Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Peer reviewed

Caracterização de aguardente de cana-de-açúcar "grogue de Cabo Verde"

A aguardente de cana é uma bebida de grande importância económica para Cabo Verde, mais concretamente para as ilhas de Santiago, Brava, Nicolau e S. Antão, que apresentam boas condições climáticas para a produção de cana. O consumo tem vindo a crescer em todas as classes sociais e tem a pretensão de conquistar o mercado internacional. Mas isso gera dificuldades para os produtores de aguardente, que muitas vezes enfrentam barreiras para entrar no mercado externo, principalmente devido à qualidade do produto e à falta de padronização desta bebida. Este trabalho teve como objectivo obter uma identidade e qualidade padrão da aguardente de cana em Cabo Verde, portanto, fizeram-se 5 destilados na ESTM os quais foram avaliados sensorialmente quanto à padronização do produto e também quanto à qualidade através de comparação com duas aguardentes feitas por produtores cabo-verdianos. Para isso, foram preparados 40 litros de calda, dividida em 5 lotes de 7,5 litros no alambique, obtendo-se 5 destilados com 450, 470, 565, 300 e 430ml. Determinou-se o grau alcoólico, acidez total, teor furfural e teor de cobre dos destilados realizados na escola e em Cabo Verde. Os valores obtidos do grau alcoólico, acidez total e furfural encontramse dentro dos limites estabelecidos pela lei brasileira, com exceção para o furfural que apresentou um resultado positivo nas amostras dos destilados feitos em Cabo Verde, correspondente a 28,57%. Os valores de acidez total variaram entre 9,38 a 136,87 mg/100 ml (álcool anidrido). O cobre foi determinado através da técnica de espectroscopia de absorção atómica com câmara grafite. As amostras analisadas apresentaram valores de cobre que variaram de 0,406 a 7,380 mgL-1. Das amostras analisadas 71,43% estavam dentro do limite e 28,57 % apresentaram teores de cobre acima do permitido pela legislação. Relativamente à padronização das 5 amostras feitas na escola, demonstrou-se que a estrutura de dados apenas se evidenciou validada para os atributos oleosidade e aroma (p = 0.000 e p = 0.037, respetivamente). Comparando as amostras feitas na escola com as duas de Cabo Verde, mostrou-se que à cor franca (P <0,000) e aceitável (P <0,013), limpidez (P <0,000) brilhante e transparente (P <0,001), as variáveis independentes não exercem influências na variável dependente segundo o modelo proposto.

Facial affect processing inbipolar disorder:a magnetoencephalography study

Background: Identifying biological markers to aid diagnosis of bipolar disorder (BD) is critically important. To be considered a possible biological marker, neural patterns in BD should be discriminant from those in healthy individuals (HI). We examined patterns of neuromagnetic responses revealed by magnetoencephalography (MEG) during implicit emotion-processing using emotional (happy, fearful, sad) and neutral facial expressions, in sixteen BD and sixteen age- and gender-matched healthy individuals. Methods: Neuromagnetic data were recorded using a 306-channel whole-head MEG ELEKTA Neuromag System, and preprocessed using Signal Space Separation as implemented in MaxFilter (ELEKTA). Custom Matlab programs removed EOG and ECG signals from filtered MEG data, and computed means of epoched data (0-250ms, 250-500ms, 500-750ms). A generalized linear model with three factors (individual, emotion intensity and time) compared BD and HI. A principal component analysis of normalized mean channel data in selected brain regions identified principal components that explained 95% of data variation. These components were used in a quadratic support vector machine (SVM) pattern classifier. SVM classifier performance was assessed using the leave-one-out approach. Results: BD and HI showed significantly different patterns of activation for 0-250ms within both left occipital and temporal regions, specifically for neutral facial expressions. PCA analysis revealed significant differences between BD and HI for mild fearful, happy, and sad facial expressions within 250-500ms. SVM quadratic classifier showed greatest accuracy (84%) and sensitivity (92%) for neutral faces, in left occipital regions within 500-750ms. Conclusions: MEG responses may be used in the search for disease specific neural markers.

Adaptação de exercícios de trompete, trombone e tuba para eufónio

Tendo por base a literatura existente para instrumentos de sopro de metal, e a parca quantidade de literatura tanto em português como especificamente para eufónio, a presente dissertação apresenta uma adaptação de exercícios técnicos de trompete, trombone e tuba para eufónio, com conselhos e exercícios de respiração e buzzing. Para tal, foi criado um guia que apresenta conselhos que devem orientar a prática individual, assim como alguns exercícios para desenvolvimento de capacidades referentes às duas problemáticas previamente mencionadas. O guia foi utilizado por alunos de idades variadas e em fases distintas do percurso académico, tendo sido registada a evolução decorrente do estudo do manual. Os resultados indicam uma evolução positiva dos tópicos em estudo. Conclui-se que os conselhos e exercícios propostos permitem uma maior facilidade na prática instrumental, beneficiando o controlo da respiração e a qualidade da produção sonora.

Excessos alimentares e saúde: o que dizem os provérbios

Perscrutando a História e perpetuando as suas raízes culturais ao longo de gerações, a alimentação terá emergido de um ato irracional, fortemente orientada para a manutenção de vida e da sobrevivência das espécies. Além de assegurar a sobrevivência humana traduz ainda o contexto em que o ser humano se move e as práticas alimentares que elege. Objetivo: Reconhecer comportamentos e atitudes de excessos alimentares e respetivas práticas sociais, através das narrativas proverbiais. Metodologia: pesquisa bibliográfica sobre as repercussões que os excessos alimentares têm na saúde. Em simultâneo pesquisaram-se achados paremiológicos sobre a temática recorrendo à AIP-Associação Internacional de Paremiologia bem como a utilização de provérbios conhecidos das autoras. Conclusões: Verificou-se existirem provérbios que encerram verdades e comportamentos a seguir relativamente à alimentação. A ingestão regrada em alimentos e bebidas é algo que os provérbios nos fazem refletir sendo muitos deles corroborados cientificamente.

Ciência e tradição: pão, água e vinho na alimentação

A alimentação influencia a saúde, de forma dinâmica a nível bio-psico-socio-cultural e de forma multifatorial. A sua natureza social e hedónica, foi construindo expressões de representações geracionais da cultura portuguesa. Objetivos: Reconhecer as expressões proverbiais acerca da água, do pão e do vinho e a sua relação com as práticas culturais alimentares e o seu contributo para a manutenção dessa cultura; Reconhecer as relações entre as expressões proverbiais e os dados científicos que eventualmente os corroborem. Metodologia: Partindo de um referencial teórico, construiu-se uma análise dialógica que confronta as relações entre os discursos proverbiais, as práticas culturais e a “massa crítica” cientificamente assumida. Usaram-se os conhecimentos paremiológicos das autoras, recorrendo-se ainda à AIP- Associação Internacional de Paremiologia. Resultados: Após análise de textos, foram encontrados provérbios que defendem o uso e a importância destes alimentos, os contextos em que emergem e advertências na Promoção da Saúde.

Excessos alimentares e saúde: o que dizem os provérbios

Perscrutando a História e perpetuando as suas raízes culturais ao longo de gerações, a alimentação terá emergido de um ato irracional, fortemente orientada para a manutenção de vida e da sobrevivência das espécies. Além de assegurar a sobrevivência humana traduz ainda o contexto em que o ser humano se move e as práticas alimentares que elege. Objetivo: Reconhecer comportamentos e atitudes de excessos alimentares e respetivas práticas sociais, através das narrativas proverbiais. Metodologia: pesquisa bibliográfica sobre as repercussões que os excessos alimentares têm na saúde. Em simultâneo pesquisaram-se achados paremiológicos sobre a temática recorrendo à AIP-Associação Internacional de Paremiologia bem como a utilização de provérbios conhecidos das autoras. Conclusões: Verificou-se existirem provérbios que encerram verdades e comportamentos a seguir relativamente à alimentação. A ingestão regrada em alimentos e bebidas é algo que os provérbios nos fazem refletir sendo muitos deles corroborados cientificamente.

Ciência e tradição: pão, água e vinho na alimentação

A alimentação influencia a saúde, de forma dinâmica a nível bio-psico-socio-cultural e de forma multifatorial. A sua natureza social e hedónica, foi construindo expressões de representações geracionais da cultura portuguesa. Objetivos: Reconhecer as expressões proverbiais acerca da água, do pão e do vinho e a sua relação com as práticas culturais alimentares e o seu contributo para a manutenção dessa cultura; Reconhecer as relações entre as expressões proverbiais e os dados científicos que eventualmente os corroborem. Metodologia: Partindo de um referencial teórico, construiu-se uma análise dialógica que confronta as relações entre os discursos proverbiais, as práticas culturais e a “massa crítica” cientificamente assumida. Usaram-se os conhecimentos paremiológicos das autoras, recorrendo-se ainda à AIP- Associação Internacional de Paremiologia. Resultados: Após análise de textos, foram encontrados provérbios que defendem o uso e a importância destes alimentos, os contextos em que emergem e advertências na Promoção da Saúde. Palavras-chave: alimentação, água, pão, vinho, provérbio.

Intercultural musical learning in the era of technology

Foreign students abroad need to feel integrated in the new community, which includes complex learning processes in multicultural environments. The fact that we have experienced these processes ourselves was certainly a motivation for this research, especially knowing that we could contribute to help our fellow Portuguese brass players undergoing the same experience. From the singularity of music performance in the style of playing and communication emerge many cultural aspects, which have been developed through centuries of orchestral practice. As the new students are confronted with the aesthetic musical concepts and both professional and social practices of the country they arrive in, they strive to understand these concepts and adapt themselves to the values promoted by the new music practice. The aim of this on-going research is the study of the integration of brass music students in German universities and in the German society. Notably, through the understanding of intercultural processes experienced by the students, professors can become more aware of the challenges that concern music education. In this research all ten Portuguese brass students enrolled in any German music university in the last five years were interviewed in order to deeply understand this process. With a growing importance of the technological facilities, students are able to gather more information, to prepare themselves for the new concepts they try to embrace and to better deal with a different culture.

Vigilância infantil no 1º ano de vida: conhecer e intervir para prevenir

O presente artigo aborda aspetos que jamais poderão ser negligenciados na abordagem da criança no 1º ano de vida. A vigilância de saúde é a melhor forma de conhecer em tempo útil as potencialidades e fragilidades associadas ao crescimento e desenvolvimento infantil. Só conhecendo o crescimento normal se poderá estar desperto para identificar desvios que urgem em termos de intervenção precoce. Pela sua fragilidade e dependência, é importante que os pais estejam envolvidos nos processos de capacitação para intervir com segurança e eficácia. Neste artigo, que pretende ser um contributo para ajudar a encontrar respostas práticas, revê-se a importância da vigilância de saúde. Após uma revisão de literatura no âmbito da temática e consulta das diretrizes dos organismos de saúde, em especial o Programa Nacional de Vigilância de Saúde Infantil e Juvenil português, realça-se a vigilância como forma de capacitação dos cuidadores e identificação precoce de desvios da normalidade.

Time-trends in infant mortality rates in the southern Europe

Infant Mortality Rate (IMR) has been considered an important health indicator in monitoring quality of health care. Objectives: To examine trends in IMR in Southern Europe (SE) over the last two decades. Methods: Number of live births and infant deaths reported for SE (Portugal, Italy, Greece and Spain) between 1990 and 2013 were abstracted from World Health Organization Database. Annual IMR per 1,000 live births was computed for each country and for SE as a whole. Joinpoint regression models were used to estimate average annual percent change (AAPC) in IMR and respective 95% Conidence Interval (95% CI) and to identify points in time when signiicant changes in trend occurred (joinpoints). Results: Between 1990 and 2013, IMR signiicantly decreased from 9.2 to 3.4 in SE and the highest decrease was observed from 1992 to 1998 (AAPC = -6.1%; 95%CI: -6.5%; -5.8%). Signiicant decline in IMR was observed in all countries but the pattern was different across countries. IMR varied across countries between 11.5 and 8.3 and between 3.1 and 3.8 in 2013; highest IMR were observed in Portugal for 1990 and in Greece for 2013. Most notable decreases in IMR were observed from 1990 to 1995 in Portugal (AAPC = -8.4% 95%CI: -8.8; -8.1), from 1993 to 1997 in Italy (AAPC = -6.6% 95%CI: -7.8; -5.5) from 1998 to 2006 in Greece (AAPC = -6.8% 95%CI: -7.0; -6.5), and from 1993 to 1996 in Spain (AAPC = -7.3% 95%CI: -9.0; -5.6). Decreases in IMR were signiicant during all time period in Italy and Greece but in Portugal and Spain IMR became unchangeable after 2010-2011. Conclusions: Decrease in IMR in countries of SE suggests steadily improvement in the quality of health care. However differences in the pattern of decrease across countries during the last years deserve particular attention.

Prevalence of surgical wound infection after surgery for breast cancer: systematic review

One of the known risk factors for abuse and neglect of the elderly is the decrease in functionat capacity, contributíng to self care dependency of instrumental actívities of daily living and basic activities of daily Itving (OMS, 2015). Methods: Cross-sectional study with non probabilistíc sample of 333 elderly, performed in a hospital, homes and day centers for the elderly. The data collectíon protocol tncluded socio-demographic data, Questíons to elicit Elder Abuse (Carney, Kahan B Paris, 2003 adap. By Ferreira Alves & Sousa, 2005), scale of instrumental actívi - ties of daily living Lawton and Brody and Katz index to assess the levei of independence in actívities of daily living. Objectives: To evaluate the assodation between abuse and neglect in the elderly, instrumental actívitíes of daily living and levei of independence in actívitíes of daily living. Results: Emotional abuse is signifícantty correlated with the levei of independence in activities of daity Uving (p = 0. 000), older peopie with less independence tend to have higher leveis of emotional abuse. The total abuse is signtficantly correlated with the leveis of independence in activittes of daily living (p = 0. 002), less independent elderty tend to suffer greater abuse and neglect. There were no statistically significant associations between abuse and neglect and instrumental activities of daily l1v1ng. Conclusions: The less independent elderly are more vulnerable to situatíons of abuse and neglect, being more exposed to emotional abuse. These results point to the need for health professionals/ nurses develop prevention interventions, including strategies to support carers and early screentng tn less independent elderly. Keywords: Elder abuse. Negligence. Nursing care. Frail elderly. PREVALENCE OF SURGICAL WOUND INFECTION AFTER SURGERY FOR BREAST CÂNCER: SYSTEMATIC REVIEW C. Amaral3, C. Teixeira"'1', F. Sousa'', C. Antãoa "Polythecnic Institute o f Bragança, Bragança, Portugal; bEPI Unit, Public Health Institute, University of Porto, Portugal. Contact details: catarinaisabeln.amaraliSsmaU.com Introduction: Breast câncer is one of the most common mahgnant pathology in European countries, as Portugal, where annual inddence is around 90 new cases per 100,000 women. Breast surgery is the usual treatment for this pathology, however such procedure can be complicated by the infection of surgical site. Objectives: To know the prevalence and determtnants of surgtcal wound infection after breast surgery. Methods: We conducted a systematic review by searching of the Web of Sdence electronic database for articles published over the last s1x years 1n developed countries. Over three hundred dtatíons were obtained and after excludtng citations with reasons, fíve artícles met our inclusion criteria and were included in the present review. Results: Prevalence of surgical wound infection varied across studies between 0. 1% and 12. 5%. Bilateral mastectomy is assodated with higher prevalence of wound infectíon than unilateral mastectomy (3. 6% vs 3, 3%), lumpectomy with immediate breast reconstruction (IBR) is related with higher frequency of wound infectíon than surgery with no IBR (0, 5% vs 0, 1%), also, mastectomy with IBR is associated with higher prevalence of wound infectíon than mastectomy wtth no IBR (1, 5% vs 0, 3%) and breast surgery followed by axiltary lymph nade dissectíon is related with higher prevalence of wound infection than surgical procedures wtth no axillary lymph node dissection (2, 82% vs 1, 66%). Conclusions: Nurses that provide post-operatíve care to women after breast surgery should be aware about risk of wound tnfectíon, partícularly after more invasive procedures.

Self-medication on the students of the school of health from Polytechnic Institute of Bragança

The self-medicatíon is a phenomenon more and more frequent and used for several years already, and tts incidence and dlstribution are related wtth the organizatíon and health system of each country. Following Medeiros thoughts (2011), this practíce conststs in the consumptíon of a medicine with the purpose of treating or relieving the symptoms and diseases or even promote self health, without using a professional prescription. Methods: With thts study, we intend to find the self-medication practice incidence on the students in the School of Health of Polytechnic Institute of Bragança (ESSa), identify the motives that lead these students to resort to this methods and identify the most used medicatíons. lt's a transversal descriptive, observational and quantítative study. To obtain the best results it was applied a questíonnaire built for that purpose. The statístícs analyses was made using Excel program. Our sample hás 219 students of the School of Health from Polytechntc Instítute of Bragança. Results: The studied sample includes 194 female and 25 male students distributed as follows: 36 frequenting Biomedical Laboratory Sdences, 26 Dietetics and Nutrition, 99 Nursing, 33 Gerontology and 22 studying Pharmacy. The self-medicatíon prevalence was 98%. The most used medicines was the analgesics and antipyretics with 86%. The most prevalent reason for the use of self-medicatíon was the thought that the disease was a "minor health issue". It was also considered a risky practice by 77% of the students. Conclusions: The self-medication is an evident practíce on the ESSa students. This results reveal some contradiction stnce the most consider 1t as a risky practíce, however it is, stíll, practíced.

Attitudes towards to sexuality among older people: a qualitative research

Sexuality is an important component of human being and contributes to the quality of life. Sexual activity dependa on altitudes toward sexuality. Although this is an important issue, the research on attitudes toward sexuatity among older people hás been a neglected topic. Objectives: To understand altitudes towards sexuality among older people and to assess the relationship between sociodemographic factors and such attitudes.Methods: This cross-sectíonal study was conducted on 35 community-dwelltng older individuais (> 65 years old; 66% were men). Data collectíon was based on a questionnaire whtch includes three components: (1) Questíons on sociodemographic characteristícs; (2) A 13-item scale assessment of attitudes toward to sexualtty (SAATS) scored from O to 52, being highervalues related with positive attítudes; and (3) an open question "in your opinton what is sexuality?". Results: In this sample 40% of participants (n = 14) reported that there is no sexuality among older people. For the whole sample, the mean score of SAATS and respective standard deviatíon (± SD) was 28. 9 (± 6. 63). There were no differences in the mean score of SAATS by gender, but such score was lower among oldest people (p = 0. 006), among individuais reporting less schooling years (p = 0. 001) and among those with no companion (p = 0. 012). In regards to the qualitatíve analysis of the open question, the main answers obtained fali into the affectíve dimension, with the majority of partidpants reporting that sexuality is "lave", "respect" and "tenderness". Conclusions: Oldest people, those with lower educatíon levei and those with no companion presenting more negative attítudes towards to sexuality. Among older people sexuality is manly based on the affective dimension.

Parental feelings face to hospitalization of the child

The hospitalizatíon of a child carnes with it major changes, etther in the child's life or parent. lllness and hospttalizatíon constitute a crisis situation for both the child and the famHy as it incorporates financiai, psychotogical, relational and social changes. The purpose of this work and analyze the satísfactíon and parents' perception on the importance of nursing care during hospttalizatíon and feelings experienced by parents. Objectives: To know the opinions and feelings of the parents in relation to the admlsston of the child 1n the service of Pediatrics at North of Portugal. Methods: Integrated this study parents of chtldren hospttalized in the pediatric inpatíent at the Hospital Trás-os-Montes e alto Douro, Vila Real, whose children were in the service to at least more than 48 hours, In total 33 escorts that replied to the questionnaire. For such a study we chose the type quantitative deschptíve. We proceeded to collect data by conductíng a questíonnaire, and the results of it were drafted in the SPSS program through Quantitatíve model wtth exploratory qualitatíve approach. Results: The age ofthe partícipants is between the 21 and 46 years - old, 75. 8% of respondents were married, 78. 8% of chtldren was hospitalized in the first time. We conclude that the mother is who else accompanies the chtld in the hospital. We had positive feedback regarding the interactíon parent-nurses since many parents stressed the good relatíonship with the nursing team (It reported that "Nurses" and "Nurses and "auxiliaries" were who else helped them, with 30. 3% and 21. 2% respectively). The feelings more mentioned were: anxiety -21 answers, sadness-20, fear-15 and hope with 15. The conditions offered to the parents were considered goodfor60.6%.