Person-Centered Attention on the provision of care for elderly: approaches, evaluation tools and relevance of its study in Portugal

Population aging is an achievement that generates new challenges and needs, highlighting the increase in dependence situations, which require quality services and professional care (Kinsella & Phillips, 2005; Zubritsky, Abbott, Hirschman, Bowles, Foust, & Naylor 2013). The biomedical model has dominated the elderly care provision in Portugal and shows signs of unsustainability (Díaz-Veiga, Uriarte, Yanguas, Cerdó, Sancho, & Orbegozo, 2016).N/

ANÁLISE DA RELAÇÃO ENTRE A IMAGEM INSTITUCIONAL E A SATISFAÇÃO DOS ALUNOS PARA SUBSIDIAR O MARKETING EDUCACIONAL

O marketing educacional das universidades precisa considerar os diversos públicos relacionados a ela e estar embasado em atributos chave, como são a satisfação e a imagem percebida. No caso das instituições de ensino superior pago o marketing torna-se mais necessário, pois a realidade atual no Brasil apresenta um mercado educacional de altíssima concorrência. Com o objetivo de preencher alguma das carências em pesquisas que abordem estes assuntos se analisa a relação existente entre a satisfação e a imagem corporativa percebida pelos alunos de uma universidade privada de Santa Catarina. Os dados foram obtidos numa pesquisa survey com 535 alunos em 2005. O questionário foi estruturado em sete blocos, correspondendo os seis primeiros às imagens percebidas das características gerais (bloco A, nove itens); instalações físicas (bloco B, 7 itens); funcionários (bloco C, 7 itens); ensino (bloco D, 6 itens); serviços oferecidos (bloco E, 5 itens); e, ambiente da universidade (bloco F, 3 itens). Por sua vez, a satisfação foi aferida por um bloco único (G) com dez itens. Os resultados obtidos na análise canônica indicam correlações significativas para os seis primeiros pares de variáveis canônicas entre o bloco da satisfação e a percepção da imagem, quando considerados em conjunto os seis blocos. A correlação canônica, nessa condição, alcançou o valor de RCAN= 0,838. As análises em separado do bloco da satisfação com cada bloco da percepção da imagem mostram que o valor máximo se registra para a correlação canônica com o ensino (RCAN= 0,735), seguido pela existente com os serviços oferecidos pela instituição de ensino superior - IES (RCAN= 0,721), as características gerais (RCAN= 0,697), o ambiente na universidade (RCAN= 0,589), os funcionários (RCAN= 0,582), até atingir o mínimo valor, mas também significativo, com as instalações físicas (RCAN= 0,528). Se for calculada a correlação canônica entre a satisfação e as afirmativas que dizem respeito da reputação e da qualidade, considerando os blocos do ensino, serviços oferecidos e características gerais, seu valor alcança RCAN= 0,782. A correlação canônica calculada a partir das segmentações idade, faixa de renda e período mostram também aspectos importantes a considerar. Os diversos achados permitem concluir que o fortalecimento da IES no mercado em que atua dependerá dos investimentos feitos no sentido de aumentar principalmente sua reputação e a qualidade dos serviços oferecidos

Percepção da imagem e satisfação em egressos universitários: uma análise correlacional.

As universidades, como instituições estratégicas no desenvolvimento nacional e regional, precisam desenvolver um marketing educacional embasado em atributos chave, como são a satisfação e a imagem percebida, tanto pelos atuais membros da organização quanto por aqueles que por ela passaram ou são servidos. No caso do Brasil, esta situação torna-se mais necessária para aquelas instituições de ensino superior pago, pois se encontram inseridas num mercado onde a concorrência foi crescente durante as duas últimas décadas. Embora esta realidade seja consenso entre os gestores, são poucas as pesquisas que abordam estes assuntos e menos, ainda, as instituições que as usam nos seus planejamentos de marketing. Com o objetivo de analisar a relação existente entre imagem e satisfação dos alunos, em uma universidade privada do Meio Oeste catarinense, foi realizada uma pesquisa survey com 273 egressos, que concluíram seus cursos em 2004. Os resultados obtidos indicam correlações significativas entre as imagens cognitiva, afetiva e global com a satisfação. Os dois primeiros fatores extraídos da matriz correspondente às percepções da imagem cognitiva, relacionados à qualidade (r = 0,59) e à reputação (r = 0,26) respectivamente, apresentam os maiores valores de correlação com a satisfação, sendo a reputação o fator que mostrou maior relacionamento com a imagem global (r = 0,36) e com a imagem afetiva (r = 0,56). A análise dos dados permite concluir que investimentos em qualidade e reputação serão relevantes para o fortalecimento da organização perante o mercado em que atua

Acute Disseminated Encephalomyelitis – A Case Series

Introdução: A encefalomielite aguda disseminada (ADEM) é uma doença desmielinizante, tipicamente monofásica, do sistema nervoso central, caracterizada por alterações neurológicas inespecíficas e neuroimagem com lesões desmielinizantes multifocais. Objetivos: Descrever dados epidemiológicos, clínicos, laboratoriais, imagiológicos, tratamento e evolução de uma coorte pediátrica com diagnóstico inicial de ADEM. Materiais e Métodos: Análise retrospectiva entre 2010- 2015 de crianças/adolescentes admitidas em hospital nível II. Resultados: Foram identificados onze casos, com predomínio do género masculino e idades entre 8 meses e 16 anos. Sete casos ocorreram no inverno/primavera. Em mais de metade dos casos havia história de patologia infeciosa recente. Sinais neurológicos mais frequentes: défices motores, neuropatia craniana e rigidez da nuca. Em todos os casos foram detetadas alterações do líquido cefalorraquidiano. Foi estabelecido diagnóstico microbiológico definitivo em duas crianças com vírus Epstein-Barr e diagnóstico provável/possível em duas crianças com infeção prévia por rotavírus e varicela. A ressonância magnética nuclear (RMN) identificou em todos os casos lesões multifocais. Todas as crianças foram submetidas a corticoterapia em altas doses. Em dois casos foi também administrada imunoglobulina humana. Verificou-se ADEM multifásica num caso, após um ano de seguimento. Em dois casos surgiram critérios de esclerose múltipla (EM). A taxa de mortalidade foi nula. Foram constatadas sequelas neurológicas em dois casos. A distinção entre ADEM e EM na altura da sua apresentação inicial permanece, em alguns casos, um desafio. Conclusões: A análise desta série de casos sugere que a presença de infeção esteja associada à etiologia da ADEM. A RMN foi o estudo de escolha para diagnóstico e seguimento. O prognóstico foi excelente. A distinção entre ADEM e EM permanece um desafio.Background: Acute disseminated encephalomyelitis (ADEM) is a demyelinating monophasic disorder of the central nervous system characterized by diffuse neurologic signs and symptoms coupled with multifocal demyelinating lesions on neuroimaging. Aims: To describe the epidemiology, symptoms and signs, laboratory features, neuroimaging, treatment and outcome in a pediatric cohort with the initial diagnosis of ADEM. Methods and Materials: A retrospective review, between 2010-2015, of children/adolescents admitted at a level II hospital. Results: Eleven cases were identified with male predominance and ages between 8 months and 16 years. Seven patients presented in winter/spring. More than half of the cases had a recent infectious disease. Patients presented most often with motor deficits, cranial neuropathy and stiff neck. All patients had spinal fluid abnormalities. A definitive microbiologic diagnosis was established in two children with Epstein-Barr virus disease and probable/possible diagnosis in two children with previous rotavirus disease or varicella. Brain magnetic resonance imaging (MRI) identified multifocal lesions in every case. All patients were treated with corticosteroids, and two were also treated with human immunoglobulin. There was one case with multiphasic ADEM (after one year follow-up) and two cases developed criteria of multiple sclerosis (MS). All patients survived. Two patients had neurologic sequelae. The differential diagnosis between ADEM and MS at first presentaion may be challenging. Conclusions: Our case series suggests that infections are associated with the etiology of ADEM. MRI was the neuroimaging study of choice for diagnosis and follow-up. Prognosis was excellent. It remains difficult to differentiate ADEM and multiple sclerosisinfo:eu-repo/semantics/publishedVersio

a video-based research

UID/EAT/00693/2013 PD/BD/114489/2016Performing Arts for Infancy has been a topic of growing interest to families and different agents involved in artistic programming throughout the world. Aligned with this trend, research on the benefits of these practices on children development has increased in the past few years. Nevertheless, this field of study has yet a wide range of issues to explore. Since the age group addressed has not yet acquired verbal communication, it seems important to find innovative and alternative ways of exploring non-verbal communication. For this purpose, LAMCI (Laboratório de Música e Comunicação na Infância) has been developing a project based on professional musical productions for young audiences by Companhia de Música Teatral. This research is grounded on concepts such as “communicative musicality” by Colwyn Trevarthen, “audiation” by Edwin Gordon or “engagement” by Edward Tronick. This project aims to report the narrative composed by infants, parents and artists during live musical-theatrical performances; and to extract the main features of musical behavior between the different parties. The research is based on selected video material from different performances created by Companhia de Música Teatral, such as BebéPlimPlim, Zyg, AliBaBach. This selection is focused on the behaviors emerging during these productions, namely between parents and infants, infants and artists, and parents, infants and artists. All video materials were colected by three researchers using previously team-defined concepts and categories of behavior. The outcomes of this work will be available as an open source that consist on video tools, providing a platform for artists, caregivers, child psychologists and infant specialists to deepen their understanding of children behavior. The goal of this paper is to review the concepts created by the authors mentioned, connecting them to the observations gathered from the selected video materials. Discussing such concepts throught video materials, contributes to a wider vision of the field, that can also bring implications for further practice, discovering new paths related to performing arts for infancy.publishersversionpublishe

From the drama of unoccupied time and isolation due to Covid-19’s pandemic to the need for person-centered care at residential care facilities in Portugal

During the pandemic, restrictive measures were implemented at Portuguese residential care facilities (PRCF), such as isolating residents and ceasing collective activities. It is important to understand how PRCF are implementing activities that allow residents to occupy their time and fight isolation. As such, we aim to analyze whether: 1. new activities were implemented for residents (identifying which were carried out); 2. occupation activities were provided to isolated residents in their rooms (identifying which were carried out); 3. the implementation of activities is associated with variables like the amount of staff. This is an exploratory, quantitative, and cross-sectional study. An online questionnaire was sent by email to 2325 PRCF and entities were asked to share it with their workers. The study was also divulged on social networks. Data collection occurred between July 8th and October 18th, 2020. The study had 784 staff members participating and 90.8% reported that new activities were implemented at their facilities, predominantly videocalls. Concerning isolated residents most respondents (64.4%) stated that providing activities was impossible. Results showed that those PRCF that expanded teams had a higher percentage of new activities and activities with residents isolated in bedrooms. These results are alarming because while residents should have had more resources to cope with the pandemic, higher risks of unoccupied time and isolation existed, a dramatic situation for its potentially harmful consequences. Focusing on sanitary issues (and less on older adults) may reinforce traditional care models that had shown negative impacts before the pandemic. This highlights the need to evolve the care paradigm during and beyond the pandemic at PRCF: with Person-Centered Care as an option.info:eu-repo/semantics/publishedVersio

Caring and Working during the COVID-19 Pandemic: Perspective of Portuguese Residential Care Facility Workers

Residential care facilities (RCF) for older people are facing high demands due to the COVID-19 pandemic. The aim of this study was to explore the workers’ perspectives on the changes in work and care dynamics amidst the first wave of the pandemic at Portuguese RCF. This is a descriptive, quantitative, and cross-sectional study. An online questionnaire about pandemic-induced changes in work and care dynamics was sent to 2325 RCF. These entities were then asked to share it with their workers. The participants (n = 784) were mostly women (92.7%) and mostly composed of technical directors (41.6%) and direct-care workers (17.1%). The respondents reported that during the first wave of the pandemic, when compared to the pre-pandemic period, there were greater difficulties in providing care related to the basic necessities of older people (52.7%); direct-care workers were required to work more consecutive hours in each shift (69.95%); direct-care workers had to live at RCF (14.8%), and there were changes concerning the possibility of promoting person-centered care (PCC) practices. It also revealed that focusing on disease prevention and sanitary measures alone facilitates practices that reinforce the traditional model of procedure-centered care and have negative consequences on the rights and well-being of those living and working at RCF, exposing and accentuating preexisting vulnerabilities. This study considers the pandemic’s serious implications and alarming questions about basic care, dignity, living, and working conditions at Portuguese RCF. These notions reinforce the need for change through redefining care policies and practices in Portuguese RCF beyond the pandemic. The current situation provides an opportunity to adopt a formal PCC model.Maria Miguel Barbosa received a PhD grant for Programa Doutoral em Gerontologia e Geriatria (PDGG, School of Medicine and Biomedical Sciences; University of Porto) from the Fundação para a Ciência e Tecnologia (FCT) under grant SFRH/BD/138897/2018, financed by national funds from Ministério da Ciência, Tecnologia e Ensino Superior (MTCES) and Fundo Social Europeu (FSE-EU) through the Programa Operacional Regional Centro (PORC-UE). The APC was funded by Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto.info:eu-repo/semantics/publishedVersio

Is it useful to ask "Está deprimido?" ("Are you depressed?") to terminally-ill Portuguese patients? Results from outpatient research

OBJECTIVES: Depression is a serious psychological problem in the palliative care setting. Brief screening tools for depression are lacking and need to be brief and acceptable. This study aimed to identify the properties of the single Portuguese question "Está deprimido?" ("Are you depressed?") to screen for depression. METHODS: Retrospective study from 100 patient's medical records identifying the answers on the single Portuguese question for depression "Está deprimido?" ("Are you depressed?") and the HADS depression sub-scale, using a score ≥11 on the latter as the gold standard for clinically significant depressive symptoms. Sensitivity, specificity, positive predictive and negative values were calculated. RESULTS: Response rate for the single Portuguese question for depression was 100%. Prevalence of depression symptoms (HADS-d ≥ 11) was 43%. To the question "Está deprimido?" 60 patients responded "yes." Sixteen patients who replied "no" to the single question had clinically significant depressive symptoms based on the HADS depression sub-scale. The single tool had 65.2% sensitivity, 49.2% specificity and 50.0% and 64.4% of positive predictive and negative values, respectively. SIGNIFICANCE OF RESULTS: In this first preliminary retrospective Portuguese study, the single question for depression has shown poor screening properties. Future research in larger and mixed patientś samples of Portuguese terminally ill is necessary to find more accurate and robust properties of this brief tool