Qualidade nos cuidados de enfermagem: que realidade?

Este trabalho de revisão bibliográfica foi realizado no âmbito do IX Programa de Doutoramento em Enfermagem, do Instituto de Ciências da Saúde da Universidade Católica Portuguesa do Porto. A existência de sistemas de saúde que garantam a prestação efectiva de cuidados de qualidade é, actualmente uma das prioridades de variadas organizações, entre elas constam: a ODCE, OMS, SNS e OE. A qualidade dos cuidados de enfermagem para além da importância que tem para a instituição e doente, deve ter uma importância máxima para o prestador de cuidados. O enfermeiro deve almejar a qualidade em cada gesto realizado, deve procurar que o desempenho da sua função seja mais do que uma simples execução de tarefas (Ascensão, 2010). Objectivos: Conhecer o estado da arte em língua portuguesa em termos da qualidade dos cuidados de enfermagem. Conhecer as metodologias usadas no estudo da qualidade dos cuidados de enfermagem. Material e Tratou-se de uma revisão de literatura tendo por finalidade identificar o conhecimento existente sobre esta temática. Foi realizada uma pesquisa na base de dados B-On, tendo em conta Dissertações de Licenciatura, de Mestrado, de Doutoramento e artigos, disponíveis em texto integral, que tivessem como palavras-chave no título: Cuidados, Qualidade e Enfermagem. A pesquisa foi efectuada para documentos em português entre os anos de 2000 e 2013. Resultados: A pesquisa encontrou, na B-on dezoito documentos, artigos de periódicos da área da saúde. Destes dezoito um artigo encontrava-se em quadruplicado e outro em duplicado. Quatro deles não foram incluídos por não dizerem respeito à área em questão. No final, após aplicação dos critérios de pesquisa, reunimos um conjunto de dez documentos (cinco teses, três artigos e duas comunicações em conferências) que se constituíram como o nosso corpus de análise. Os documentos estão disponíveis em texto integral. Discussão e Conclusão: Depois de analisados os documentos encontrados concluímos que os enfermeiros proporcionam um importante contributo na melhoria da qualidade das organizações (Aleixo, 2010). Conclui-se também que existe uma urgência na execução de ações de educação continuada, uma vez que a formação é considerada instrumento de reflexão e mudança, sendo esta um dos pilares para a prestação de cuidados de enfermagem de excelência (Padilha, 2010; Castro, 2007). Paralelamente, conclui-se que os principais resultados da qualidade dos cuidados de enfermagem envolvem mais trabalho e decisão em equipa multidisciplinar, mais recursos materiais e humanos e melhores condições físicas (Carvalhais, 2010)

Assessing the impact of universities’ entrepreneurial activity on regional competitiveness

The aim of this study is to test the multidimensional construct of the Entrepreneurial University (EU), and therefore to confirm whether EU factors make a positive contribution to regional competitiveness. Data were collected from ten Portuguese Public Universities (PPUs) through a self-administered questionnaire. First- and second-order confirmatory factor analyses (CFA) were performed through factor and multiple linear regression analyses. The main findings show that EU related factors—perceived and combined with actual regional metrics—especially entrepreneurial supporting measures, positively contributed to regional competitiveness. This study shows policy makers that universities are not merely cost centres but provide knowledge spillovers that can have a positive influence on regional competitiveness.info:eu-repo/semantics/publishedVersio

Neurohormonal modulation: The new paradigm of pharmacological treatment of heart failure

The current paradigm of medical therapy for heart failure with reduced ejection fraction (HFrEF) is triple neurohormonal blockade with an angiotensin-converting enzyme inhibitor (ACEI), a beta-blocker (BB) and a mineralocorticoid receptor antagonist (MRA). However, three-year mortality remains over 30%. Stimulation of counter-regulatory systems in addition to neurohormonal blockade constitutes a new paradigm, termed neurohormonal modulation. Sacubitril/valsartan is the first element of this new strategy. PARADIGM-HF was the largest randomized clinical trial conducted in HFrEF. It included 8442 patients and compared the efficacy and safety of sacubitril/valsartan versus enalapril. The primary endpoint was the composite of cardiovascular mortality and hospitalization due to HF, which occurred in 914 (21.8%) patients receiving sacubitril/valsartan and in 1117 (26.5%) patients receiving enalapril (HR 0.8, 95% CI 0.73-0.87, p=0.0000002; NNT 21). Sacubitril/valsartan reduced both primary endpoint components, as well as sudden cardiac death, death due to worsening HF, and death from all causes. Patients on sacubitril/valsartan reported less frequent deterioration of HF and of quality of life, and discontinued study medication less frequently because of an adverse event. PARADIGM-HF demonstrated the superiority of sacubitril/valsartan over enalapril, with a 20% greater impact on cardiovascular mortality compared to ACEIs. Accordingly, in 2016, the European (ESC) and American (ACC/AHA/HFSA) cardiology societies simultaneously issued a class I recommendation for the replacement of ACEIs by sacubitril/valsartan in patients resembling PARADIGM-HF trial participants.info:eu-repo/semantics/publishedVersio

Wind power forecasting with machine learning: single and combined methods

In Portugal, wind power represents one of the largest renewable sources of energy in the national energy mix. The investment in wind power started several decades ago and is still on the roadmap of political and industrial players. One example is that by 2030 it is estimated that wind power is going to represent up to 35% of renewable energy production in Portugal. With the growth of the installed wind capacity, the development of methods to forecast the amount of energy generated becomes increasingly necessary. Historically, Numerical Weather Prediction (NWP) models were used. However, forecasting accuracy depends on many variables such as on-site conditions, surrounding terrain relief, local meteorology, etc. Thus, it becomes a challenge to obtain improved results using such methods. This article aims to report the development of a machine learning pipeline with the objective of improving the forecasting capability of the NWP’s to obtain an error lower than 10%.info:eu-repo/semantics/publishedVersio

High-risk features and predictors of unexplained syncope in the young SCD-SOS cohort

Introduction: The Sudden Cardiac Death-Screening of Risk FactOrS survey included a 12-lead ECG plus a digital-based questionnaire and aimed to screen for warning signs of diseases that may course with sudden cardiac death in children and young adults. We aimed to estimate the prevalence of unexplained syncope (US) and characterize its high-risk features and predictors in this cohort. // Methods &Results: We determined the most probable etiology of transient loss of consciousness (TLOC) episodes based on clinical criteria. US was an exclusion diagnosis and we analyzed its potential clinical and ECG predictors. Among 11,878 individuals, with a mean age of 21±6 (range 6-40) years-old, the cumulative incidence of TLOC was 26.5%, 76.2% corresponding to females. Reflex syncope was present in 66.4%, orthostatic hypotension in 8.2% and 14.8% of the individuals had US. Unexplained syncope was independently associated with age <18years-old (OR 1.695; 95%CI 1.26-2.29,p=0.001), male gender (OR 1.642; 95%CI 1.22-2.22,p=0.001), participation in competitive sports (OR 1.644;95%CI 1.01-2.66,p=0.043), syncope during exertion and/or palpitations preceding syncope (OR 2.556; 95%CI 1.92-3.40,p<0.001), syncope after exertion (OR 2.662; 95%CI 1.73-4.10,p<0.001), fever context (OR 9.606; 95%CI 4.13-22.34,p<0.001), isolated previous syncopal episode (OR 2.780; 95%CI 0.2.06-3.75,p<0.001) and history of palpitations requiring medical care (OR 1.945; 95%CI 1.14-3.31,p=0.014). We found no ECG predictors of US in this population. // Conclusions: The cumulative incidence of TLOC in children and young adults is high and remains unexplained in an important proportion of individuals. We identified eight clinical characteristics that may be useful for the risk stratification of individuals evaluated in a non-acute setting

Technological and Sustainable Perception on the Advancements of Prefabrication in Construction Industry

The construction industry has experienced phenomenal growth because of technological advancements in the past couple of decades. Prefabrication constitutes a sizeable share of this industry and is being adopted all over the world. The method of casting construction elements in a controlled environment and assembling them on-site has revolutionised the industry. Research on various aspects of the technology is ongoing around the world, and an impressive number of articles have been published. However, the prefab technology, materials used, and terminology have varied across locations, which may have hindered the method’s wider acceptability. By evaluating technical articles published between 1991 and 2022, this report analyses the present body of knowledge regarding prefab technology, its evolution, sustainability, and stakeholder views. This technology effectively contributes around 40% in time saving, 27% in cost reduction, 30% in reduced carbon emissions, and 84% in on-site wastage reduction. It also increases quality, gives a dependable alternative for meeting mass construction targets, is energy efficient, and provides environmentally conscious options. This paper contributes to the body of knowledge by providing a snapshot of the prefab industry spanning three decades, detailing a wide range of factors affecting the industry

Life Cycle Assessment of a Sustainable Prefabricated Housing System: A Cradle-to-Site Approach Based on a Small-Scale Experimental Model

India is in need of rapid construction technology with sustainability and environmentally friendly aspects. Prefabrication is a well-known technique that lowers carbon emissions and reduces environmental impacts. Life cycle assessment (LCA) evaluates these impacts of developed product/process. A new-age construction product was designed from a locally available agro-industrial waste called co-fired ash (CFA). Expanded polystyrene beads, fly ash, and crushed sand were also used in designing lightweight (LW) sustainable prefabricated panels. The effect of incorporating sustainable alternates into the mix designs is to be studied. An experimental small-scale model house was erected and LCA for the same was carried out with cradle-to-site approach. Based on the inventory, the environmental impact was assessed for four different indicators: acidification potential (AP), eutrophication potential (EP), global warming potential (GWP), and ozone depletion potential (ODP) were evaluated. Carbon emissions of the respective CFA-based concrete and LW prefabricated mix were found to be 0.162 kgCO2e/kg and 0.268 kgCO2e/kg, respectively. The impact of energy required during production, transport, and indirect emissions were found to contribute 3%, 3%, and 94%, respectively, to the proposed prefabricated system. Comprehensively, the phase involving mixing of LW mix contributed majorly towards all the impact indicators followed by mould preparation and material transport. The presented data helps the academia to quantify and recognise the possibilities to enhance their products’ performance

Paradoxical effects of Worrisome Thoughts Suppression: the influence of depressive mood

Thought suppression increases the persistence of unwanted idiosyncratic worries thoughts when individuals try to suppress them. The failure of suppression may contribute to the development and maintenance of emotional disorders. Depressive people seem particulary prone to engage in unsuccessful mental control strategies such as thought suppression. Worry has been reported to be elevated in depressed individuals and a dysphoric mood may also contribute for the failure of suppression. No studies examine, however, the suppression of worisome thoughts in individuals with depressive symptoms. To investigate the suppression effects of worrisome thoughts, 46 participants were selected according to the cut-off score of a depressive symptomatology scale and they were divided in two groups (subclinical and nonclinical group). All the individuals took part in an experimental paradigm of thought suppression. The results of the mixed factorial analysis of variance revealed an increased frequency of worrisome thoughts during the suppression phase on depending of the depressive symptoms. These findings confirm that depressive mood can reduce the success of suppression.info:eu-repo/semantics/publishedVersio

Alergias “alimentares” a medicamentos: presença de proteína do leite de vaca, soja e /ou glúten

Poster apresentado no Congresso Nacional dos Farmacêuticos 2020 “Abrir Horizontes. Fazer Acontecer” e XIV Congresso Mundial dos Farmacêuticos de Língua Portuguesa. 26-28 Novembro 2020, Lisboa, PortugalN/