Tamoxifen and Assymptomatic Endometrial Thickness

Tamoxifen is a first-line agent for adjuvant treatment of estrogen-receptor positive breast cancer, and is used to reduce the risk of this condition in high-risk individuals. Retrospective studies established an association between tamoxifen use, endometrial thickness and endometrial cancer. There have been many attempts to identify an effective screening program for tamoxifen-related endometrial cancer, which have led to the use of transvaginal ultrasound and invasive procedures. The use of a 5mm endometrial cut-off in vaginal ultrasound is known to raise the number of endometrial biopsies with no gain in early cancer diagnosis. A review of the scientific literature was performed in order to establish the best available evidence for endometrial evaluation of asymptomatic breast cancer patients on tamoxifen

Psychological trauma and resilience : the aftermath of Madeira island’s wildfires and floods

Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicologia Clínica Sistémica), Universidade de Lisboa, Faculdade de Psicologia, 2017Studying the experience of a disaster, a potentially traumatic event rather idiosyncratic, gets its relevance from the proven impact of disasters in the survivors’ mental health. The present dissertation aims, then, to explore the concepts of resilience, psychological trauma and posttraumatic growth associated to the experience of one or more disasters. The sample, gathered through the non-probabilistic sampling method “Snowball”, was constituted by adults from both genders (n=15) who resided in Madeira island and were exposed to wildfires and/or February 2010’s floods. Both situations refer to a generalized impact in the community, with considerable material damage and loss of human lives. The variables selected for analysis were resilience, posttraumatic growth, main event (single or multiple), traumatic exposure, preventive and interventive measures, social support and sociodemographic information. The quantitative information, collected through questionnaires regarding resilience, posttraumatic growth and sociodemographic information, was subsequently analysed via IBM SPSS Statistics (22.0 version for Windows). The qualitative data, of exploratory nature, was obtained through semi-structured interviews and analysed via NVivo software (11.0 version for Windows). Results point towards several possible relationships, namely between the severity of traumatic exposure and posttraumatic growth values, and between the attributed source of origin and the disaster measures. Lastly, implications at several levels (including clinical) are described, and future directions are suggested.O estudo da vivência de desastres, enquanto acontecimentos idiossincráticos e potencialmente traumáticos, constitui-se da maior relevância atendendo ao seu impacto na saúde mental. A presente investigação visa, assim, explorar os conceitos de resiliência, trauma psicológico e crescimento pós-traumático associados à experiência de um ou mais desastres. A amostra, recolhida através da técnica não probabilística “bola de neve”, abrangeu indivíduos adultos de ambos os sexos (n=15) residentes na ilha da Madeira que tenham sido expostos a incêndios florestais e/ou às cheias de Fevereiro de 2010. Ambas as situações remetem para um impacto generalizado na comunidade, com danos materiais consideráveis e perda de vidas humanas. As variáveis consideradas para análise prendem-se com os níveis de resiliência e de crescimento pós-traumático, o evento stressor (único ou múltiplo), a exposição traumática, as medidas preventivas e interventivas, o suporte social e as variáveis sociodemográficas (sexo, idade, estado civil, habilitações académicas). A informação quantitativa, recolhida com recurso a questionários referentes às variáveis de resiliência, crescimento pós-traumático e sociodemográficas, foi posteriormente analisada no IBM SPSS Statistics (22.0 para Windows). A informação qualitativa, de carácter exploratório, foi obtida através da realização de uma entrevista semi-estruturada e analisada através do software NVIVO (11.0 versão para Windows). Os resultados apontam para diversas possíveis relações, nomeadamente entre os graus de exposição traumática e os valores de crescimento pós-traumático, e entre a atribuição de origem e as medidas tomadas durante o desastre. São, por fim, descritas possíveis implicações dos dados encontrados, e sugeridas direcções futuras

Michel Latchoumanin et Thierry Malbert, Familles et parentalité : rôles et fonctions entre tradition et modernité

Cet ouvrage paru en 2007 constitue une importante contribution à l’étude de la parenté. Il s’agit des actes d’un colloque organisé par le Centre interdisciplinaire de recherche sur la construction identitaire (circi), de l’université de la Réunion, et l’Association des maisons de la famille de la Réunion – École des parents et des éducateurs (amafar-epe). Les auteurs, universitaires et chercheurs de différentes disciplines (anthropologie, sociologie, démographie familiale) mais aussi formateu..

Interpersonal reactivity : the impact of infant juvenile positive experiences

Poster presented at the 4th International Congress of CiiEM – “Health, Well-being and Ageing in the XXI Century.” 2-5 June 2019, Monte de Caparica, PortugalN/

Interpersonal reactivity: the impact of infant-juvenile positive experiences

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

La création de la justice des mineurs au Portugal

La création des tribunaux pour enfants au Portugal intervient très tôt dans l’histoire de cette juridiction en Europe, puisqu’elle date de 1911. Mais la définition de leur cadre juridique ne cessera d’évoluer jusqu’aux années 1930 approximativement. Ce sont les bases et les principales étapes de l’établissement de cette juridiction que nous chercherons à décrire ici. De nature essentiellement tutélaire, elle connaît en 1925 un tournant marqué par la pensée de défense sociale. Parallèlement à sa complète dépénalisation, l’approche de la délinquance infantile à partir de cette date, dans un sens plus subjectif, qui va jusqu’à intégrer la notion de prédélinquance, témoigne, de l’influence croissante de la psychologie et de la psychiatrie.The creation of children’s courts in Portugal happened quite early in the history of such jurisdiction in Europe, since it goes back to 1911. But the definition of their legal framework will endlessly evolve until the thirties. What I’ll try to describe here are the foundations and main stages of such jurisdiction. Being of a nature mostly tutelary, it took however a dramatic turn in 1925, marked by thoughts of social protection. In parallel to its complete decriminalization, the approach of child delinquency from that year onwards, will testify, in a more subjective sense that will even integrate the notion of pre-delinquency, to the growing influence of psychology and psychiatry

Mioma Parasita: Forma Rara de Apresentação de uma Entidade Comum

Parasitic myomas are a rare form of uterine leiomyomas. Distinction from other abdominal masses may be difficult, due to parasitic leiomyomas' variable anatomic locations and clinical manifestations. We describe the case of a 45 years-old woman, presenting with abdominal pain and a large pelvic mass that turned out to be a parasitic myoma at surgical assessment. Histological analysis confirmed the intraoperative suspicion. We intend to bring awareness to the inclusion of this condition in the differential diagnosis of pelvic masses, especially in women with risk factors for parasitic myomas, such as previous surgery for uterine fibromyomatosis or concomitant uterine myomas.info:eu-repo/semantics/publishedVersio

Avaliação económica do custo-efectividade da intervenção das equipas de rua num contexto populacional de toxicodependência

O presente trabalho, cujo objectivo foi avaliar o custo – efectividade da intervenção das Equipas de Rua na população utilizadora de drogas injectáveis, começa por fazer uma abordagem do Vírus de Imunodeficiência Humana – VIH e da Síndroma de Imunodeficiência Adquirida – SIDA. Após uma breve descrição da evolução da doença, da sua caracterização e da população infectada a nível mundial e nacional, é apontada a sua incidência nos diversos continentes, o estigma social dos seus portadores, para além de identificar a população (utilizadores de drogas injectáveis) onde o risco de contaminação é mais elevado. No quadro das políticas de prevenção, redução de riscos e minimização de danos, foi abordada a importância, do Programa de Troca de Seringas na prevenção da contaminação do VIH. Neste contexto e reflectindo o panorama europeu, as Equipas de Rua surgem como um alternativa de intervenção, num contexto de proximidade. Foram identificados os modelos de avaliação económica em saúde, os seus aspectos conceptuais, custos e respectivos benefícios, com relevo para o modelo custo-efectividade adequado à intervenção das Equipas de Rua. Foi utilizado o teste de Mann-Whitney e o coeficiente de Correlação de Spearman, que confirmaram o impacto das Equipas de Rua, para além de uma associação entre o aumento daquelas estruturas e a diminuição das infecções. Por fim foi efectuada a análise económica custo – efectividade com base no número de infecções pelo VIH evitadas pela intervenção das Equipas de Rua, concluindo-se que foram evitadas 1.007 infecções nos três anos do estudo, com um custo de cerca de € 3.075 por infecção evitada, contra um custo de tratamento de cerca de € 11.000 por infecção.The aim of this work was to assess the cost-effectiveness analysis of the Street Teams intervention with an injection drugs population. It starts by an approach to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). After a brief description of the disease’s evolution, of its characteristics and of the infected population, both globally and nationally, we show it’s incidence in each continent and the social stigma suffered by the patients, in addition to identifying the population (injection drugs users) where the risk of contamination is higher. In the framework of prevention, risk reduction and harm minimization policies, we addressed the importance of the Needle Exchange Program in the prevention of HIV infection. In this context, reflecting the European standards, the Street Teams arise as an alternative intervention in a context of proximity. We identified the models of economic evaluation in health, its conceptual aspects, costs and benefits, giving special attention to the cost-effectiveness model more suitable to the Street Teams intervention. The Mann-Whitney test and the Spearman’s correlation coefficient were used, which confirmed not only the Street Teams impact but also an association between the rise of these structures and the fall of infections. Finally, we made an economic analysis of cost-effectiveness based on the number of HIV infections prevented by the intervention of the Street Teams. Our conclusion was that we averted 1007 infections during the time of this study (three years), with an average cost of € 3.075 per infection avoided, when the treatment cost is estimated round € 11,000 per infection

O COHOUSING: BREVE ABORDAGEM JURÍDICO-PRÁTICA

Emerging as an alternative to traditional housing, but having adapted to the needs of society in which we live, where the weakest and the elderly needgreater social protection. We are talking about collaborative housing or cohousing. Historically imbued with the principles that characterize the collaborativeeconomy, such as solidarity and support for others, the sharing of tasks and thesharing of costs, its main objective is to alleviate the difficulties of the most needy,whether economically or emotionally. Cohousing emerged to promote communitylife, where the loneliness of the senior population so characteristic of the consumer societies in which we live is fought. The object in this working paper, is a case--study of senior public-private residences, more specifically, a project that unitedthe Lisbon City Council and the Santa Casa da Misericórdia of Lisbon on behalfof social insertion.Surgiu como alternativa à habitação tradicional, mas foi-se adaptandoàs necessidades da sociedade em que vivemos, onde os mais frágeis e idosos necessitam de uma maior protecção social. Falamos da habitação colaborativa ou cohousing.Historicamente imbuída dos princípios que caracterizam a economia colaborativa, como a solidariedade e o apoio ao próximo, a comunhão de tarefas e a partilhade custos, tem como principal objectivo minorar as dificuldades dos mais carentes,seja económica, seja emocionalmente, o cohousing surgiu para promover a vida emcomunidade, onde se combata a solidão da população sénior, tão característica dassociedades de consumo em que vivemos. Neste trabalho, é objecto de estudo umexemplo de residências sénior de iniciativa público-privada, mais concretamente,um projecto que uniu a Câmara Municipal de Lisboa e a Santa Casa da Misericórdiade Lisboa em prol da inserção social, sito no Bairro Padre Cruz, em Lisbo