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- Imported Malaria in Portugal 2000–2009: A Role for Hospital Statistics for Better Estimates and SurveillancePublication . Fonseca, Ana Glória; Dias, Sara S.; Baptista, João Luis; Torgal, JorgeBackground. Although eradicated in Portugal, malaria keeps taking its toll on travelers and migrants from endemic countries. Disease notification is mandatory but is compromised by underreporting. Methods. A retrospective study on malaria hospitalizations for 10 consecutive years (2000–2009) was conducted. Data on hospitalizations and notifications were obtained from Central Administration of Health System and Health Protection Agency, respectively. For data selection ICD-9 CM and ICD-10 were used: codes 084∗, 647.4, and B50–B54. Variables were gender, age, agent and origin of infection, length of stay (LOS), lethality, and comorbidities. Analysis included description, hypothesis testing, and regression. Results.There were 2003 malaria hospitalizations and 480 notified hospitalized cases, mainly in young male adults. P. falciparum was the main agent of infection acquired mainly in sub-Saharan Africa. Lethality was 1.95% and mean LOS was 8.09 days. Older age entailed longer LOS and increased lethality. Discussion. From 2000 to 2009, there were 2003 malaria hospitalizations with decreasing annual incidence, these numbers being remarkably higher than those notified. The national database of diagnosis related groups, reflecting hospitalizations on NHS hospitals, may be an unexplored complementary source for better estimates on imported malaria.
- Velocidade do alcance em tarefas de atenção e memória: validação do teste como marcador funcional na população geriátricaPublication . Rosa, Marlene; Pires, Miguel; Michelle, DanianaOBJETIVO: Validar a velocidade do alcance durante tarefas de atenção e memória como um indicador funcional na população geriátrica. MÉTODOS: Idosos institucionalizados residentes em 4 instituições no centro de Portugal foram caraterizados quanto ao seu perfil funcional, constando as seguintes variáveis: (i) cognição; (ii) independência nas atividades da básicas da vida diária (AVD); (iii) independência nas atividades instrumentais da vida diária (AIVD); (iii) força de preensão, (iv) diagnóstico de depressão; (v) função sensório-motora membro superior; (vi) funções executivas. Os vários instrumentos foram submetidos a um processo de linking com a Classificação Internacional de Funcionalidade e Saúde (CIF). A amostra foi dividida em quatro grupos funcionais considerando os valores abaixo e superiores à média da velocidade de alcance em tarefas de atenção (Grupo 1 - G1, Grupo 2 - G2) e a velocidade de alcance em tarefas de memória (Grupo 3 - G3, Grupo 4 - G4). A caraterização dos grupos de amostra foi realizada utilizando medidas de estatística descritiva dos qualificadores da CIF e a diferença entre grupos (G1/G2 e G3/G4) foi testada utilizando testes t para amostras independentes. RESULTADOS: Os resultados mostraram diferenças significativas entre grupos de baixo e elevado perfil nos testes de alcance (p<0.05), identificando as seguintes áreas prioritárias de intervenção em idosos institucionalizados: d6. Vida doméstica, d1. Aprendizagem e aplicação de conhecimento, d4. Mobilidade, d5. Autocuidados e d8. Áreas significativas da vida. Idosos com velocidade no teste de alcance em tarefas de atenção <0.06m/s ou com valores <0.07m/s no teste de alcance em tarefas de memória tendem a apresentar uma incapacidade moderada a grave em áreas como a Mobilidade e os Autocuidados e uma incapacidade grave a completa na participação de tarefas da Vida Doméstica. CONCLUSÃO: Este estudo foi um importante contributo para a validação da velocidade do alcance (um teste para a função do membro superior) durante tarefas de atenção e memória como um indicador funcional, possibilitando a avaliação funcional de um largo espectro de idosos, incluindo os não ambulantes.
- DIFICULDADES INTRAESCOLARES NA EFETIVIDADE DO PROJETO DE CULTURA DE PAZPublication . Lopes, Marina Frota; Pontes, Herika Paiva; Oliveira, Denise Nunes; Melo, Juliana Carneiro; Ribeiro, Jaime; Frota, Mirna AlbuquerqueObjetivo: Investigar as dificuldades intraescolares para efetividade da cultura de paz na escola.Método: configura-se como um estudo exploratório e descritivo, com abordagem qualitativa, concretizado num estudo de caso em uma escola pública da Rede Municipal de Fortaleza-Ceará, com o grupo gestor e professores da referida escola. A coleta de dados foi de fevereiro a junho de 2015. A produção dos dados foi realizada por intermédio de entrevista semiestruturada. A análise e organização dos dados foram realizadas mediante Análise de Conteúdo.Resultado: verificou-se falha de comunicação, desgaste e desmotivação dos docentes, despreparo para realizarem atividades que contemplem a paz, assim como a ausência de parcerias municipais e governamentais.Conclusão: necessidade de capacitação dos professores e gestores para que ocorra de forma efetiva a promoção da Cultura de Paz nas escolas.
- Translation, adaptation and validation of the Relationship Questionnaire among portuguese young peoplePublication . Dixe, Maria dos Anjos; Pereira Catarino, Helena; Custódio, Susana; Veríssimo, Cristina; Fabião, Joana; Sá, MariaBackground: Within interpersonal relationships, romantic relationships take on a special meaning at the end of adolescence. Objectives: The main purpose of this methodological study was to translate and adapt the Relationship Questionnaire into the Portuguese culture. Methodology: A questionnaire (questions related to socio-demographic characteristics and romantic relationships, as well as the relationship questionnaire) was applied to a sample composed of 127 higher education students, obtained using a nonprobability purposive sampling. Results: Results showed a 16-item scale, distributed into four factors (Possessive relationship, Controlling relationship, Demeaning relationship, and Destructive relationship), which explained 63.850% of the variance. The correlation matrix (χ²=840.544;p<.000) and the Kaiser-Meyer-Olkin measure (KMO=0.815) ensured the adequacy of the factor model. The scale showed good internal consistency (Cronbach’s alpha = 0.847). Data confirmed that the instrument is accurate, reliable and valid. Young people have healthy relationships, though female students have better relationships than male students. Conclusion: Results indicated that this is a reliable and valid questionnaire to assess romantic relationships.
- Assistive technologies for children with cognitive and/or motor disabilities: interviews as a means to diagnose the training needs of informal caregiversPublication . Almeida, Ivone Carmo Rodrigues; Ribeiro, Jaime; Moreira, AntónioPurpose: The present study seeks to survey information and training needs of informal caregivers related to the use of assistive technologies at home, so as to, in the near future, try to meet them. Therefore, the full aim of this study is to contribute to reducing technology abandonment and to enhancing its use in the family setting by children with cognitive and/or motor limitations. Materials and methods: Content analysis of a set of ten interviews with informal caregivers of children and youngsters with cognitive and/or motor disabilities. Results: Assistive technologies open a wide range of opportunities, mostly to students whose learning skills diverge from standard development. They promote communication, independence as well as inclusion of children with cognitive and/or motor disabilities. Despite the human and material resources available, the implementation of assistive technologies in many family settings is still a struggling task. The results reveal a perspective on (i) the interaction between those caregivers and their children, (ii) children’s skills in using assistive technology, (iii) caregivers’ digital literacy and (iv) their training needs. Conclusions: The present paper highlights the fact that carrying out interviews with informal caregivers leads to obtaining significant data for a diagnosis of the use of assistive technologies in the family setting and to assess the needs of informal caregivers. From this study, the need to provide caregivers with further training on assistive technologies emerges as preponderant, and to improve caregivers’ skills in the search for and access to practical information.
- Adaptability and cohesion of families in times of the COVID-19 pandemicPublication . Fernandes, Carla Sílvia; Magalhães, Bruno; Silva, Sílvia; Edra, BeatrizBackground & Aim: This Covid-19 pandemic represents a threat and a crisis for families’ well-being. According to the Olson Circumplex Model, this study aimed to assess the family functioning through the components of cohesion and adaptability of Portuguese families during this pandemic. Methods & Materials: This is a descriptive, exploratory, and correlational study. A non-probabilistic and convenience sample consisted of 376 people. Sociodemographic data, the family’s characterization, the type of housing, the Vital Duvall cycle phase was collected from the participants, and FACES II was used to assess family cohesion and adaptability. The reliability of this instrument is high. The instruments for data collection were organized and sent through Google® forms, including the Informed Consent Form. The data were analyzed by SPSS-26 software using non-parametric tests were used for inferential analysis. Results: The results showed that 14,6% have a disengaged family cohesion; 7,4% have a very rigid dimension in family adaptability, and about the type of family, 6,1% have an unbalanced dimension. Conclusion: Although on average, the participants have a connected family cohesion and family flexible adaptability, many participants have extreme values, under which it will be necessary to intervene. It is a priority for family nursing to understand the experience of families living in this current social, economic, and health context.
- Is the Sagittal Postural Alignment Different in Normal and Dysphonic Adult Speakers?Publication . Franco, Débora; Martins, Fernando; Andrea, Mário; Fragoso, Isabel; Carrão, Luís; Teles, JúliaObjective Clinical research in the field of voice disorders, in particular functional dysphonia, has suggested abnormal laryngeal posture due to muscle adaptive changes, although specific evidence regarding body posture has been lacking. The aim of our study was to verify if there were significant differences in sagittal spine alignment between normal (41 subjects) and dysphonic speakers (33 subjects). Study Design Cross-sectional study. Methods Seventy-four adults, 35 males and 39 females, were submitted to sagittal plane photographs so that spine alignment could be analyzed through the Digimizer - MedCalc Software Ltd program. Perceptual and acoustic evaluation and nasoendoscopy were used for dysphonic judgments: normal and dysphonic speakers. Results For thoracic length curvature (TL) and for the kyphosis index (KI), a significant effect of dysphonia was observed with mean TL and KI significantly higher for the dysphonic speakers than for the normal speakers. Concerning the TL variable, a significant effect of sex was found, in which the mean of the TL was higher for males than females. The interaction between dysphonia and sex did not have a significant effect on TL and KI variables. For the lumbar length curvature variable, a significant main effect of sex was demonstrated; there was no significant main effect of dysphonia or significant sex × dysphonia interaction. Conclusions Findings indicated significant differences in some sagittal spine posture measures between normal and dysphonic speakers. Postural measures can add useful information to voice assessment protocols and should be taken into account when considering particular treatment strategies.
- Symptom perception management education improves self-care in patients with heart failurePublication . Sousa, Joana Pereira; Oliveira, Cláudia; Pais-Vieira, MiguelBACKGROUND: Patients with heart failure often have difficulty recognizing signs and symptoms of the disease, which delays seeking help, and therefore interferes with patient engagement and self-care management. Early detection of these symptoms could lead to care-seeking and avoid hospitalizations. OBJECTIVE: The purpose of this study was to design a complex intervention through a systematic literature review and qualitative study. METHODS: Our design followed the Medical Research Council's recommendations. To design a complex intervention, we combined a systematic literature review on education, symptom recognition, and self-care management in patients with heart failure, and semi-structured interviews with cardiology healthcare providers and patients with heart failure admitted to a cardiology ward. RESULTS: The systematic literature review identified 582 studies published between 2005 and 2014, of which four were included in the final review. These suggested that patient education focused on symptom recognition, combined with reinforcements, led to better self-care behaviors. Additionally, content analysis of semi-structured interviews revealed three themes: health management, behavior management, and support received. CONCLUSIONS: Combining the findings of the literature review and the themes that emerged from the semi-structured interviews, we proposed the development and implementation of a complex intervention on symptom perception and fluid management.
- Investigação Qualitativa: Diferentes abordagens em EducaçãoPublication . Costa, António Pedro; Freitas, Fábio; Sanmamed, Mercedes GonzálezApresentação do Dossier sobre investigação qualitativa e as diferentes abordagens em Educação.
- Promoting Nerve Regeneration in a Neurotmesis Rat Model Using Poly(DL-lactide-ε-caprolactone) Membranes and Mesenchymal Stem Cells from the Wharton’s Jelly: In Vitro and In Vivo AnalysisPublication . Pereira, T.; Gärtner, A.; Amorim, I.; Almeida, A.; Caseiro, A.R.; Armada-da-Silva, Paulo A. S.; Amado, Sandra; Fregnan, Federica; Varejão, A. S. P.; Santos, J. D.; Bártolo, P. J.; Geuna, S.; Luís, A. L.; Maurício, A. C.In peripheral nerves MSCs can modulate Wallerian degeneration and the overall regenerative response by acting through paracrine mechanisms directly on regenerating axons or upon the nerve-supporting Schwann cells. In the present study, the effect of human MSCs from Wharton’s jelly (HMSCs), differentiated into neuroglial-like cells associated to poly (DL-lactide-ε-caprolactone) membrane, on nerve regeneration, was evaluated in the neurotmesis injury rat sciatic nerve model. Resultsin vitroshowed successful differentiation of HMSCs into neuroglial-like cells, characterized by expression of specific neuroglial markers confirmed by immunocytochemistry and by RT-PCR and qPCR targeting specific genes expressed.In vivotesting evaluated during the healing period of 20 weeks, showed no evident positive effect of HMSCs or neuroglial-like cell enrichment at the sciatic nerve repair site on most of the functional and nerve morphometric predictors of nerve regeneration although the nociception function was almost normal. EPT on the other hand, recovered significantly better after HMSCs enriched membrane employment, to values of residual functional impairment compared to other treated groups. When the neurotmesis injury can be surgically reconstructed with an end-to-end suture or by grafting, the addition of a PLC membrane associated with HMSCs seems to bring significant advantage, especially concerning the motor function recovery.