Informal Caregivers’ Health Literacy in Lisbon, Portugal: A Profile for Health Promotion Prioritization

Health literacy (HL) allows people to access, understand and evaluate health information. Informal caregivers' levels of HL may impact long-term care outcomes. 'Informal caregivers' profile in Lisbon county: a health community approach' is a nurse-led research project aiming to assess informal caregivers' health literacy and associated factors in Lisbon county, as well as to foster the development of a local-specific health literacy strategy. A survey to identify a health/social caregiver profile, including questions about HL (HLS-EU-PT), was submitted to a representative sample of carers. Descriptive and bivariate inferential analysis was developed. Informal caregivers' level of HL was mostly sufficient (n = 99, 38%). More than 60% of caregivers have limited HL regarding health promotion. 'Access', 'Appraisal' and 'Use' are the information processing stages with lower mean scores of HL. Carers with low HL levels appear to be older and to have less education, low knowledge of community resources and decreased wellbeing (p < 0.05). A strategy focused on health promotion-related HL through primary care resources can potentially improve caregivers' knowledge, competencies and motivation, as well as health system sustainability. Reported HLS-EU-PT scores deserve special attention. Future work should emphasize the role of HL-associated factors and health outcomes for caregivers and cared-for persons.info:eu-repo/semantics/publishedVersio

Does Reality Overcome the Expected? Survey on Informal Caregivers' Profile: A Nurse-Led Study in Times of COVID-19

The increasing overload of chronic conditions raises challenges for the health system. Informal caregivers have a major role in ensuring the quality of life of the cared-for person, despite the reported lack of working resources which can lead to unmet needs. This article reports on the first part of a nurse-led research project entitled “Informal caregiver’ profiles in Lisbon county: a health community approach.’ We aimed to support decision-making by developing an informal caregiver profile to promote tailored interventions. A survey addressing the dyad was developed and submitted to a convenient, network-based, stratified sample of carers aged 18 years or above. More than thirty community partners supported the identification of caregivers. Data were submitted to univariate descriptive analysis. A profile of the cared-for person and the informal caregiver was uncovered by identifying 639 caregivers, of whom the majority lived with the cared-for person. Only four percent planned the transition to a caregiver role, and no more than 10% had access to support programs. Approximately half of the respondents found that COVID-19 negatively impacted their performance in the caregiver role. Developing a local and tailored strategy with collaboration between healthcare professionals, academics, and community partners is key to ensuring that meaningful support is provided to caregivers.info:eu-repo/semantics/publishedVersio

Prospective study of patients with persistent symptoms of dengue in Brazil

Dengue is an arboviral infection clinically recognized as an acute and self-limited disease. Persistence of dengue symptoms is known, but it has been little studied. The aim of this study was to characterize persistent symptoms in 113 patients with dengue followed up clinically and by laboratory testing at a tertiary hospital. Symptoms that persisted for more than 14 days were observed in 61 (54.0%) patients, and six (6.2%) of them had symptoms for 6 months or more. The persistent symptoms identified were myalgia, weakness, hair loss, memory loss, reduced resistance to physical effort, headache, reasoning problems, arthralgia, sleepiness- and emotional lability. The progression to persistent symptoms was significantly associated with hospitalization, older age, more severe disease, the presence of bleeding and comorbidities upon univariate analysis. Upon multivariate analysis, the presence of persistent symptoms continued to be significantly associated only with increased age and dengue with warning signs. The platelet count during the acute phase of the disease was significantly lower in the group with persistent symptoms. In conclusion, the frequency of progression to persistent symptoms in dengue is relevant in patients seen at a tertiary hospital and the persistence of symptoms is more common in patients with dengue with warning signs

Institutionalisation of Social Movements: Co-option And Democratic Policy-making

Over the past 30 years, urban policy in Brazil has undergone a major transformation, both in terms of regulatory frameworks and the involvement of citizens in the process of policy-making. As an intense process of institutional innovation and mobilisation for decent publicservices took place, academics started to consider the impact of institutionalisation on the autonomy of social movements. Using empirical evidence from a city in the northeast of Brazil, this article addresses the wider literature on citizen participation and social movements to examine specifically the problem with co-optation. I examine the risks linked to co-optation, risks that can undermine the credibility of social movements as agents of change, and explore the tensions that go beyond the ‘co-optation versus autonomy’ divide, an issue frequently found in the practices of social movements, in their dealings with those in power. In particular, this article explores the learning processes and contentious relationships between mainly institutionally oriented urban movements and local government. This study found that the learning of deliberative skills not only led to changes in the objectives and repertoires of housing movements, but also to the inclusion of new components in their objectives that provide room for creative agency and which, in some cases, might allow them to maintain their autonomy from the state

Fire Effects on Understory Forest Regeneration in Southern Amazonia

This is the final version. Available on open access from Frontiers Media via the DOI in this recordData Availability Statement: The datasets generated for this study are available on request to the corresponding author.Fire in tropical forests increases tree mortality, degrades forest structure, and reduces carbon stocks. Currently, there are large gaps in understanding how fire affects understory forest structure and composition, interactions with fire recurrence, and long-term impacts. Understanding these changes is critical to evaluate the present and future response of tropical forests to fire. We studied post-fire changes in understory regeneration in forests in Mato Grosso State, southern Amazonia, Brazil, aiming to answer the following questions: (i) does forest structure (basal area) and tree community composition vary with fire frequency and time since the last fire? (ii) does the response differ among strata (e.g., sapling, larger trees)? (iii) are changes in diversity associated with changes in forest structure? We surveyed trees and lianas in previously structurally intact forests that underwent selective logging, followed by different fire histories, including 5 and 16 years after once-burned, 5 years after three times burned, and unburned (control). Overall, species composition (abundance, richness, and number of families) and diversity were highest for the unburned treatment and lowest for the recurrent burned areas. Fire frequency negatively affected plant structure and basal area; basal area of small, medium, and large plants declined significantly by more than 50% in the most frequently burned areas. Richness was positively related to basal area in the three times burned sites and in the 16 years regenerating site for all strata. Our results demonstrate the negative influence of frequent fires on both the composition and structure of small trees in Amazonian forest. These changes to the cohort of small-sized trees may persist and have long-term impacts on forest structure, affecting the capacity, and direction of forest recovery. With wildfire widespread across the region and increasing in frequency, fire may negatively affect tree diversity in remaining selectively logged forests, and affect regional carbon cycling with consequences for the global vegetation carbon sink.Coordination of Improvement of Personnel in Higher Education, Brazil (CAPES

Reliable Classifier to Differentiate Primary and Secondary Acute Dengue Infection Based on IgG ELISA

Dengue virus infection causes a wide spectrum of illness, ranging from sub-clinical to severe disease. Severe dengue is associated with sequential viral infections. A strict definition of primary versus secondary dengue infections requires a combination of several tests performed at different stages of the disease, which is not practical.We developed a simple method to classify dengue infections as primary or secondary based on the levels of dengue-specific IgG. A group of 109 dengue infection patients were classified as having primary or secondary dengue infection on the basis of a strict combination of results from assays of antigen-specific IgM and IgG, isolation of virus and detection of the viral genome by PCR tests performed on multiple samples, collected from each patient over a period of 30 days. The dengue-specific IgG levels of all samples from 59 of the patients were analyzed by linear discriminant analysis (LDA), and one- and two-dimensional classifiers were designed. The one-dimensional classifier was estimated by bolstered resubstitution error estimation to have 75.1% sensitivity and 92.5% specificity. The two-dimensional classifier was designed by taking also into consideration the number of days after the onset of symptoms, with an estimated sensitivity and specificity of 91.64% and 92.46%. The performance of the two-dimensional classifier was validated using an independent test set of standard samples from the remaining 50 patients. The classifications of the independent set of samples determined by the two-dimensional classifiers were further validated by comparing with two other dengue classification methods: hemagglutination inhibition (HI) assay and an in-house anti-dengue IgG-capture ELISA method. The decisions made with the two-dimensional classifier were in 100% accordance with the HI assay and 96% with the in-house ELISA.Once acute dengue infection has been determined, a 2-D classifier based on common dengue virus IgG kits can reliably distinguish primary and secondary dengue infections. Software for calculation and validation of the 2-D classifier is made available for download