Aspectos psicossociais associados à percepção da dor pós-operatória em indivíduos submetidos a cirurgia coronária

Objectivo: Identificar os factores psicossociais que influenciam a percepção da dor pós-operatória em doentes submetidos a cirurgia de revascularização do miocárdio (CRM). Material e Métodos: Estudo exploratório correlacional de 91 doentes (71 homens e 20 mulheres) submetidos a CRM (pontagem aortocoronária) por esternotomia). A idade média era de 63,8 ± 9,6 anos (entre 39 e 84). Foram utilizados os seguintes instrumentos: Escala Analógica Visual às 24, 48 e 96 horas do pós-operatório; Questionário de Caracterização Demográfica; Mental Health Inventory de 5 itens; Percepção de Saúde Geral (SF-36); Escala de Expectativas de Dor; Escala de Percepção de Apoio; Escala de Expectativas de Auto-eficácia; Satisfação com o tratamento, médicos e enfermeiros (American Pain Society Questionnaire) aplicados às 96 horas após a cirurgia. Resultados: Os doentes que apresentaram expectativas elevadas de dor, percepcionaram maior apoio, apresentaram níveis elevados de auto-eficácia para lidar com a dor ou, se pertenciam ao sexo masculino, sentiram menos dor. De igual modo, os doentes que apresentaram melhor saúde mental, percepcionaram a sua saúde como boa e os doentes que expressaram maior satisfação com o tratamento sentiram menos dor. A dor não foi influenciada pela idade, grau de escolaridade ou pela satisfação com a conduta de médicos e enfermeiros. Conclusão: Após as primeiras 48 horas do pós-operatório, a experiência de dor é influenciada por factores psicossociais, em oarticular pela expectativa de dor, expectativa de auto-eficácia, apoio percebido, percepção da saúde geral, percepção de saúde mental e satisfação com o tratamento para a dor. Perante os resultados, evidencia-se a necessidade de conjugar conhecimentos no sentido de dar respostas mais alargadas e de carácter multidisciplinar no tratamento da dor pós-operatória em CRM devendo, a par de outros aspectos, focar-se na gestão das expectativas dos doentes. ABSTRACT - Objective: To identify the psychological factors that influence post-surgery pain perception in patients undergoing coronary artery bypass graft surgery (CABG). Methods: This was an exploratory correlational study of 91 patients (71 men and 20 women) who underwent CABG (aortocoronary anastomosis) by sternotomy. Mean age was 63.8 ± 9.6 years (between 39 and 84). The following instruments were used: visual analogical scales at 24, 48 and 96 hours of post-surgery; demographic characteristics survey; pain expectations scale; perceived support scale; self-efficacy scale, Mental Inventory (5 items); health perception scale; and satisfaction with treatment, doctors and nurses (American Pain Society questionnaire) at 96 hours after surgery. Results: Patients who had presented high expectations of pain, perceived more support, presented high levels of self-efficacy to deal with pain or were male, felt less pain. Furthermore, patients who presented better mental health, perceived their general health as being good, or expressed greater satisfaction with treatment, felt less pain. Pain was not influenced by age, level of education or satisfaction with doctors and nurses. Conclusion: After the first 48 hours following surgery, the pain experience is influenced by psychosocial factors, in particular by expectation of pain and of self-efficacy, perceived support, perception of general and mental health, and satisfaction with pain treatment. The results confirm the need to bring together different kinds of knowledge for a broad, multidisciplinary approach to postoperative CABG pain treatment, focusing, along with other aspects, on management of patients’ expectations.

Environmental sustainability in superior education: case study of Lisbon College of Health Technology

Over the centuries there has been a growing trend of societies and it is possible to verify their economic growth. This growth has provided an increased pressure on natural resources, often over-reaching the boundaries of each country, which has called into question the level of environmental sustainability in different countries. Sustainability is understood as a complex concept involving ecological, social, economic dimensions and temporal urban processes. Therefore, Firmino (2009) suggests that the ecological footprint (EF) allows people to establish dependency relations between human activities and the natural resources required for such activities and for the absorption of waste generated. According to Bergh & Verbruggen (1999) the EF is an objective, impartial and one-dimensional indicator that enables people to assess the sustainability. The Superior Schools have a crucial role in building the vision of a sustainable future as a reality, because in transmitting values and environmental principles to his students, are providing that they, in exercising his professional activity, make decisions weighing the environmental values. This ensures improved quality of life. The present study aims to determine the level of environmental sustainability of the Academic Community of Lisbon College of Health Technology (ESTeSL), by calculating the EF, and describe whether a relation between Footprint and various socio-demographic characteristics of the subjects.

Avaliação da satisfação dos utentes dos serviços farmacêuticos da Unidade Local de Saúde do Norte Alentejano

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde.

Adesão à terapêutica como determinante da efectividade dos cuidados de saúde: a problemática da não adesão à terapêutica em doentes submetidos a angioplastia transluminal percutânea coronária

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde.

O evento desencadeador do empreendedorismo : a proposta de Bygrave aplicada aos empreendedores portugueses

Mestrado em Gestão e Empreendedorismo

Epidemiology of malaria, schistosomiasis, geohelminths, anemia and malnutrition in the context of a demographic surveillance system in Northern Angola

Background: Malaria, schistosomiasis and geohelminth infection are linked to maternal and child morbidity and mortality in sub-Saharan Africa. Knowing the prevalence levels of these infections is vital to guide governments towards the implementation of successful and cost-effective disease control initiatives. Methodology/Principal Findings: A cross-sectional study of 1,237 preschool children (0–5 year olds), 1,142 school-aged children (6–15 year olds) and 960 women (.15 year olds) was conducted to understand the distribution of malnutrition, anemia, malaria, schistosomiasis (intestinal and urinary) and geohelminths in a north-western province of Angola. We used a recent demographic surveillance system (DSS) database to select and recruit suitable households. Malnutrition was common among children (23.3% under-weight, 9.9% wasting and 32.2% stunting), and anemia was found to be a severe public health problem (i.e., .40%). Malaria prevalence was highest among preschool children reaching 20.2%. Microhematuria prevalence levels reached 10.0% of preschool children, 16.6% of school-aged children and 21.7% of mothers. Geohelminth infections were common, affecting 22.3% of preschool children, 31.6% of school-aged children and 28.0% of mothers. Conclusions: Here we report prevalence levels of malaria, schistosomiasis and geohelminths; all endemic in this poorly described area where a DSS has been recently established. Furthermore we found evidence that the studied infections are associated with the observed levels of anemia and malnutrition, which can justify the implementation of integrated interventions for the control of these diseases and morbidities.

Haptoglobin, acid phosphatase and demographic factors: obesity risk

The aim of this work is to study the risk of obesity posed by two genetic factors: haptoglobin phenotype and acid phosphatase phenotype, one enzymatic activity: acid phosphatase activity (ACP1), age and gender. Haptoglobin (Hp) is a protein of the immune system, and three phenotypes of Hp are found in humans: Hp1-1, Hp2-1, and Hp2-2. This protein is associated with a susceptibility to common pathological conditions, such as obesity. ACP1 is an intracellular enzyme The phenotypes of ACP1 (AA, AB, AC, BB, BC, CC) are also considered. We took a sample of 127 subjects with complete data from 714 registers. Since we intend to identify risk factors for obesity, an ordinal regression model is adjusted, using the Body Mass Index, BMI, to define weight categories. Haptoglobin phenotype, enzymatic activity of ACP1, acid phosphatase phenotype, age and gender are considered as regressor variables. We found three factors associated with an increased risk of obesity: phenotype Hp2-1 of haptoglobin (estimated odds ratio OR 11.54), phenotype AA of acid phosphatase (OR 33.788) and age (OR 1.39). The interaction between phenotype Hp2-1 and phenotype AC is associated with a decreased risk of obesity (OR 0.032); The interaction between phenotype AA and ACP1 activity is associated with a decreased risk of obesity (OR 0.954).

Early literacy development in Catalan: characteristics and instructional influence

Resumo: Este artigo analisa a relação entre o nível de consciência fonológica, conhecimento das letra e as estratégias utilizadas para ler e escrever, em crianças de cinco anos, ensinadas em catalão. Participaram 69 crianças de três classes diferentes. Cada um dos seus professores utilizava um método diferente de ensino: analítico, sintético ou analítico-sintético. As crianças foram avaliadas no início e no final do ano letivo em: Reconhecimento de letras, segmentação palavra oral, leitura de palavras, leitura de um texto curto e um ditado. Foram realizadas análises de granulação fina em nas respostas das crianças, para identificar estratégias e padrões específicos. A análise qualitativa indica que a capacidade de segmentar uma palavra em sílabas por via oral parece ser suficiente para as crianças começarem a ler de uma forma convencional. Além disso, a consciência fonológica e o conhecimento das letras são usados em formas relativamente diferentes, dependendo do tipo de texto a ser lido. As abordagens de ensino dos professores parecem ter uma influência nos resultados das crianças.

O cinema como ferramenta andragógica para a terceira idade: o Projeto CINAGE

The demographics of the early 21st century in Europe point to a notorious ageing of the population of most countries. Consequently, elderly people tend to be considered a social burden for the national healthcare and social security systems and their desire to participate actively in the civic and cultural activities of their countries is ignored. The first response to demographic ageing should therefore be a change in mentalities, which is what the area of gerontology is all about. It was in this context that the European Project CINAGE - European Cinema for Active Ageing was created. It is a transnational project, promoted by Portugal, and partnered by UK, Italy and Slovenia, oriented for the creation of a cinema course for elders and directly supported by filmic tools, within an andragogical self-reflexive approach. The modules of this course will be created on the basis of European cinematic examples and the input of focus groups consisting of experts in andragogy, active ageing, cinema and elders. In the end, twelve short films will be produced by senior members of the CINAGE course. We aim to present the project CINAGE in all its characteristics and thus reveal a way in which cinema can positively contribute to a more active ageing and the maintenance of mental health in later stages of life. It is relevant to consider what films Europe has been lately producing on this subject. We will use some of them to explain and corroborate our point of view and the project itself.

Measuring and evaluating the impacts of TOD measures: searching for evidence of TOD characteristics in Azambuja train line

TOD (Transit Oriented Development) is typically defined as a high density mixed area (residential and commercial) within easy walking distance of a high capacity public transport station (typically within an 800m buffer area). TOO is viewed as a set of strategies to increase the use of public transport, increasing walking activity, containing urban sprawl, and creating more liveable places. It is believed that this type of combined strategies will improve sustainable growth. This work is an exploratory work for evidence of TOD characteristics in train station areas in Azambuja train line, setting further methodologies to evaluate the success of TOD areas.

Characteristics of IEF, SDS and SAR-PAGE of Cuba EPO biosimilar

EPO is a glycoprotein produced in the kidney, which stimulates the division and differentiation of red cells in the bone marrow. Erythropoietin is available as a therapeutic agent produced by recombinant DNA technology in mammalian cell culture into which the human EPO gene has been transfected. Biosimilar Epoetins are mostly erythropoietins of the Epoetin alfa, beta or omega type, which are being produced at much lower cost due to expired patents. Recombinant human erythropoietin (rh-EPO) contains the identical amino acid sequence of natural EPO: 165 amino acids, with a molecular weight of 30,400 Da. Since glycosylation is not only dependent on the cell-line used for the expression of Epoetins but also on the entire biotechnological process the glycosylation patterns of biosimilars do not necessarily reflect the patterns of the originator compounds. Today biosimilar Epoetins are manufactured and distributed worldwide and under many different names. The use of recombinant EPOs for doping is prohibited because of its performance enhancing effect. The aim of the present study was to investigated whether biosimilar alpha r-HuEPO – ior®-EPOCIM, produced in Cuba and also available in other countries in all continents, could be differentiated from endogenous one by iso-electro-focusing plus double blotting, SDS-PAGE and SAR-PAGE for antidoping analysis.