Aan de start

REDE gehouden op 7 oktober 1966 ter gelegenheid van de opening van de Medische Faculteit Rotterdam door prof. dr. A. QUERID

Addressing spiritual needs, facilities and barriers in portuguese palliative care: a cross-sectional survey

Background: Spiritual care is an essential component of Palliative Care (PC) and a dimension of holistic care that preserves dignity and helps sick people to find meaning in suffering and in life. The knowledge about its implementation is still scarce in the Portuguese context. This study aimed to evaluate the facilities, barriers and needs for spiritual care in PC. Method: We conducted a descriptive cross-sectional survey of 180 health professionals in the period November 2018 to September 2019 at PC units. The data were collected through an online questionnaire published on social networks, after approval by an Ethics Committee. Sociodemographic and professional data, spiritual beliefs and knowledge about the objectives and purposes of PCs were collected. These were evaluated using an instrument consisting of 26 statements of dichotomous response (true/false). Results: The average age of participants was 42.42 years (SD=11.35), most are female (82.2%), nurses (43.9%), and 70% work in the health field. The total sample has worked on average for 15.67 ± 10.28 years and more than half (58.9%) perform functions in palliative care. Most identify with a religious belief (87.8%), attaching great importance to spiritual/religious conviction (45% of participants). The results suggest that empathy and the therapeutic use of silence (82.2%) are facilitators of spiritual care. The key barriers refer to the lack of expert professionals and the organization of care (36.1%). The results also highlight the need for specific training in the area of spirituality, hope and intervention strategies (53.9%). Conclusion: This study has provided insight into spiritual care in PC in Portugal. Future studies are necessary to investigate the effects of spiritual care more fully, and to develop outcome measurements that appropriately capture the effects of the variety of spiritual care practices.info:eu-repo/semantics/publishedVersio

Adjustment strategies adopted by higher education students during COVID-19 pandemic: focus group discussions

Introduction: With the closure of higher education institutions during the COVID-19 sanitary crisis, students have experienced problems such as interruptions to their education, loss of peer support networks, and mental health issues. Objectives: This study aimed to explore adjustment patterns used by students to overcome the impact of the COVID-19 pandemic. Methods:A qualitative descriptive study was developed by carrying out Focus Group Discussions (FGDs). Portuguese students enrolled in education levels above high school, including undergraduate and graduate programs, were considered eligible. Participants were recruited using convenience sampling. Each FGD took approximately 60–90 min. Results: Twelve students were participated in 2 FGDs, each one with 6 participants. Mostly were undergraduate students (Bachelor’s degree), in the field of health area. The thematic analysis revealed three main themes. The first theme was related to the personal sphere and included most of adjustment strategies used, namely: pandemic as a “window of opportunity” to be involved in new academic and professional projects; work-life balance by organizing and separating work from private life; selfcare through the adoption of healthy lifestyles; being compassionate with others and compliance with sanitary measures. In the social sphere, students evoked new ways of communicating via digital networking to compensate for the lack of physical proximity and stay in safe contact with friends and relatives. In the contextual sphere, students talked about the importance of adapting the “teaching/learning” environment. Tailored teaching support was a significant strategy, especially in maintaining their motivation. Conclusions: Several strategies were pointed by students to stay mentally healthy and mitigate delayed-onset post-traumatic stress disorder during the COVID-19 pandemic. Besides, positive coping and hope should be integrated into the standard training of students across all study areas.info:eu-repo/semantics/publishedVersio

Improving rainwater-use in Cabo Verde drylands by reducing runoff

Dryland agriculture in Cabo Verde copes with steep slopes, inadequate practices, irregular intense rain, recurrent droughts, high runoff rates, severe soil erosion and declining fertility, leading to the inefficient use of rainwater. Maize and beans occupy N80% of the arable land in low-input, low-yielding subsistence farming. Three collaborative field trialswere conducted in different agroecological zones to evaluate the effects ofwater-conservation techniques (mulching of crop residue, a soil surfactant and pigeon-pea hedges) combinedwith organic amendments (compost and animal or green manure) on runoff and soil loss. During the 2011 and 2012 rainy seasons, three treatments and one control (traditional practice) were applied to 44- and 24-m2 field plots. A local maize variety and two types of beanswere planted. Runoff and suspended sedimentswere collected and quantified after each daily erosive rainfall. Runoff occurred for rainfalls≥50mm(slope b10%, loamy Kastanozem),≥60mm(slope≤23%, silt–clay–loam Regosol) and≥40mm(slope≤37%, sandy loam Cambisol). Runoffwas significantly reduced only with themulch treatment on the slope N10% and in the treatment of surfactant with organic amendment on the slope b10%. Soil loss reached 16.6, 5.1, 6.6 and 0.4 Mg ha−1 on the Regosol (≤23% slope) for the control, surfactant, pigeon-pea and mulch/pigeon-pea (with organic amendment) treatments, respectively; 3.2, 0.9, 1.3 and 0.1 Mg ha−1 on the Cambisol (≤37% slope) and b0. 2Mg ha−1 for all treatments and control on the Kastanozem(b10% slope). Erosion was highly positively correlated with runoff. Mulch with pigeon-pea combinedwith an organic amendment significantly reduced runoff and erosion fromagricultural fields on steep slopes, contributing to improved use of rainwater at the plot level. Sustainable land management techniques, such as mulching with pigeon-pea hedges and an organic amendment, should be advocated and promoted for the semiarid hillsides of Cabo Verde prone to erosion to increase rainwater-use and to prevent further soil degradation

Sex differences in exercise-induced diaphragmatic fatigue in endurance-trained athletes

There is evidence that female athletes may be more susceptible to exercise-induced arterial hypoxemia and expiratory flow limitation and have greater increases in operational lung volumes during exercise relative to men. These pulmonary limitations may ultimately lead to greater levels of diaphragmatic fatigue in women. Accordingly, the purpose of this study was to determine whether there are sex differences in the prevalence and severity of exercise-induced diaphragmatic fatigue in 38 healthy endurance-trained men (n = 19; maximal aerobic capacity = 64.0 ± 1.9 ml·kg–1·min–1) and women (n = 19; maximal aerobic capacity = 57.1 ± 1.5 ml·kg–1·min–1). Transdiaphragmatic pressure (Pdi) was calculated as the difference between gastric and esophageal pressures. Inspiratory pressure-time products of the diaphragm and esophagus were calculated as the product of breathing frequency and the Pdi and esophageal pressure time integrals, respectively. Cervical magnetic stimulation was used to measure potentiated Pdi twitches (Pdi,tw) before and 10, 30, and 60 min after a constant-load cycling test performed at 90% of peak work rate until exhaustion. Diaphragm fatigue was considered present if there was a 15% reduction in Pdi,tw after exercise. Diaphragm fatigue occurred in 11 of 19 men (58%) and 8 of 19 women (42%). The percent drop in Pdi,tw at 10, 30, and 60 min after exercise in men (n = 11) was 30.6 ± 2.3, 20.7 ± 3.2, and 13.3 ± 4.5%, respectively, whereas results in women (n = 8) were 21.0 ± 2.1, 11.6 ± 2.9, and 9.7 ± 4.2%, respectively, with sex differences occurring at 10 and 30 min (P < 0.05). Men continued to have a reduced contribution of the diaphragm to total inspiratory force output (pressure-time product of the diaphragm/pressure-time product of the esophagus) during exercise, whereas diaphragmatic contribution in women changed very little over time. The findings from this study point to a female diaphragm that is more resistant to fatigue relative to their male counterparts

Goitre and Iodine Deficiency in Europe

The prevalence of endemic iodine-deficiency goitre in Europe has been reduced in many areas by the introduction of iodination programmes. Recent reports, however, show that goitre remains a significant problem and that its prevalence has not decreased in a number of European countries. Hetzel1 has pointed out that the high global prevalence of iodine-deficiency disorders could be eradicated within 5-10 years by introduction of an iodised salt programme. The current World Health Organisation recommendations for iodine intake are between 150 and 300 μg/da

Soil and water conservation strategies and impact on sustainable livelihood in Cape Verde – Case study of Ribeira Seca watershed

Cape Verde, located off the coast of Senegal in western Africa, is a volcanic archipelago where a combination of human, climatic, geomorphologic and pedologic factors has led to extensive degradation of the soils. Like other Sahelian countries, Cape Verde has suffered the effects of desertification through the years, threatening the livelihood of the islands population and its fragile environment. In fact, the steep slopes in the ore agricultural islands, together with semi-arid and arid environments, characterized by an irregular and poorly distributed rainy season, with high intensity rainfall events, make dryland production a challenge. To survive in these fragile conditions, the stabilization of the farming systems and the maintenance of sustainable yields have become absolute priorities, making the islands an erosion control laboratory. Soil and water conservation strategies have been a centerpiece of the government0s agricultural policies for the last half century. Aiming to maintain the soil in place and the water inside the soil, the successive governments of Cape Verde have implemented a number of soil and water conservation techniques, the most common ones being terraces, half moons, live barriers, contour rock walls, contour furrows and microcatchments, check dams and reforestation with drought resistant species. The soil and water conservation techniques implemented have contributed to the improvement of the economical and environmental conditions of the treated landscape, making crop production possible, consequently, improving the livelihood of the people living on the islands. In this paper, we survey the existing soil and water conservation techniques, analyze their impact on the livelihood condition of the population through a thorough literature review and field monitoring using a semi-quantitative methodology and evaluate their effectiveness and impact on crop yield in the Ribeira Seca watershed. A brief discussion is given on the cost and effectiveness of the techniques to reduce soil erosion and to promote rainfall infiltration. Finally, we discuss the critical governance factors that lead to the successful implementation of such strategy in a country with scarce natural resources