22 research outputs found
A inquetação de Maria "Barraca". Desenho como exorcismo.
info:eu-repo/semantics/publishedVersio
A dimensão autoetnográfica dos desenhos de Pitseolak
Contém: Inuit de corpo e alma. Desenho como sobrevivência. Auto - etno - grafia. De Cape Dorset para o mundoThis article proposes to look at the work of Pitseolak Ashoona through its autoethnographic hand, focusing attention on how the artist transformed her personal experiences in visual narratives that represent and characterize the social space and the Inuit culture. Within this context it is important to understand how their drawings are testimony of the adaptation strategies of an indigenous group, under the imposition of industrialized and capitalist society, in the globalized worldinfo:eu-repo/semantics/publishedVersio
Associação entre as políticas de tabagismo escolar e o tabagismo em adolescentes portugueses dos 15 aos 17 anos: estudo SILNE-R
RESUMO - Introdução: O tabagismo é um dos principais problemas de saúde pública global. O consumo de tabaco inicia-se, na maioria dos casos, na adolescência ou no início da idade adulta. As políticas escolares de prevenção e controlo do tabagismo são uma estratégia fulcral na redução da prevalência de fumadores. O presente estudo pretende investigar a associação entre estas políticas escolares e o tabagismo dos adolescentes portugueses, dos 15 aos 17 anos, e documentar a evolução entre 2013 e 2016.
Metodologia: Seguindo um estudo observacional analítico transversal repetido foram analisados dados de 1670 jovens, em 2013, e 1633 em 2016, dos 15 aos 17 anos, resultantes do projeto SILNE-R. Calculou-se a prevalência de fumadores experimentais, semanais e diários. Foi medida a perceção da aplicação das políticas de tabagismo escolar, baseado num score total, composto pelas dimensões: regulamentação, comunicação e sanções. Posteriormente, foi modelizado o tabagismo em função do score total e das suas dimensões, ajustando-se o modelo pelas características demográficas dos alunos, nível educacional dos pais e pelo ano, através de regressões logísticas.
Resultados: Os resultados revelaram que não houve uma associação estatisticamente significativa entre o score total e os três status de fumadores, em 2013 e 2016. Porém, quando substituído o score pelas suas dimensões verificou-se uma associação estatisticamente significativa entre a regulamentação e a comunicação com o fumador diário. Observou-se também uma redução estatisticamente significativa de todos os tipos de fumadores, entre 2013 e 2016.
Conclusões: As políticas de tabagismo escolar, nas suas vertentes de regulamentação e comunicação, têm o potencial para reduzir a prevalência de fumadores diários, nos adolescentes.ABSTRACT
Introduction: Smoking is one of the major global public health threats. Tobacco consumption usually begins during adolescence or early adulthood. School tobacco prevention policies are a key strategy to reduce the smoking prevalence. This study aims at investigating the association between these school policies and smoking behaviours of Portuguese adolescents, from 15 to 17 years, and to document the evolution between 2013 and 2016.
Methodology: Following a repeated cross-sectional observational study, data were analyzed from 1670 young people in 2013 and 1633 in 2016, 15 to 17 years old, from the SILNE-R project. The prevalence of experimental, weekly and daily smoking was calculated. The perception of school smoking policies was measured based on a total score, composed of the dimensions: regulation, communication and sanctions. Then, smoking was modeled based on the total score and its dimensions, and the model was adjusted by the individual demographic characteristics of the students, parental education and by year, using logistic regressions.
Results: The results showed that there was no statistically significant association between the total score and the three smoking status, in 2013 and 2016. However, when the score was replaced by its dimensions, there was a statistically significant association between regulation and communication and the daily smoking. There was a statistically significant reduction of smoking prevalence between 2013 and 2016.
Conclusions: School smoking policies, in its regulation and communication dimensions, have the potential to reduce the prevalence of daily smoking among adolescents
Auditoria clínica à morbilidade materna "near miss" numa maternidade terciária
A taxa de mortalidade materna nos países em desenvolvimento é muito baixa. Mas,
vários estudos demonstram que a morbilidade "near miss" materna é cem vezes superior. Este
indicador permite avaliar os serviços perinatais e delinear estratégias para uma melhoria
contínua da qualidade e segurança dos cuidados prestados.
Em Portugal, o registo de morbilidade "near miss" é inexistente. E, por razões
demográficas e contingências sócio-económicas, novos desafios surgiram pondo em perigo a
excelência dos indicadores materno-infantis do país.
O estudo de corte transversal retrospetivo objectivou a avaliação dos cuidados
prestados às grávidas e puérperas numa maternidade terciária universitária, utilizando a
ferramenta da OMS para o estudo da morbilidade "near miss". A auditoria clínica realizada,
entre 1 janeiro de 2015 e 31 dezembro de 2017 identificou 89 mulheres com morbilidade
aguda grave (45 evoluiram para near miss), definindo uma razão de morbilidade "near miss"
materna de 6,1:1000 nados vivos, uma razão de morbilidade "near miss" materna/mortalidade
materna de 22,5:1 e um índice de mortalidade de 4,3%. Ocorreram dois óbitos maternos. A
análise descritiva definiu, como principais causas de morbilidade "near miss", a hemorragia
pós-parto (36,2%), a doença hipertensiva da gravidez (25,5%) e as causas indiretas (19,2%),
semelhante a outros países desenvolvidos.
Num contexto de Governança Clínica, identificaram-se oportunidades de melhoria na
qualidade dos serviços prestados, com propostas de medidas a implementar para uma gestão
mais eficiente dos recursos disponíveis. Posteriormente, os indicadores de processo obtidos
poderão ser utilizados para "benchmarking" com outras instituições portuguesas e delineamento
de estratégias concertadas de melhoria contínua.The maternal mortality ratio in developing countries is very low. But, several studies
have shown maternal near miss morbidity to be 100 times higher. This indicator allows
perinatal services evaluation and outline strategies for a continuous improvement in the
quality and safety of care provided.
In Portugal, the near miss morbidity register is non-existent. Besides, due to
demographic reasons and socio-economic contingencies, new challenges have emerged
endangering the excellence of the country's maternal and child indicators.
This cross-sectional retrospective study aimed at evaluating the provided care to
pregnant and puerperal women in a university tertiary maternity hospital using the WHO tool
for the study of near miss morbidity. The clinical audit performed between January 1, 2015
and December 31, 2017 identified 89 women with severe acute morbidity (45 evolved to near
miss), defining a maternal near miss ratio of 6.1: 1000 live births, a maternal near miss
mortality ratio of 22.5: 1 and a mortality index of 4.3%. Two maternal deaths occurred. The
descriptive analysis defined, as the main causes of near miss morbidity, postpartum
haemorrhage (36.2%), hypertensive pregnancy disease (25.5%) and indirect causes (19.2%),
similar to others developed countries.
In the context of Clinical Governance, opportunities for improvement in the quality of
the services provided were identified, with proposed measures to be implemented for a more
efficient management of available resources. Subsequently, the process indicators obtained
can be used for benchmarking with other portuguese institutions and the delineation of
concerted strategies for continuous improvement
Anesthesia for ex utero intrapartum treatment: renewed insight on a rare procedure
AbstractThe ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal–fetal circulation.Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow.We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report
Riscos profissionais numa serralharia: Implementação de um manual de segurança
As atividades produtivas da metalurgia e metalomecânica, por diversos fatores, mas principalmente pelos processos tecnológicos, têm uma grande diversidade de riscos profissionais que é importante conhecer, exige medidas preventivas adequadas.
A presente dissertação insere-se no âmbito do trabalho desenvolvido numa indústria metalomecânica pretende caracterizar os principais fatores de riscos associados à tecnologia do setor (processos, equipamentos), analisar os riscos específicos para cada tarefa da metalurgia e metalomecânica, tendo como principal objetivo a elaboração de uma avaliação de riscos em toda a empresa utilizando o método MARAT, foram aplicadas diversas metodologias, como análise documental e legislativa, técnicas de observação das tarefas, criação e aplicação da lista de verificação, e após a identificação dos riscos existentes, foram criadas fichas de segurança das máquinas e procedimentos de segurança para consulta dos trabalhadores, tendo o objetivo implementar ações corretivas e sensibilizar os trabalhadores, surgindo assim a criação do manual de segurança para informar e sensibilizar os trabalhadores.
Tomando a empresa a responsabilidade de acompanhar e controlar as respetivas ações corretivas e preventivas vinculadas à segurança das máquinas e equipamento de trabalho, equipamentos de proteção individual e coletivo, substâncias perigosas, segurança contra incêndios, entre outras. Esta deve planear ações de formação e sensibilização com o objetivo de eliminar as falhas, contribuindo para uma melhoria continua na gestão de risco
Psychological impact of diagnostic exams
Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognized anxiety may lead to exam repetition, and impedance of exam performance. Objective: The aim of the study was to examine the anxiety levels of patients who are to undergo diagnostic exams related to cancer diagnostic: PET/CT and mammography. Methods: Two hundred and thirty two patients who undergo PET/CT and one hundred thirteen women who undergo mammography filled out one questionnaire after the procedure to determine their concerns, expectations and perceptions of anxiety. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself and fear of the results. Patients who suffered from greater anxiety were those who were scanned during the initial stage of an oncological disease. On the other hand, the diagnostic is the main cause of anxiety in women who are requiring a mammography. 28% of the women reported having experienced pain or intense pain. Conclusions: The performance of diagnostic exams related to cancer diagnostic like a PET/CT and a mammography are important and statistically generators of anxiety. Patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. These results provide expertise that can be used in the development of future training programs to integrate post-graduate courses of health professionals
Structural lipid changes and Na+/K+-ATPase activity of gill cells'basolateral membranes during saltwater acclimation in sea lamprey (Petromyzon marinus, L.) juveniles
Seawater acclimation is a critical period for anadromous species and a process yet to be understood in lampreys. Considering that changes in lipid composition of the gill cells' basolateral membranes may disrupt the major transporter Na+K+-ATPase, the goal of this study was to detect changes at this level during juvenile sea lamprey seawater acclimation. The results showed that saltwater acclimation has a direct effect on the fatty acid composition of gill cells basolateral membrane's phospholipids. When held in full-strength seawater, the fatty acid profile of basolateral membrane's phospholipids suffered a restructure by increasing either saturation or the ratio between oleic acid and eicosapentaenoic acid. Simultaneously, the activity of Na+K+-
2
ATPase revealed a significant and positive correlation with basolateral membrane's cholesterol content in the presence of highest salinity. Our results pointed out for lipid adjustments involving the functional transporter present on the gill cell basolateral membranes to ensure the role played by branchial Na+K+-ATPase in ion transport during saltwater acclimation process. The responses observed contributed to the strategy adopted by gill cell's basolateral membranes to compensate for osmotic and ionic stressors, to ensure the success of the process of seawater acclimation associated with the downstream trophic migration of juvenile sea lamprey.This work was financially supported by the Foundation for Science and Technology (FCT) project PTDC/BIA-BEC/103258/2008 and project UID/MAR/04292/2013 (national funds FCT/MEC–PIDDAC through Acordo de Parceria PT2020)
A contribution to the establishment of diagnostic reference levels in multidetector CT equipments
Actualmente a Tomografia Computorizada (TC) é um dos métodos de diagnóstico por imagem que tem uma maior contribuição para a dose de radiação X recebida pelos pacientes. Pretende-se com este estudo avaliar as doses praticadas em TC e contribuir para o estabelecimento de Níveis de Referência de Diagnóstico (NRD) na região da Grande Lisboa, Portugal. Foram efectuadas medições de dose em 5 equipamentos de TC multidetectores, considerando o abdómen como área anatómica de interesse. Recorreu-se a uma câmara de ionização e a um fantoma para obter o índice de dose de TC (CTDI) e o produto dose-comprimento (DLP), que permitem determinar os NRD. Estes valores foram comparados com os NRD propostos pela Guideline Europeia e com os estudos desenvolvidos em outros países, como o Reino Unido, Grécia e Taiwan. Os resultados revelaram que os valores de NRD obtidos neste estudo (16,7 mGy para o CTDIvol e 436,5 mGy·cm para o DLP) são discrepantes relativamente à Guideline Europeia (±50%), mas muito próximos relativamente aos NRD estabelecidos nos países considerados. Estes valores podem ser eventualmente explicados pelos equipamentos em análise e pela utilização de protocolos de exame adoptados pelos profissionais de Radiologia nas instituições analisadas. ABSTRACT - Nowadays Computed Tomography (CT) is one of the imaging techniques which have a large contribution to radiation dose received by patients. The purpose of this study is to evaluate CT doses and contribute to the establishment of Diagnostic Reference Levels (DRL) in Lisbon, Portugal. Dose measurements on 5 multidetector CT scanners have been performed, considering the abdomen as the anatomic region of interest. All measurements were performed using an ionization chamber and a phantom to obtain the index CT dose (CTDI) and the dose-length product (DLP), which are used to determine DRL. These values were compared not only with European reference dose values but also with DRL studies developed in other countries like United Kingdom, Greece and Taiwan. The results revealed that DRL values obtained in this study (CTDIvol is 16,7 mGy and DLP is 436,5 mGy·cm) have a higher discrepancy to European Guideline (±50%), while the DRL´s of other countries are nearest to values obtained in this study. Those differences may be eventually explained by the type of the evaluated equipments but also by the exam protocols used by the Radiology professionals on the analyzed institutions
Severe Postpartum Coagulopathy Without Haemorrhage: A Case Report
Postpartum haemorrhage is an important health issue worldwide, and it can be caused by uterine atony, retained placental tissue, trauma or coagulation disorders. Although coagulopathy represents a rare cause, it is a significant contributor to postpartum haemorrhage with poor outcomes. Associated with high morbidity and mortality rates, postpartum haemorrhage demands prevention, prompt diagnosis and effective management. We describe a unique case of severe coagulopathy caused by underestimated blood loss during caesarean section without postpartum bleeding, in which transfusion requirements were thromboelastometry-guided. This case report depicts how an early multidisciplinary approach and patient-centred care in an obstetric emergency contributes to a positive outcome from a challenging situation, enabling the prevention of an imminent, catastrophic haemorrhage