Influência da terapia ocupacional na capacidade funcional e na autonomia dos doentes com esclerose lateral amiotrófica

Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2014A Esclerose Lateral Amiotrófica (ELA) é uma doença neurológica degenerativa progressivamente incapacitante, que leva à morte entre dois a cinco anos após o início dos sintomas, normalmente devido a problemas respiratórios. O Riluzol é a única intervenção farmacológica estabelecida com acréscimo de três a seis meses na sobrevida. A Ventilação Não-Invasiva (VNI) e a gastrostomia por via endoscópica também são terapêuticas aceites que minimizam os efeitos da insuficiência respiratória e da desnutrição respetivamente. Atualmente é consensual a necessidade de uma abordagem multidisciplinar, mas a evidência da reabilitação não é convincente, devido às controvérsias relativas ao exercício e aos escassos estudos que avaliam a eficácia da terapia ocupacional. O presente estudo visa determinar se a intervenção da terapia ocupacional influencia a capacidade funcional e a qualidade de vida em termos de participação e autonomia dos doentes com ELA, e analisar as possíveis relações entre a capacidade funcional dos referidos doentes com o seu nível de participação e autonomia, e quais as suas repercussões em termos de qualidade de vida. A amostra total do estudo é constituída por 36 doentes com ELA, que foram subdivididos em dois grupos de 18 doentes cada, tendo um dos grupos usufruído da intervenção da Terapia Ocupacional e o outro não. Os instrumentos utilizados na recolha de dados foram os seguintes: Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), Medida de Independência Funcional (MIF), Impact on Participation and Autonomy (IPA), Edmonton Symptom Assessment Scale (ESAS), Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ 40), EuroQol - 5 Dimensions - 3 Levels (EQ-5D-3L) e Medical Outcomes Study 36 – Item Short Form Health Survey (SF-36). Neste estudo não foram encontradas diferenças significativas na capacidade funcional, na participação e na autonomia dos doentes submetidos a intervenção no grupo experimental entre os dois momentos de avaliação, o que mostra que a intervenção da terapia ocupacional pode ajudar a manter os seus níveis de funcionalidade. Relativamente à qualidade de vida foram encontradas diferenças significativas entre os momentos de avaliação, o que evidencia o papel fundamental da intervenção da terapia ocupacional na melhoria da qualidade de vida destes doentes. Estes resultados demonstram que a intervenção da terapia ocupacional contribui para a diminuição do declínio funcional e influencia a participação e autonomia dos doentes com ELA, e que isso se traduz numa melhoria da sua qualidade de vida, pelo que é de recomendar a inclusão da terapia ocupacional nos programas de reabilitação.Amyotrophic Lateral Sclerosis (ALS) is a degenerative neurological disease progressively disabling, leading to the death between two to five years after onset of symptoms, usually due to respiratory problems. Riluzole is an orphan therapy and it just increases survival for 3-6 months. A multidisciplinary approach is the mainstay today recognizing the evidence regarding to non-invasive ventilation to overcome respiratory symptoms and percutaneous endoscopic gastrostomy to deal with swallowing and nutrition issues. Overall there is no convincing evidence towards rehabilitation, in particular due to the exercise controversies and the very few studies evaluating the efficacy of occupational therapy. This study aims to determine whether the intervention of occupational therapy influences the functional capacity, participation and autonomy of patients with ALS, and analyze the possible relationships between functional capacity to the level of participation and empowerment, and what is their impact on quality of life. Our sample consisted of 36 ALS patients divided into two groups of 18 patients each, with one group enjoyed the intervention of occupational therapy (G2) and the other not (G1). The instruments used in data collection were: Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), International Classification of Functioning, Disability and Health (ICF), Functional Independence Measure (FIM), Impact on Participation and Autonomy (IPA), Edmonton Symptom Assessment Scale (ESAS), Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40), EuroQol – 5 Dimensions - 3 Levels (EQ-5D-3L) and Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36). There were no significant differences in functional capacity, participation and autonomy of patients between the two time points in G2, which shows that the intervention of occupational therapy can help keep your levels of functionality. Regarding quality of life was found significant differences between time points, which highlight the role of occupational therapy intervention in improving the quality of life of these patients. These results demonstrate that the intervention of occupational therapy has an influence on functional ability, participation and autonomy of patients with ALS, and that this translates into a better quality of life, which is to recommend its inclusion in rehabilitation programs

Characterization of Cynara cardunculus L. flower from Alentejo as a coagulant agent for cheesemaking

The cardoon (Cynara cardunculus L.) is a mandatory vegetable coagulant for certain Protected Designation of Origin Portuguese cheeses. It grows wild in Portugal and is used without any type of control regarding flower picking or extract preparation, representing some uncertainty in cheese manufacture. The variability in technological properties, in the context of traditional cheese manufacture, of cardoon flower ecotypes from the Alentejo region was evaluated, including milk clotting and proteolytic activities, coagulation properties and potential cheesemaking yield of flower extracts. Multivariate statistics highlighted the variability of flower properties for cheesemaking, but allowed the aggregation of the ecotypes into five groups under the major influence of milk clotting activity and effect on gel firmness and micellar aggregation rate, followed by proteolytic activity. These differences may have an impact on cheese properties and therefore can allow the selection of cardoon flower for the manufacture of different types of cheese

Produção de Açaí em Terra Firme: prospectando demandas a partir de conteúdos exibidos no YouTube

This article analyzes data displayed on YouTube related to videos about the planting of açaí on dry land. The chosen theme considered: the importance of açaí (Euterpe oleracea Mart.) production for the state of Pará; the role of Embrapa in generating technologies that meet society's demands, like açaí cultivated variety; and the public's interest in the content displayed on the platform. The data were collected on Youtube, from the keyword "açaí plantation" for classification and quantitative analysis of the most relevant videos and with the highest number of views and likes. The main results indicate that the videos that arouse the greatest public engagement address the following subjects: açaí planting, seedling production, irrigation, açaí consortium and profitability. Therefore, it is concluded that the prospecting of demands from videos shown on YouTube can generate new opportunities for the development of content, technological solutions, business and communication strategies.O presente artigo analisa dados exibidos no YouTube relacionados a vídeos sobre o plantio de açaí em terra firme. A temática escolhida considerou a importância da produção de açaí (Euterpe oleracea Mart.) para o estado do Pará, o papel da Embrapa na geração de tecnologias que atendam às demandas da sociedade, considerando a cultivar de açaí, e o interesse do público pelo conteúdo exibido na plataforma. Os dados foram coletados no Youtube, a partir da palavra-chave “plantio de açaí” para classificação e análise quantitativa dos vídeos com maior número de visualizações e de likes. Os principais resultados indicam que aqueles que despertam maior engajamento do público abordam os seguintes assuntos: plantio de açaí, produção de mudas, irrigação, açaí consorciado e rentabilidade. Portanto, conclui-se que a prospecção de demandas a partir de vídeos exibidos no YouTube pode gerar novas oportunidade para o desenvolvimento de conteúdos, soluções tecnológicas, negócios e estratégias de comunicação

Conhecimento das mães no puerpério sobre a desobstrução das vias aéreas em recém-nascidos

Foreign body aspiration or choking is characterized as a condition in which an object or substance enters the airway. In the case of children, when incomplete choking occurs, the signs can be high respiratory rate, coughing and crying. In complete choking, the child has a purplish mouth, lack of air, inability to cough or cry, and the maneuver is necessary. It is essential that parents are trained to unblock the airways properly and efficiently, and health professionals play a key role in educating pregnant women and their families. This is an integrative literature review. 15 articles were found. Then, 4 categories emerged, the main reasons that can result in choking in the newborn, lack of knowledge of postpartum women regarding first aid in choking episodes, the role of nurses in guiding the puerperal woman in prevention and in the moment of choking, educational method for better understanding of the Heimlich Maneuver. It is considered that the difficulties of postpartum mothers go beyond knowledge about the subject, which includes living conditions, access to knowledge, occupations at work, housework, irregularity in the search for care in the care of the NB and domestic dangers.A aspiração de corpo estranho ou engasgo é caracterizada como uma condição em que um objeto ou substância adentra nas vias aéreas. Se tratando de crianças, quando ocorre o engasgo incompleto, os sinais podem ser a frequência respiratória elevada, tosse e choro. No engasgo completo, a criança apresenta boca arroxeada, ausência ar, inaptidão para tossir ou chorar, sendo necessário a realização da manobra. É imprescindível que pais estejam capacitados para realizar a desobstruir as vias respiratórias de modo adequado e eficiente e os profissionais da saúde desempenham um papel primordial na educação à gestante e familiares. Trata-se de uma revisão integrativa da literatura. Foram encontrados 15 artigos. Emergiram, então, 4 categorias, os principais motivos que podem resultar o engasgo no recém-nascido, déficit de conhecimento das puérperas frente aos primeiros socorros em episódios de engasgo, o papel do enfermeiro na orientação à puérpera na prevenção e no instante do engasgo, método educativo para melhor compreensão da Manobra de Heimlich. Considera-se que as dificuldades das mães puérperas vão além do conhecimento sobre o assunto, o que inclui condições de vida, acesso ao conhecimento, ocupações no trabalho, afazeres de casa, irregularidade na busca por atendimento na atenção do RN e os perigos domésticos

Characterization of Cynara cardunculus L. flower from Alentejo as a coagulant agent for cheesemaking

This work was supported by the project ValBioTecCynara (ALT2003-0145- FEDER-000038) - Economic valorisation of Cardoon (Cynara cardunculus): study of natural variability and biotechnological applications), cofinanced by FEDER under the Alentejo 2020 Program.The cardoon (Cynara cardunculus L.) is a mandatory vegetable coagulant for certain Protected Designation of Origin Portuguese cheeses. It grows wild in Portugal and is used without any type of control regarding flower picking or extract preparation, representing some uncertainty in cheese manufacture. The variability in technological properties, in the context of traditional cheese manufacture, of cardoon flower ecotypes from the Alentejo region was evaluated, including milk clotting and proteolytic activities, coagulation properties and potential cheesemaking yield of flower extracts. Multivariate statistics highlighted the variability of flower properties for cheesemaking, but allowed the aggregation of the ecotypes into five groups under the major influence of milk clotting activity and effect on gel firmness and micellar aggregation rate, followed by proteolytic activity. These differences may have an impact on cheese properties and therefore can allow the selection of cardoon flower for the manufacture of different types of cheese.publishersversionpublishe

Figurações do ‘Outro’ em representações de Portugal, da Grã-Bretanha e dos EUA na poesia e no romance portugueses e anglo-americanos do século XIX

Grupo de Investigação INTCULTPOET sobre "Figurações Literárias do "Outro"; Página Web do Grupo de Investigação: http://ceh.ilch.uminho.pt/intcultpoet.phpNo contexto de uma perspectiva intercultural que congrega diversas áreas científicas, incluindo a história da literatura, a literatura comparada e a antropologia cultural, torna-se extremamente relevante inquirir sobre as noções psicológicas e os pressupostos culturais que subjazem a certas representações imaginárias ou literárias de Portugal, da Grã-Bretanha e dos EUA, assim como dos seus respectivos povos (Hall, 2003). Interessa não apenas explorar a forma como essas noções, pressupostos e representações evoluíram ao longo do século dezanove nas respectivas literaturas (aproximadamente de 1800 a 1900), mas também reflectir sobre os seus verdadeiros efeitos ou resultados no processo identitário destas nações e da própria Europa. Para servir esta finalidade, as questões ou conceitos operacionais de idealização artística e preconceito cultural, por parte dos respectivos escritores, os seus públicos e a crítica, serão cuidadosamente analisados e comparados no sentido de se detectarem os métodos, estratégias, motivos e pressupostos das suas frequentemente controversas descrições literárias. Este grupo de investigação pretende analisar as diferentes formas como o ‘Outro’, entendido quer como país estranho quer como povo estranho, é reciprocamente representado em certas obras poéticas e narrativas da literatura anglo-americana e portuguesa do século XIX. Esta escolha temporal explica-se por ser este um período de grandes mudanças relativamente à forma como se encara aquilo que é diferente ou estranho devido a uma nova e, por vezes, forçada mobilidade causada por recorrentes conflitos armados ou sociais e também pela grande expansão comercial e colonial que caracterizou a época de oitocentos. Um dos seus objectivos principais é analisar de forma rigorosamente documentada, e de uma perspectiva quer anglo-americana quer portuguesa, as representações literárias de Portugal, da Grã-Bretanha e dos EUA nesse confronto intercultural, feito de sinergias e fricções, resultante do contacto intelectual, político e económico entre estes povos no decorrer do século dezanove. Noções de ignorância ou de estranhamento cultural estarão envolvidas quer na análise da idealização poética do ‘Outro’, a respectiva nação e o seu povo, como remoto, idílico ou exótico, quer no estudo de estereótipos enraizados (Plous, 2003), incluindo preconceitos contra formas de religião, género, governação política e hábitos e costumes sociais, que subjazem a certos textos literários. Tanto as representações documentadas mais favoráveis como as francamente desfavoráveis serão estudadas, quer em textos de cariz mais sério quer em textos satíricos, escritos em inglês e/ou em português, assim como em poesia ou ficção.info:eu-repo/semantics/draf

Designing menus to shape consumers’ perception of traditional gastronomy: does it work for the Portuguese Alentejo cuisine?

ABSTRACT: Restaurant menus have been shown to be important communicating and selling tools. In this online experimental study, we focused on the role of descriptive menus in influencing food choice and shaping customers’ perception of a traditional restaurant. Participants were randomly assigned to one of two menu conditions. In the intervention menu, five traditional dishes from the region of Alentejo (Portugal) were described using sensory (e.g., “fresh”) and authenticity (e.g., “genuine”) labels, while in the control condition, the dish name and its ingredients were presented with no further description. No significant differences were found regarding hedonic expectations, choice intention or willingness-to-pay for any of the individual dishes. However, participants in the intervention condition imagined the restaurant to have better service and ambience and serving tastier and fresher dishes. This study adds to the evidence suggesting the potential impact of menus in shaping consumers’ expectations of restaurants’ service quality, which in turn may affect how people perceive and assess their dining experience

Association of 3-Phenoxybenzoic Acid Exposure during Pregnancy with Maternal Outcomes and Newborn Anthropometric Measures: Results from the IoMum Cohort Study

The aims of this study were to characterize the exposure of pregnant women living in Portugal to 3-phenoxybenzoic acid (3-PBA) and to evaluate the association of this exposure with maternal outcomes and newborn anthropometric measures. We also aimed to compare exposure in summer with exposure in winter. Pregnant women attending ultrasound scans from April 2018 to April 2019 at a central hospital in Porto, Portugal, were invited to participate. Inclusion criteria were: gestational week between 10 and 13, confirmed fetal vitality, and a signature of informed consent. 3-PBA was measured in spot urine samples by gas chromatography with mass spectrometry (GC-MS). The median 3-PBA concentration was 0.263 (0.167; 0.458) μg/g creatinine (n = 145). 3-PBA excretion was negatively associated with maternal pre-pregnancy body mass index (BMI) (p = 0.049), and it was higher during the summer when compared to winter (p < 0.001). The frequency of fish or yogurt consumption was associated positively with 3-PBA excretion, particularly during the winter (p = 0.002 and p = 0.015, respectively), when environmental exposure is low. Moreover, 3-PBA was associated with levothyroxine use (p = 0.01), a proxy for hypothyroidism, which could be due to a putative 3-PBA—thyroid hormone antagonistic effect. 3-PBA levels were not associated with the anthropometric measures of the newborn. In conclusion, pregnant women living in Portugal are exposed to 3-PBA, particularly during summer, and this exposure may be associated with maternal clinical features.This article was supported by national funds through the FCT Foundation for Science and Technology, I.P., within the scope of the projects RISE - LA/P/0053/2020; CINTESIS, R&D UNIT (reference UIDB/4255/2020) and LAQV (references: UIDB/50006/2020 AND UIDP/50006/2020). Virgínia Cruz Fernandes was funded by FCT/MCTES (Foundation for Science and Technology and Ministry of Science, Technology and Higher Education) and the ESF (European Social Fund) through NORTE 2020 (North Region Operational Program) through a grant of Post-Doc (reference SFRH/BPD/109153/2015). Juliana Guimarães was funded by FCT/MCTES (Foundation for Science and Technology and Ministry of Science, Technology and Higher Education) under CINTESIS by a PhD scholarship (reference UI/BD/152087/2021). The authors would like to thank the kind participation of all pregnant women and the support of the recruitment activities by the health professionals of the Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal and also to the professionals of REQUIMTE/LAQV, Instituto Superior de Engenharia, Politécnico do Porto, for their collaboration in carrying out the analyzes of the 3-PBA metabolite. This work received support from PT national funds (FCT/MCTES, Fundação para a Ciência e Tecnologia and Ministério da Ciência, Tecnologia e Ensino Superior) through the projects LA/P/0053/2020; UIDB/4255/2020; UIDB/5006/2020 and UIDP/50006/2020. Virgínia Cruz Fernandes thanks FCT/MCTES (Fundação para a Ciência e Tecnologia and Ministério da Ciência, Tecnologia e Ensino Superior) and ESF (European Social Fund) through NORTE 2020 (Programa Operacional Região Norte) for his/her Post-Doc grant ref. SFRH/BPD/109153/2015). Juliana Guimarães was funded by FCT/MCTES (Foundation for Science and Technology and Ministry of Science, Technology and Higher Education) under CINTESIS by a PhD scholarship (reference UI/BD/152087/2021).info:eu-repo/semantics/publishedVersio

Strategies used by Primary Care Nurses in the prevention of cervical cancer: integrative review

Objective: to identify, in the scientific literature, the strategies used by primary care nurses to prevent cervical cancer. Methods: An integrative review of the EMBASE, LILACS (BVS), SCOPUS, and Web of Science databases between March and April 2023. After the search, the selected articles were read in full, and the data were extracted for analysis. The final sample consisted of 5 studies. Results: the main strategies used were educational interventions, with a predominance of lectures and subsequent invitations or collection of material to carry out the preventive exam. Conversation circles (culture circles), telephone guidance, and the provision of a self-completed clinical form during the nursing consultation were also used. Conclusions: the studies made it possible to identify positive strategies for preventing cervical cancer, which could direct nurses to increasingly invest in methodologies aimed at increasing women’s autonomy. men