidade das mudanças que essa vivência transicional lhes possa vir a suscitar.

Novel critical phenomena in optimization driven processes on networks

The work presented in this Ph.D thesis was developed in the context of complex network theory, from a statistical physics standpoint. We examine two distinct problems in this research field, taking a special interest in their respective critical properties. In both cases, the emergence of criticality is driven by a local optimization dynamics. Firstly, a recently introduced class of percolation problems that attracted a significant amount of attention from the scientific community, and was quickly followed up by an abundance of other works. Percolation transitions were believed to be continuous, until, recently, an 'explosive' percolation problem was reported to undergo a discontinuous transition, in [93]. The system's evolution is driven by a metropolis-like algorithm, apparently producing a discontinuous jump on the giant component's size at the percolation threshold. This finding was subsequently supported by number of other experimental studies [96, 97, 98, 99, 100, 101]. However, in [1] we have proved that the explosive percolation transition is actually continuous. The discontinuity which was observed in the evolution of the giant component's relative size is explained by the unusual smallness of the corresponding critical exponent, combined with the finiteness of the systems considered in experiments. Therefore, the size of the jump vanishes as the system's size goes to infinity. Additionally, we provide the complete theoretical description of the critical properties for a generalized version of the explosive percolation model [2], as well as a method [3] for a precise calculation of percolation's critical properties from numerical data (useful when exact results are not available). Secondly, we study a network flow optimization model, where the dynamics consists of consecutive mergings and splittings of currents flowing in the network. The current conservation constraint does not impose any particular criterion for the split of current among channels outgoing nodes, allowing us to introduce an asymmetrical rule, observed in several real systems. We solved analytically the dynamic equations describing this model in the high and low current regimes. The solutions found are compared with numerical results, for the two regimes, showing an excellent agreement. Surprisingly, in the low current regime, this model exhibits some features usually associated with continuous phase transitions.

Phase transitions and nonlinear phenomena in neuronal network models

Communication and cooperation between billions of neurons underlie the power of the brain. How do complex functions of the brain arise from its cellular constituents? How do groups of neurons self-organize into patterns of activity? These are crucial questions in neuroscience. In order to answer them, it is necessary to have solid theoretical understanding of how single neurons communicate at the microscopic level, and how cooperative activity emerges. In this thesis we aim to understand how complex collective phenomena can arise in a simple model of neuronal networks. We use a model with balanced excitation and inhibition and complex network architecture, and we develop analytical and numerical methods for describing its neuronal dynamics. We study how interaction between neurons generates various collective phenomena, such as spontaneous appearance of network oscillations and seizures, and early warnings of these transitions in neuronal networks. Within our model, we show that phase transitions separate various dynamical regimes, and we investigate the corresponding bifurcations and critical phenomena. It permits us to suggest a qualitative explanation of the Berger effect, and to investigate phenomena such as avalanches, band-pass filter, and stochastic resonance. The role of modular structure in the detection of weak signals is also discussed. Moreover, we find nonlinear excitations that can describe paroxysmal spikes observed in electroencephalograms from epileptic brains. It allows us to propose a method to predict epileptic seizures. Memory and learning are key functions of the brain. There are evidences that these processes result from dynamical changes in the structure of the brain. At the microscopic level, synaptic connections are plastic and are modified according to the dynamics of neurons. Thus, we generalize our cortical model to take into account synaptic plasticity and we show that the repertoire of dynamical regimes becomes richer. In particular, we find mixed-mode oscillations and a chaotic regime in neuronal network dynamics.

Ecological quality assessment in transitional systems

Estuaries are poles of attraction for human settlement which is a source of pressures to surface water bodies. The implementation of the European Water Framework Directive (WDF, 2000/60/EC) has increased the investigation in order to develop methodologies to assess the Ecological Quality Status (EQS) of aquatic ecosystems. Transitional systems are naturally stressed and characterized by highly dynamic physical, chemical and hydro-morphologic conditions and by species with a higher level of tolerance to change, being more difficult to develop suitable quality indicators for these systems. The general purpose of this study is to test the ability of synthesis descriptors, including primary (S, taxa richness) and derived biological variable (H’, Shannon-Wiener diversity), biotic indices (AMBI and M-AMBI), body size properties (abundance distribution by body size classes, length, weight and length-weight relationships) and non-taxonomic indices (ISS), as well as functional indicators related to the decomposition rates of various experimental substrates, a macrophyte (Phragmites australis) and an alga (Fucus vesiculosus), to evaluate the environmental quality in transitional systems. This study was carried out in one of the most pristine channels of the Ria the Aveiro, Mira Channel, along a full salinity gradient and in a metals and metalloid sediment contamination area, the Estarreja Channel, and two reference channels (Canelas and Salreu). In this study were used different sampling techniques, the leaf-bag technique and a hand-held corer. In Mira Channel, the alga and the macrophyte presented an opposite trend in the decomposition rate along the salinity gradient, with the decomposition rates of the alga always higher than those of the macrophyte. The decomposition rates of the macrophyte and the alga were higher in the mid estuary and in higher salinity areas, respectively, corresponding to the preferencial distribution areas of each species. The macrobenthic fauna associated with the decaying and an artificial substrate (control) showed equally well the benthic succession from the marine to the freshwater areas and, despite the strong differences in the decay rates, no significant differences were found between the benthic communities associated with the alga and the macrophyte. The body size properties of the macrobenthic fauna associated with the P. australis leaf-bag (1mm and 5mm) and corer samples were studied along the full salinity gradient. The dominant species of the sub-set of measured specimens were not the same of the original macrobenthic fauna sampled but, despite that, the sub-set of measured specimens was also able to show the benthic succession from the marine to the freshwater areas. The body size abundance distribution of the benthic macroinvertebrates according to the ISS size classes did not show a particular trend in any sampler along the salinity gradient. Significant differences were found in the length, weight and length-weight relationships of Annelids, , Molluscs and even some species along the salinity gradient. No significant differences were found in the AMBI, M-AMBI and ISS values along the salinity gradient for all the samplers. The EQS of the corer samples obtained using the M-AMBI was lower than that of the leaf-bags. The EQS obtained with the ISS was higher than that obtained with the M-AMBI in the leaf-bags but not in the corer samples. The ecological effects of contaminated sediments associated with the industrial chemical effluents discharged in the Estarreja Channel were studied a decade after ceasing the emissions, using the Sediment Quality Triad approach and two reference channels. The results showed that despite the emissions ceased in 2004, the sediment remains polluted with high levels of metals and metalloid, available to bioaccumulation and with severe consequences at the community level. The sediment contamination problem was also studied using the leaf-bag technique with a macrophyte, an alga and a control substrate. The results showed that the decay rates, the associated macrofauna and the application of the AMBI, M-AMBI and ISS indices to the mesh-bag samples were not able to identify the sediment contamination. Contrarily to the AMBI, the M-AMBI and the ISS showed significant differences between the contaminated and the reference channels for the corer samples. Although such statistical significance, the interest of using these complex biotic indices could be questioned, when much simple ones, like the S and H’ allow to reach the same conclusions.

Modeling some real phenomena by fractional differential equations

This paper deals with fractional differential equations, with dependence on a Caputo fractional derivative of real order. The goal is to show, based on concrete examples and experimental data from several experiments, that fractional differential equations may model more efficiently certain problems than ordinary differential equations. A numerical optimization approach based on least squares approximation is used to determine the order of the fractional operator that better describes real data, as well as other related parameters.