Gerontological social workers’ perspectives about the future at the start of a COVID-19 vaccination program: A photovoice study

Summary: The COVID-19 pandemic is a continuing public health crisis, although it has lessened in its intensity since the start of worldwide vaccination programs. In aged care facilities, gerontological social workers have become frontline professionals facing multiple challenges and demands. One year after the first COVID-19 case in Portugal, during the second major lockdown in the country, and with vaccination starting in these facilities, a photovoice program to identify the experiences of these professionals was developed. This study aimed to understand how gerontological social workers foresee the future of practice and intervention with older adults. A thematic analysis was conducted based on the photographs and associated narratives from 10 participants, all female, aged between 22 and 35 years, who attended a program’s session. Findings: Three themes were identified with the thematic analysis: (1) personal and professional growth (with renewed life perspectives and increased resilience), (2) reinvention of intervention (with improved management of emotions, teamwork, and alternative ways of intervening), and (3) hope to use the lessons learned (hope that vaccination will bring conditions to recover the older adults’ well-being and opportunities to use the good les- sons learned). Applications: These findings are relevant to inform policymakers and governments about practices in aged care facilities and to improve the training of gerontological social workers in acute action management and intervention. We stress alternative ways of inter- vening that came up in the response to the pandemic such as emotional management, digital technology, communication strategies, self-care, or the families’ involvement.info:eu-repo/semantics/publishedVersio

O bom funcionamento das equipas de apoio a famílias com crianças e jovens em risco da Santa Casa da Misericórdia de Lisboa

Tese de mestrado integrado em Psicologia (Secção de Psicologia Clínica e da Saúde - Núcleo de Psicologia Clínica Sistémica), apresentada à Universidade de Lisboa através da Faculdade de Psicologia e de Ciências da Educação, 2008Esta investigação propõe-se a conhecer e valorizar o que de melhor funciona nas Equipas de Apoio a Famílias com Crianças e Jovens em Risco da Santa Casa daMisericórdia de Lisboa. Para tal foi aplicada a Entrevista Apreciativa a uma amostra de14 sujeitos, técnicos das referidas equipa, com idades compreendidas entre os 27 e os 54anos. Os resultados obtidos reflectem a importância da coesão grupal e do suporte nasequipas, o empenho como característica essencial do perfil de um técnico que trabalhenesta área e a necessidade de supervisão e reconhecimento por parte da instituição.The aim of this study was to understand and value the best practices of Equipas de Apoio a Famílias com Crianças e Jovens em Risco1 from Santa Casa daMisericórdia in Lisbon. The Appreciative Interview was applied to a sample of 14subjects, members of these teams, from 27 to 54 years old. The final results suggest theimportance of team's grupal cohesion and support, commitment as an essential individual attribute of social workers and the need of supervision and recognition from the institution

Efetividade dos grupos psicoeducativos na sobrecarga de cuidadores informais de pessoas com demência

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Matemática na hora do conto

Este artigo procura realçar que, através da conexão entre a literatura e a matemática, se podem criar situações em que as crianças abordem conceitos matemáticos de uma forma significativa permitindo que as habilidades matemáticas e as de linguagem se desenvolvam em conjunto. Uma das formas mais significativas de se construir conhecimento matemático é resolver problemas e desafios, tão comuns nos contos infantis. Apresentamos duas situações, que se enquadram nesta perspetiva pedagógica. Em ambas as situações foi usado um conto como ponto de partida para a construção de atividades matemáticas e tendo presente uma visão construtivista do ensino da matemática.This article seeks to highlight that, through the connection between literature and mathematics, can create situations where children addressing mathematical concepts in a meaningful way allowing mathematical skills and language develop together. One of the most significant ways to construct mathematical knowledge is to solve problems and challenges, so common in children stories. Here are two situations that fall into this pedagogical perspective. In both cases we used a short story as a starting point for the construction of mathematical activities and bearing a constructivist view of teaching mathematics

Candida auris in Intensive Care Setting: The First Case Reported in Portugal

(This article belongs to the Special Issue Genomic Epidemiology of Fungal Diseases 2023)Candida auris is an opportunistic human pathogen that has rapidly spread to multiple countries and continents and has been associated with a high number of nosocomial outbreaks. Herein, we report the first case of C. auris in Portugal, which was associated with a patient transferred from Angola to an ICU in Portugal for liver transplantation after a SARS-CoV-2 infection. C. auris was isolated during the course of bronchoalveolar lavage, and it was subjected to antifungal susceptibility testing and whole-genome sequence analysis. This isolate presents low susceptibility to azoles and belongs to the genetic clade III with a phylogenetic placement close to African isolates. Although clade III has already been reported in Europe, taking into account the patient’s clinical history, we cannot discard the possibility that the patient’s colonization/infection occurred in Angola, prior to admission in the Portuguese hospital. Considering that C. auris is a fungal pathogen referenced by WHO as a critical priority, this case reinforces the need for continuous surveillance in a hospital settingThis work was supported by funding from the European Union EU4Health Programme under grant agreement no. 101113460 (GENEO) and by national funds through the Foundation for Science and Technology (FCT), I.P., under Individual CEEC 2022.00851.CEECIND/CP1748/CT0001.info:eu-repo/semantics/publishedVersio

Relação entre a Fadiga e a Atividade Física na DPOC

Introdução e Objetivos: A Doença Pulmonar Obstrutiva Crónica (DPOC) manifesta-se através da dispneia, tosse e expetoração. Porém, o 2º sintoma mais prevalente – a fadiga - é muitas vezes negligenciado e pode estar associado a uma menor capacidade para a prática de Atividade Física (AF). Assim, explorou-se a relação entre a fadiga e a AF na DPOC, e a influência de outros fatores na fadiga (objetivo secundário). Material e Métodos: Foi realizado um estudo transversal em pessoas com DPOC. Foram recolhidos dados de espirometria e dos instrumentos: Modified Medical Research Council (mMRC) para avaliar a dispneia; n.º de exacerbações no último ano; classificação GOLD e ABCD; Checklist of Individual Strength (CIS20) e a sua Dimensão Subjetiva de Fadiga (DSF); acelerómetro Actigraph GT3X para avaliar a AF (i.e., AF leve, AF Moderada-a-Vigorosa (AFMV), AF total e n.º de passos). Realizaram-se correlações de Spearman (ρ) e de Phi (ϕ) e regressões lineares. Resultados: A amostra incluiu 83 participantes (68±8 anos; 83% homens; 47±18 FEV1% previsto), em que 72% relatou presença de fadiga (DSF≥27) e apresentou uma média de 73±25 no score total do CIS20-P. Foi observada uma correlação negativa entre a fadiga e a AF (AFMV e CIS20-P: ρ=-0,29; AFMV e DSF: ρ=-0,28; passos/dia e CIS20-P: ρ=-0,30; passos/dia e DSF: ρ=-0,25) (p<0,05). Verificaram-se correlações positivas entre a fadiga e as exacerbações (CIS20-P: ρ=0,30; DSF: ρ=0,27), classificação ABCD (CIS20-P: ρ=0,43; DSF: ρ=0,38) e a dispneia (CIS20-P ρ=0,50; DSF: ρ=0,47) (p<0,05). A correlação entre ‘ter fadiga’ e a participação num programa de reabilitação respiratória, hábitos tabágicos e nível de dispneia (mMRC<2 vs. mMRC≥2) foi fraca (ϕ= 0,12, ϕ= 0,16, ϕ= 0,30, respetivamente). A dispneia revelou-se o maior preditor do CIS20-P e da DSF (ambos β=0,48, p<0,005). Conclusões: As pessoas com DPOC menos ativas apresentam maiores níveis de fadiga, embora a relação seja fraca. A dispneia parece ter a maior influência sobre a fadiga. São necessários mais estudos para explorar a relação entre a fadiga, a AF e outros fatores nesta população.N/

Qualidade de Vida e Participação em Iniciativas de Base Comunitária: Um estudo num município da zona centro de Portugal

Face ao reconhecimento da importância da participação social como fator promotor de envelhecimento bem-sucedido, procura-se, através de um estudo de natureza quantitativo, analisar os efeitos de variáveis sociodemográficas e da participação social em atividades/programas de base comunitária, promovidas por um município da zona centro de Portugal, ao nível da qualidade de vida de pessoas com mais de 56 anos, residentes no concelho.info:eu-repo/semantics/publishedVersio

Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal

URBANTB group: Patrícia Soares (Representative of the consortium), Mário Carreira, Sofia Pereira, Catarina Alves, Filipe Alves, Ana Rodrigues, Ana Moreira, Márcia Cardoso, Sandra Mota, Ana Gomes, Liliana Ferreira, Marta Lopes, Isabel Correia, Juan Rachadell, Maria Gameiro, Ângela Dias, Manuel Pereira, Jorge Gonçalves, Maria Gonçalves, Adriana Taveira, Celene Neves, Lucinda Silva, Maria Mendes, Maria Teixeira, Maria Pereira, Milena Piedade, Antónia Teixeira & Carlos Carvalho.Background: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.This work was supported by the Fundação para a Ciência e Tecnologia (FCT, Portugal) [Grant: PTDC/SAU-PUB/31346/2017]. The present publication was funded by Fundação para a Ciência e Tecnologia (FCT, Portugal) national support through Comprehensive Health Research Centre (CHRC) [UIDP/04923/2020].info:eu-repo/semantics/publishedVersio

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe