Sofrimento do doente oncológico com necessidade de cuidados paliativos e a sobrecarga do cuidador informal

Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2011O estudo de investigação incide sobre o Sofrimento do Doente Oncológico com Necessidade de Cuidados Paliativos e a Sobrecarga do Cuidador Informal. O aumento do número de doentes crónicos da população portuguesa tornou-se preocupante com repercussões sociais, económicas e na saúde. É pertinente a análise da percepção do sofrimento dos doentes, identificando as suas características e a existência de associação destas com as dimensões do sofrimento. Os Cuidadores Informais (CI) constituem o principal suporte do doente, tendo de desempenhar tarefas extras e alterar papéis. Analisou-se as suas características e determinou-se a associação entre estas e a sobrecarga. Trata-se de um estudo Quantitativo, Descritivo, Correlacional e Transversal e utiliza-se como instrumentos de colheita de dados o Inventário de Experiências Subjectivas de Sofrimento na Doença (IESSD) e a Escala de Sobrecarga dos Cuidadores (ESC). A amostra é constituída por 38 doentes, bem como os seus CI. A maioria dos doentes são do sexo masculino, casados, com idade entre os 46 e os 59 anos, reformados e com Ensino Básico. Os CI são maioritariamente do género feminino, casados, com idade entre os 21 e os 67 anos e com Ensino Básico. Salienta-se que os doentes apresentam um nível médio de sofrimento global de 3,13 e que todas as dimensões estão acima do valor médio ponderado. Relativamente à sobrecarga, constata-se que apenas a dimensão das expectativas com o cuidar (3,16) apresenta valor acima do intermédio da escala. Evidencia-se correlação (rs=+0,34 e p=0,039) entre o sofrimento psicológico e as expectativas com o cuidar do CI. Existe correlação entre a idade e o sofrimento sócio- -relacional (rs=-0,35 e p=0,030), entre as habilitações literárias e o sofrimento existencial (p=0,025) e entre o sofrimento global (p=0,034). Quanto à sobrecarga, apenas observa-se uma diferença estatisticamente significativa (p=0,046) ao nível da percepção de auto-eficácia em função da situação laboral.The research study focuses on the Suffering of Cancer patients with the Need for Palliative Care and the Burden on the Informal Caregivers. The increase in the number of chronically ill patients in the population becomes worrying with social, economic and health repercussions. The analysis of the perception of the suffering of patients is relevant, identifying its characteristics and the existence of association of these characteristics with the dimensions of suffering. Informal caregivers (IC) are the main support of the patient, having to perform additional tasks and change roles. Thus, we analyzed their characteristics and determined the association between these and the burden. This is a Quantitative, Descriptive, Co relational and Cross-sectional study and uses the Inventário de Experiências Subjectivas de Sofrimento na Doença (IESSD) and the Escala de Sobrecarga dos Cuidadores (ESC) as data collection instruments. The sample consists by 38 patients, as well as their IC. The majority of the patients are male, married, aged between 46 and 59 years, retired and have a basic education. The caregivers are mostly female, married and aged between 21 and 67 years and have a basic education. It’s noted that the patients have an average level of global suffering of 3,13 and that all dimensions are above weighted average value. Regarding the burden, it’s noted that only the dimension of expectations with the caring (3,16) has a value above the intermediate scale. A correlation of (rs=+0,34 and p=0,039) between the psychological suffering and expectations with the care of the caregiver is evident. There is a correlation between age and socio-relational suffering (rs=-0,35 and p=0,030) between qualifications and existential suffering (p=0,025) and between global suffering (p=0,034). Regarding the burden, there is only a statistically significant difference (p=0,046) at the level of perceived self-efficiency depending on the employment situation

Individual wellness according to college students

Aims:This study aims to identify the values of the dimension Individual Well-being, defended by the students of the University of Madeira (Uma), Portugal and the University of Fortaleza (UNIFOR), Brazil. Methods: this is a representative sample of University students (n = 605) 225 of the University of Madeira (UMa) and 380 of the University of Fortaleza (UNIFOR). The data were collected in the year 2017 in all centres of universities. As inclusion criteria 18-24 years’students the students of 18-24 years attending graduate courses. We used the structured questionnaire on values (adapted from the European Values Survey), composed of 30 questions, grouped by 6 dimensions: Individual well-being; Interpersonal Relationships; Participation and Social intervention; Ethics and Sense of life; Family and socio-political values. Ethical issues and ethical rules were respected. This article focuses only one-dimension well-being encompassing issues of personal satisfaction, physical/psychological well-being and conception of success in life. Results: the majority are female (65.3% UMa and 74.2% UNIFOR) and single (96.0% UMa and 96.3% UNIFOR). With regard to the Individual well-being much of the population refers to feelings of instability (53.8% UMa and 53.2% UNIFOR) and anxiety (36.1% UMa and 41.6% UNIFOR). As for the personal satisfaction a significant percentage of students are not satisfied with your luck (UMa 48.8% and 38.4% UNIFOR), health (UMa 47.6% and UNIFOR 23.4%), work (42.6% UMa and 42.4% UNIFOR) and your social position (UMa 37.4% and UNIFOR 24.8%), being the most valued satisfaction aspects the family (UMa 92.4% and 93.4% UNIFOR), health (Uma 92% and UNIFOR 76.6%) and have a good job (UMa 91.6% and UNIFOR 96.8%). In contrast, the less valuable is to have influence and power (UMa 52.5% and UNIFOR 57.9%). The majority considers to be people with success in life (UMA57.8% and UNIFOR 85.8%), on the understanding that the success in life is to have a happy family (Uma 72.4%) and to be a good person (57.8% UMa). Conclusions: this study is intended as a contribution to further research in this field, because the knowledge of the Individual well-being of college students provides the establishment of programs directed to mental health, with interventions of prevention and promotion of health that are aimed at improving the quality of life and well-being.info:eu-repo/semantics/publishedVersio

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Sofrimento do doente oncológico em situação paliativa

Contexto: o aumento da incidência do número de doentes crónicos da população portuguesa tornou-se um fenómeno preocupante com repercussões sociais, económicas e de saúde, estes doentes apresentam níveis de sofrimento variáveis. Este foco representa uma área de intervenção importante nos cuidados de enfermagem à pessoa em situação paliativa quer na perspetiva da sua prevenção quer no seu alívio. Objetivo: analisar a perceção do doente oncológico em situação paliativa quanto ao sofrimento e às suas várias dimensões. Metodologia: desenhou-se um estudo descritivo-correlacional com dimensão transversal. Aplicou-se o Inventário de Experiências Subjetivas de Sofrimento na Doença a 38 doentes em situação paliativa, internados num serviço de cirurgia e hemato-oncologia e que tivessem mais de 18 anos. Resultados: os doentes evidenciaram níveis intermédios de sofrimento global e observou-se a existência de correlação significativa entre a idade e a dimensão do sofrimento sócio relacional. Conclusão: pensamos ter contribuído para alicerçar de uma forma estruturada a importância desta área de intervenção do enfermeiro à pessoa em situação paliativa e desenvolver intervenções ao nível da prevenção e alívio do sofrimento destes doentes.Context: the increase in the number of chronically ill people in the Portuguese population has become a worrying phenomenon with social, economic and health repercussions, and with patients having varying degrees of suffering. This issue is an important area of nursing intervention for people at the palliative stage, whether from a preventive perspective or for the relief of suffering. Objectives: to analyze perceptions of the situation of cancer patients with regard to suffering and its various dimensions. Methodology: a descriptive-correlational study with a cross-sectional dimension was designed. We administered the Inventory of Subjective Experiences of Suffering to 38 patients in a palliative situation who had been admitted to surgical and hematology-oncology services and who were over 18 years of age. Results: patients showed intermediate levels of global suffering and a significant correlation was observed between age and the social relational dimension of distress. Conclusion: we believe that we have identified in a structured way the importance of this area of nursing intervention for people in a palliative situation and for the development of interventions for the prevention and relief of suffering of these patients.info:eu-repo/semantics/publishedVersio

Sofrimento do doente oncológico em situação paliativa El sufrimiento de pacientes con cáncer en situación paliativa Suffering of cancer patients in a palliative situation

Contexto: o aumento da incidência do número de doentes crónicos da população portuguesa tornou-se um fenómeno preocupante com repercussões sociais, económicas e de saúde, estes doentes apresentam níveis de sofrimento variáveis. Este foco representa uma área de intervenção importante nos cuidados de enfermagem à pessoa em situação paliativa quer na perspetiva da sua prevenção quer no seu alívio. Objetivo: analisar a perceção do doente oncológico em situação paliativa quanto ao sofrimento e às suas várias dimensões. Metodologia: desenhou-se um estudo descritivo-correlacional com dimensão transversal. Aplicou-se o Inventário de Experiências Subjetivas de Sofrimento na Doença a 38 doentes em situação paliativa, internados num serviço de cirurgia e hemato-oncologia e que tivessem mais de 18 anos. Resultados: os doentes evidenciaram níveis intermédios de sofrimento global e observou-se a existência de correlação significativa entre a idade e a dimensão do sofrimento sócio relacional. Conclusão: pensamos ter contribuído para alicerçar de uma forma estruturada a importância desta área de intervenção do enfermeiro à pessoa em situação paliativa e desenvolver intervenções ao nível da prevenção e alívio do sofrimento destes doentes.<br>Contexto: el aumento de la incidencia del número de enfermos crónicos de la población portuguesa se ha convertido en un fenómeno preocupante con consecuencias sociales, económicas y, cuyos pacientes presentan niveles variables de sufrimiento. Este enfoque representa un área de intervención importante para los cuidados de enfermería a la persona en situación paliativa bien desde la perspectiva de su prevención, bien en su alivio. Objetivos: analizar la percepción del paciente con cáncer en situación paliativa con respecto al sufrimiento y a sus diversas dimensiones. Metodología: se diseñó un estudio descritivo-correlacional con una dimensión transversal. Se aplicó el Inventario de experiencias subjetivas de sufrimiento durante la enfermedad a 38 pacientes en situación paliativa, ingresados en los servicios quirúrgicos y de hemato-oncología, y quienes tenían más de 18 años. Resultados: los pacientes mostraron niveles intermedios de sufrimiento global y se observó una correlación significativa entre la edad y la dimensión del sufrimiento socio-relacional. Conclusión: pensamos haber contribuido a fundamentar de forma estructurada la importancia de esta área de intervención del enfermero a la persona en situación paliativa y a desarrollar intervenciones al nivel de la prevención y del alivio del sufrimiento de estos pacientes.<br>Context: the increase in the number of chronically ill people in the Portuguese population has become a worrying phenomenon with social, economic and health repercussions, and with patients having varying degrees of suffering. This issue is an important area of nursing intervention for people at the palliative stage, whether from a preventive perspective or for the relief of suffering. Objectives: to analyze perceptions of the situation of cancer patients with regard to suffering and its various dimensions. Methodology: a descriptive-correlational study with a cross-sectional dimension was designed. We administered the Inventory of Subjective Experiences of Suffering to 38 patients in a palliative situation who had been admitted to surgical and hematology-oncology services and who were over 18 years of age. Results: patients showed intermediate levels of global suffering and a significant correlation was observed between age and the social relational dimension of distress. Conclusion: we believe that we have identified in a structured way the importance of this area of nursing intervention for people in a palliative situation and for the development of interventions for the prevention and relief of suffering of these patients

Valores dos Universitários Portugal/Brasil: dimensão sociopolítica

This study assesses the socio-political values of colleges students (n = 605) Portugal/Brazil, employing a questionnaire on socio-political dimension Values. The results revealed significate differences about fundamental values. We find indifference/scepticism in Portuguese and Brazilian students practice, essentially with regard to the causes of social inequalities. In Brazil are connect from bad luck, laziness and inactivity and in Portugal a short instruction distinguish. This research empowers the implementation of programmes of education for citizenship in academic context. Este estudo analisa os valores sociopolíticos dos universitários (n=605) Portugal/Brasil, mediante um Questionário sobre Valores na dimensão sociopolítica. Os resultados revelaram diferenças quanto a valores fundamentais. Constatamos indiferença/descrença política nos estudantes portugueses e brasileiros, essencialmente no respeitante às causas das desigualdades sociais. No Brasil são decorrentes da pouca sorte, preguiça e inatividade laboral e em Portugal particularizam a pouca instrução. Esta pesquisa viabiliza a implementação de programas de educação para a cidadania em contexto académico.

Valores dos Universitários Portugal/Brasil: dimensão sociopolítica

This study assesses the socio-political values of colleges students (n = 605) Portugal/Brazil, employing a questionnaire on socio-political dimension Values. The results revealed significate differences about fundamental values. We find indifference/scepticism in Portuguese and Brazilian students practice, essentially with regard to the causes of social inequalities. In Brazil are connect from bad luck, laziness and inactivity and in Portugal a short instruction distinguish. This research empowers the implementation of programmes of education for citizenship in academic context. Este estudo analisa os valores sociopolíticos dos universitários (n=605) Portugal/Brasil, mediante um Questionário sobre Valores na dimensão sociopolítica. Os resultados revelaram diferenças quanto a valores fundamentais. Constatamos indiferença/descrença política nos estudantes portugueses e brasileiros, essencialmente no respeitante às causas das desigualdades sociais. No Brasil são decorrentes da pouca sorte, preguiça e inatividade laboral e em Portugal particularizam a pouca instrução. Esta pesquisa viabiliza a implementação de programas de educação para a cidadania em contexto académico.

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora