Avaliação de necessidades das pessoas idosas em Medicina Geral e Familiar: um estudo de exequibilidade

RESUMO: Os médicos de família devem participar na detecção precoce dos factores de risco que favorecem o declínio funcional nas pessoas idosas. A avaliação estruturada das suas necessidades poderá contribuir para identificar os problemas de saúde que traduzam deterioração funcional. O objectivo deste trabalho foi avaliar a exequibilidade da implementação de um processo de avaliação de necessidades de cuidados em saúde das pessoas idosas na consulta de MGF.Seleccionou-se uma amostra não aleatória de pacientes com 65 ou mais anos de idade, na consulta médica de uma Unidade de Saúde Familiar da região de Lisboa. A avaliação de necessidades foi realizada, pelos médicos, com cinco itens da entrevista Camberwell Assessment of Need for the Elderly (CANE-5). Avaliou-se a percepção dos médicos e dos pacientes sobre este processo de avaliação de necessidades mediante um questionário escrito e entrevistas individuais, respectivamente. Identificaram-se necessidades em 38 (75%) dos 51 pacientes avaliados. Do total das 83 necessidades identificadas, 17 não estavam cobertas. O sofrimento psicológico foi a necessidade não coberta mais frequente. A comparação das avaliações do médico com as do paciente mostrou concordância razoável ou boa nas cinco áreas avaliadas. Esta avaliação foi bem aceite e considerada útil na perspectiva dos médicos e dos pacientes. A principal dificuldade identificada pelos médicos foi o tempo despendido na avaliação face à duração da consulta. Este estudo aponta para a exequibilidade da utilização da entrevista CANE-5 na prática clínica de MGF. No entanto, será importante alargar este estudo a amostras de maior dimensão e avaliar a utilidade da entrevista em intervenções sobre a funcionalidade dos pacientes idosos.----------ABSTRACT: General practitioners (GP) should participate in the early detection of risk factors for fuctional disability in elderly people. Structured needs assessments may contribute to a better identification of health problems that are linked to functional decline. The aim of this study was to assess the feasibility of a structured assessment of needs in the elderly, in the context of opportunistic screening in primary care. A convenience sample was selected of patients aged 65 years and over with scheduled appointments in one general practice in the Lisbon region. The assessment of needs was done by their GPs, using five items of the Camberwell Assessment of Need for the Elderly (CANE-5). Perceptions of GPs and patients about this process of needs assessment were ev+aluated by means of a written questionnaire and individual interviews, respectively. Needs were identified in 38 (75%) of 51 patients. Seventeen unmet needs were identified, out of a total number of 83 needs. Psychological distress was the most frequent unmet need. GP’s and patients’ assessments showed moderate or good agreement in all five areas. This needs’ assessment process was well accepted and considered useful by both GPs and patients. The main difficulty, according to the views of GPs, was the time consumed in this process, given the length of consultation. This study suggests the feasibility of using the CANE-5 interview in clinical practice in primary care settings. However it is important to replicate this study in larger samples and to evaluate the usefulness of the interview regarding interventions related to functionality in elderly patients.

Improving building technologies with a sustainable strategy

In recent years it has been noticed the progressive disappearance of vernacular sustainable building technologies all over the world mainly due to a strong urban rehabilitation process with modern technologies not compatible with ancient knowledge. Simultaneously new dwellings are needed all over the world and in this sense it was decided to study an ecological and cost-controlled building technology of monolithic walls that can combine the use of low carbon footprint materials, such as earth, fibres and lime using an invasive species: giant reed cane (Arundo Donax). This paper explains the development of this building technology through testing diverse prototypes.

ReedCob – An eco-efficient building technology for monolithic walls based on earth and reeds

4th Conference COST ACTION FP1303 – Designing with Bio-based Materials – Challenges and opportiunities. INIA – CSIC, Madrid, 24-25 February 2016. Book of abstracts, T.Troya, J.Galván, D.Jones (Eds.), INIA and IETcc – CSIS, pg. 79-80 (ISBN: 978-91-88349-16-3)

Citric acid production by Y. lipolytica W29 from crude glycerol: strain improvement by mutagenesis

[Excerpt] Citric acid, an important and versatile organic acid extensively used in several industries, is originally produced by Aspergillus niger in submerged fermentation from molasses [1]. However, Yarrowia lipolytica have been studied and demonstrate a great potential as citric acid producer from several carbon sources [1–5] including crude glycerol, a low cost byproduct from the biodiesel industry [6]. The simultaneous production of the isomer isocitric acid is the major problem in using this yeast in the citric acid production. (...)

Valorization of agro-industrial wastes towards the production of rhamnolipids

In this work, oil mill wastewater (OMW), a residue generated during olive oil extraction, was evaluated as an inducer of rhamnolipid production. Using a medium containing as sole ingredients corn steep liquor (10%, v/v), sugarcane molasses (10%, w/v) and OMW (25%, v/v), Pseudomonas aeruginosa #112 produced 4.5 and 5.1 g of rhamnolipid per liter in flasks and reactor, respectively, with critical micelle concentrations as low as 13 mg/l. Furthermore, in the medium supplemented with OMW, a higher proportion of more hydrophobic rhamnolipid congeners was observed comparing with the same medium without OMW. OMW is a hazardous waste which disposal represents a serious environmental problem; therefore, its valorization as a substrate for the production of added-value compounds such as rhamnolipids is of great interest. This is the first report of rhamnolipid production using a mixture of these three agro-industrial by-products, which can be useful for the sustainable production of rhamnolipids.

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Introduction

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Mammalia

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Aves. v. 1. Introduction -- Subclass Aves Carinate. Order Passeres.

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Aves. v. 2. Subclass Aves Carinate. Order[s]: Passeres (contd.), Macrochires, Pici, Coccyges, Psitta

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Aves. v. 3. Subclass Aves Carinate. Order[s]: Striges, Accipitres, Steganopodes, Phoenicopteri, Colu

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Aves. v. 4. Plates.

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Reptilia and Batrachia

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Pisces

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Land and Freshwater Mollusca

Biologia Centrali-Americana :zoology, botany and archaeology /edited by Frederick Ducane Godman and Osbert Salvin.

Arachnida Araneidea