Resiliência educacional e construção do conhecimento

The article discusses academic resilience, with an emphasis on the construction of mathematical communication as a result of processes of social interaction among students and teachers. It is an educational dynamics which resulted in a growing appreciation and recognition of students’ mathematical knowledge, framing the primordial role of new strategies and forms of learning. In this framework, the researchers, based on the interpersonal relationships, empathy, social skills and sense of belonging to a group on the interface with the social and emotional resilience, highlight the importance of positive experiences to generate feelings of self-efficacy, self-esteem and academic success, contributing to help students and teachers to cope with the changes and adaptations to new learning situations.http://dx.doi.org/10.5902/1984644414343O artigo debruça-se sobre a resiliência académica, com ênfase na construção progressiva da comunicação matemática, em aulas dos primeiros anos de escolaridade, em Portugal, em resultado dos processos de interação social entre os alunos e entre estes e o professor. Trata-se de uma  dinâmica educativa que resultou numa crescente valorização e reconhecimento dos conhecimentos matemáticos dos alunos, num contexto comunicativo com uma abordagem reflexiva e instrutiva, enquadrando-se no papel primordial de novas formas de aprendizagem e de novas estratégias, bem como do aumento e fortalecimento de competência na resolução de problemas. Neste enquadramento, os investigadores, partindo dos relacionamentos interpessoais, da empatia, das competências sociais e do senso de pertença a um grupo na interface com a resiliência social e a emocional, destacam a importância das experiências positivas ao gerarem sentimentos de autoeficácia, de autoestima e de sucesso académico, por parte de alunos e de professores, contribuindo para os ajudar a saberem  lidar com as mudanças e com as adaptações a novas situações de aprendizagem, em que o fator comunicacional é da maior relevância

Self-reported variables as determinants of upper limb musculoskeletal symptoms in assembly line workers

Background: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms—discomfort/pain–during a 6-month follow-up. Methods: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. Results: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, “having upper limb symptoms during the previous 6 months” and “education” were possible predictors. Conclusion: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.publishersversionpublishe

Evolución del cobre sérico en pacientes sometidos a gastrostomía endoscópica para nutrición enteral a largo plazo

Background and aims: Copper (Cu) is a well studied trace element but little is known about Cu evolution in long term endoscopic gastrostomy (PEG) feeding. We aimed to evaluate the evolution serum Cu since the gastrostomy until 12 weeks after the procedure in PEG patients fed with homemade meals. Methods: A prospective observational study was performed evaluating serum copper, albumin, transferrin and body mass index (BMI) at the time of the gastrostomy, 4 weeks and 12 weeks after. Data also included age, gender, NRS 2002 and nature of the underlying disease causing dysphagia: head and neck cancer (HNC) or neurological dysphagia (ND). After gastrostomy, patients were fed with homemade PEG meals. Results: One hundred and forty-six patients enrolled, 89 men, aged 21-95 years, 90 with neurologic dysphagia (ND), and 56 with head and neck cancer (HNC). 78 (53%) showed low BMI. Initially, Cu ranged 42-160 μg/dl (normal: 70-140 μg/dl); 130 patients (89%) presented normal Cu, 16 (11%) presented hypocupremia, 53% low albumin (n = 77), and 94 (65%) low transferrin. After 4 weeks, 93% presented normal Cu, 7% presented hypocupremia, low albumin was present in 34%, and low transferrin in 52%. After 12 weeks, 95% presented normal Cu, 5% presented hypocupremia, low albumin was present in 25%, and low transferrin in 32%. Comparing age, gender, underlying disease, BMI, albumin and transferrin, there were no significant differences on serum Cu. Conclusions: Most patients present normal serum Cu when gastrostomy is performed. For patients presenting hypocupremia before gastrostomy, homemade meals are effective for normalizing serum Cu.RESUMEN - Introducción y objetivos: El cobre (Cu) es un oligoelemento muy estudiado, pero poco se sabe de su evolución en los pacientes alimentados por gastrostomía endoscópica (GEP). Pretendemos evaluar la evolución del Cu sérico desde la gastrostomía hasta 12 semanas después de la intervención en estos pacientes alimentados con preparaciones domésticas. Métodos: Realizamos un estudio observacional prospectivo para evaluar el Cu sérico, la albúmina, la transferrina y el índice de masa corporal (IMC) en el momento de la GEP, tras 4 semanas y 12 semanas después de la intervención. Los datos incluyen edad, género, NRS 2002 y enfermedad subyacente: cánceres de cabeza y cuello (CCC) y disfagia neurológica (DN). Después de la intervención, estos pacientes fueron alimentados con preparaciones domésticas. Resultados: 146 enfermos (89 hombres), entre 21‑95 años: CCC-56, DN-90. Valores de Cu entre 42-160 μg/dl (normal: 70-140 μg/dl); normales 89% (n = 130); bajos 11% (n = 16), albúmina baja: 53% (n = 77), transferrina baja: 65% (n = 94), IMC bajo: 53% (n = 78). Después de 4 semanas: valores normales de Cu en 93% y bajos en 7%, albúmina baja en 34%, transferrina baja en 52%. Tras 12 semanas: valores normales de Cu en 95% y bajos en 5%, albúmina baja en 25%, transferrina baja en 32%. No encontramos diferencias significativas en el Cu sérico cuando se compara edad, género, enfermedad subyacente, IMC, albúmina y transferrina. Conclusiones: La mayoría de los enfermos presentan Cu sérico normal en el momento de la gastrostomía. Para los enfermos con Cu sérico bajo antes del procedimiento, la alimentación con preparaciones domésticas parece suficiente para su normalización progresiva

Selenium in dysphagic patients who underwent endoscopic gastrostomy for long term enteral feeding

Background and aims - Endoscopic gastrostomy (PEG) patients usually present protein-energy malnutrition, but little is known about selenium deficiency. We aimed to assess serum selenium evolution when patients underwent PEG, after 4 and 12 weeks. We also evaluated the evolution of albumin, transferrin and Body Mass Index and the influence of the nature of the underlying disease. Methods - A blood sample was obtained before PEG (T0), after 4 (T1) and 12 (T3) weeks. Selenium was assayed using GFAAS (Furnace Atomic Absorption Spectroscopy). The PEG patients were fed through homemade meals. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND). Results - We assessed 146 patients (89 males), between 21-95 years old: HNC-56; ND-90. Normal values of selenium in 79% (n=115); low albumin in 77, low transferrin in 94, low values for both serum proteins in 66. Low BMI in 78. Selenium has slow evolution, with most patients still displaying normal Selenium at T3 (82%). Serum protein levels increase from T0 to T3, most patients reaching normal values. The nature of the underlying disease is associated with serum proteins but not with selenium. Conclusions - Low serum selenium is uncommon when PEG is performed, after 4 and 12 weeks of enteral feeding and cannot be related with serum proteins levels or dysphagia cause. Enteral nutrition using customized homemade kitchen meals is satisfactory to prevent or correct Selenium deficiency in the majority of PEG patients.RESUMEN - Introducción y objetivos: Los pacientes con gastrostomía endoscópica (GEP) presentan malnutrición calórica-proteica, pero poco se conoce sobre la deficiencia de selenio. Estudiamos la evolución del selenio sérico en el momento de la GEP y después 4 y 12 semanas. Además, evaluamos la evolución de albúmina, transferrina, índice de masa corporal (IMC) y la influencia de la enfermedad subyacente. Métodos: Obtenemos una muestra de sangre antes de la gastrostomía (T0), y después de 4 (T1) y 12 (T3) semanas. El selenio fue valorado mediante GFAAS (Furnace Atomic Absorption Spectroscopy). Los enfermos consumieron alimentos de preparación doméstica. Los pacientes fueron estudiados como un grupo y después separados en dos grupos: cánceres de cabeza y cuello (CCC) y disfagia neurológica (DN). Resultados: 146 Enfermos (89 hombres), entre 21‑95 años: CCC-56, DN-90. Valores normales de selenio en 79% (n = 115), albúmina baja: 77 enfermos, transferrina baja: 94, las dos proteínas bajas: 66, IMC bajo: 78. El selenio ha demostrado una evolución lenta en el 82% de los enfermos presentando selenio normal en T3. Las proteínas séricas incrementaron sus valores en T0-T3, la mayoría de los enfermos alcanzó niveles normales. La enfermedad subyacente, CCC o DN, se relacionó con las proteínas, pero no con el selenio. Conclusiones: El selenio sérico bajo es poco común antes de la gastrostomía; después de 4 y 12 semanas de nutrición enteral no tiene relación con las proteínas séricas ni con la enfermedad que causa la disfagia. La nutrición con alimentación de preparación doméstica es suficiente para prevenir o corregir la deficiencia de selenio de la mayoría de los enfermos

Cox-2 inhibition with nutraceuticals: a new therapeutic approach against Helicobacter pylori infection

Abstract no.: P3.7 publicado em: Helicobacter 2012;17(Suppl.1):98Accumulated evidence in humans and animals shows that H. pylori up-regulate the expression of cyclooxygenase (COX)-2 both at mRNA and protein levels which might be one of the mechanisms leading to several gastric diseases. Aim: To study the expression of COX-2 on mice gastric mucosa during long-term treatment with two nutraceuticals: curcumin and synbiotic 2000 on H. pylori experimental chronic infection. Materials and Methods: We infected 45 C57BL/6 mice with SS1 – H. pylori strain. After infection confirmation by 13C-urea breath test mice where then treated with either PBS, curcumin (10 mg/mouse) or Synbiotic 2000 (50 mg/ mouse), three times per week. Five mice from each treatment group were euthanized at week 6, 18 and 27. Gastric samples were removed for COX-2 immunohistochemistry analysis. Results: All the 45 mice were Hp positive by 13C-urea breath test and immunohistochemistry. In the PBS group the production of COX-2 was significantly up-regulated at week 6 (area of positive immunostaining 393–544 · 103 pixels), 18 (area of positive immunostaining 242–614 · 103 pixels) and 27 week (area of positive immunostaining 129–175 · 103 pixels). The treatment with either curcumin or synbiotic significantly decreased the expression of COX-2 at all time points. Conclusions: These results suggest the therapeutic usefulness of both nutraceuticals on COX-2 inhibition during chronic experimental mice H. pylori infection. The supplementation of diet in humans with curcumin or Synbiotic 2000 may be a novel therapeutic approach against gastric inflammation induced by Hp infection

The patients’ perspective : what causes hospitalizations for ambulatory care sensitive conditions?

© Ubiquity Press 2019Introduction: In Portugal, the hospitalizations for ambulatory care sensitive conditions (ACSH) account for 12% of all hospitalizations with an estimated financial impact of up to 450 million€. Therefore, understanding the determinants of avoidable hospitalizations is important to develop policies and interventions that reduce the ACSH. Analyzing the patient’s perspective brings an angle relevant to explain the ACSH. Despite patients are the most qualified to express the social and individual context of their experience, few studies have investigated the patients’ perspective about what causes ACSH. The aim of this study is to compare the perspective of patients on the determinants of the ACSH.info:eu-repo/semantics/publishedVersio

Risk factors for metabolic bone disease in Crohn's disease patients

Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn’s disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both groups had dual-energy x-ray absorptionmetry and a nutritional evaluation. Single nucleotide polymorphisms at the IL1, TNF-a, LTa, and IL-6 genes were analyzed in patients only. Statistical analysis was performed using SPSS software. Results: The prevalence of MBD was significantly higher in patients (P ¼ 0.006). CD patients with osteoporosis were older (P < 0.005), small bowel involvement and surgical resections were more frequent (P < 0.005), they more often exhibited a penetrating or stricturing phenotype (P < 0.05), duration of disease over 15 years (P < 0.005), and body mass index (BMI) under 18.5 kg/m2 (P < 0.01) were more often found. No association was found with steroid use. Patients with a Z-score < 2.0 more frequently had chronic active disease (P < 0.05). With regard to diet, low vitamin K intake was more frequent (P ¼ 0.03) and intake of total, monounsaturated, and polyunsaturated fat was higher in patients with Z-score < 2.0 (P < 0.05). With respect to genetics, carriage of the polymorphic allele for LTa252 A/G was associated with a higher risk of osteoporosis (P ¼ 0.02). Regression analysis showed that age over 40 years, chronic active disease, and previous colonic resections were independently associated with the risk of developing MBD. Conclusions: The prevalence of MBD was significantly higher in CD patients. Besides the usual risk factors, we observed that factors related to chronic active and long-lasting disease increased the risk of MBD

development and validation of a questionnaire

Funding Information: We thank Centro Hospitalar de Lisboa Central for helping to conduct the study, and the patients that participated in the study. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Ambulatory care sensitive conditions (ACSC) can be avoided through effective care in the ambulatory setting. Patients are the most qualified individuals to express the social and individual contexts of their own experience. Thus, understanding why potentially preventable hospitalizations occur is important to develop patient-centred policies or interventions that may reduce them. This study aims to develop and validate a questionnaire to capture the patients’ perspective on the causes of the hospitalizations for ACSC. The development of a new questionnaire involved four phases: a literature review, face validity, pre-test, and validation. We conducted a three-step face validity verification to confirm the relevance of the identified determinants and to collect determinants not previously identified by interviewing healthcare providers, representatives of patients’ associations, and patients. Determinants were identified through the literature review predominantly in the “Healthcare Access”, “Disease self-management”, and “Social Support” domains. The validated resulting questionnaire comprises 25 questions, distributed by two dimensions (individual/contextual) covering seven domains and 20 determinants of ACSC hospitalization. Currently, there are no validated instruments as comprehensive and easy to use as the one described in this paper. This questionnaire should provide a base for further language/context validations.publishersversionpublishe

Impact of transferring arts dispensing from hospital to community pharmacies : a pilot study in Portugal

Copyright © 2018 Elsevier B.V. or its licensors or contributors.Objectives: Currently, in Portugal, People Living with HIV (PLHIV) refill antiretroviral therapy (ART) at Hospital Pharmacies (HP). We aimed to assess the impact of transferring ARTs dispensing from HP to community pharmacies (CPs) in the Portuguese setting.info:eu-repo/semantics/publishedVersio